Chapter 58 Medical Surgical Nursing Preparation For Practice 2nd Edition

Chapter 58  Medical Surgical Nursing Preparation For Practice 2nd Edition

Complete Chapter Questions And Answers
 

Sample Questions

Question 1
Type: MCSA
The nurse is conducting an integumentary assessment on an older adult. Which patient statement would the nurse prioritize as it does not reflect a normal age-related change?
1. “My skin is so thin and gets injured so easily.”
2. “My skin is so greasy even though I wash frequently.”
3. “My nails are growing more slowly.”
4. “I’ve had mostly gray hair since I was in my thirties.”
Correct Answer: 2
Rationale 1: Both the epidermis and the dermis thin with aging, making skin more susceptible to breakdown.
Rationale 2: Sebaceous gland activity decreases in older adults, resulting in drier and scalier skin. Greasy skin is not part of normal aging.
Rationale 3: Both hair and nail growth slows with aging.
Rationale 4: Hair graying is related to genetics. Some patients gray very early, and others do not gray until late in life.
Global Rationale:

Cognitive Level: Analyzing
Client Need: Physiological Integrity
Client Need Sub: Physiological Adaptation
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 58-1

Question 2
Type: MCSA
During a conversation with the nurse, a patient says, “I avoid going outside when the sun is shining because I don’t want to get skin cancer.” The nurse should inform the patient that sun avoidance may predispose the patient to which condition?
1. Vitamin D deficiency
2. Hypokalemia
3. Hypernatremia
4. Hypercholesterolemia
Correct Answer: 1
Rationale 1: The skin functions as a synthesizer of vitamin D (sunlight reacts with cholesterol).
Rationale 2: Exposure to sunlight is not a primary cause of hypokalemia.
Rationale 3: Exposure to sun would not cause an increase in sodium.
Rationale 4: Hypercholesterolemia results from factors such as dietary intake and cholesterol that is produced by the body, not from exposure to the sun.
Global Rationale:

Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Physiological Adaptation
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 58-1

Question 3
Type: MCSA
While recording the health history, the nurse learns that a patient has worked at a landfill for the last 35 years. Why is this information important?
1. It reflects the patient’s level of education.
2. The patient has had possible exposure to environmental toxins.
3. Patients who work out of doors are more likely to develop skin cancer.
4. The patient probably also uses tobacco.
Correct Answer: 2
Rationale 1: Working in a landfill is not pertinent to the patient’s education level.
Rationale 2: Occupation can reveal the potential for exposure to toxins such as arsenic, coal tar, creosote, and petroleum products. Even if the patient does not work directly with these chemicals, they may be present in the atmosphere and environment.
Rationale 3: Working in a landfill does not necessarily mean working in the sun. The patient could work in an office or in an area not in sunlight.
Rationale 4: It would be stereotyping for the nurse to assume that a patient who works in a landfill uses tobacco. The nurse should ask about personal habits, not make assumptions.
Global Rationale:

Cognitive Level: Analyzing
Client Need: Health Promotion and Maintenance
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 58-2

Question 4
Type: MCSA
Which information would the nurse identify as a patient’s chief complaint about a skin disorder?
1. “My rash first started a week ago.”
2. “I have a rash on my arm.”
3. “I put some ointment on this rash, but it did not help.”
4. “My son had a similar rash last month.”
Correct Answer: 2
Rationale 1: This statement provides information about the onset of the rash.
Rationale 2: The chief complaint is the patient’s current issue or reason for seeking health care. In this situation the patient has presented with a rash.
Rationale 3: This statement indicates the patient’s attempt at self-care.
Rationale 4: This statement gives information about the possible etiology of the rash.
Global Rationale:

Cognitive Level: Analyzing
Client Need: Physiological Integrity
Client Need Sub: Physiological Adaptation
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 58-3