Chapter 66 Medical Surgical Nursing Preparation For Practice 2nd Edition

Chapter 66  Medical Surgical Nursing Preparation For Practice 2nd Edition

Complete Chapter Questions And Answers
 

Sample Questions

Question 1
Type: MCSA
The prehospital nurse is screening several people injured in a store robbery. Of those injured, the nurse should encourage which one to seek additional care at the nearest emergency department?
1. Male in his mid-20s who had several light boxes of products fall on him while the robbers ran through the store
2. Teenage female who took cover under a shelving unit and sustained a scratch on her arm
3. Middle-age female who crouched down in a corner of the room and strained her knee
4. Elderly male who was briefly unconscious
Correct Answer: 4
Rationale 1: Because this patient is young and the boxes were light, emergency care will probably not be needed.
Rationale 2: This teenager sustained only a minor injury that could be treated at the scene. She should be referred to her primary care physician for follow-up if necessary.
Rationale 3: A knee strain can likely be managed at home or through follow-up with her personal primary care physician.
Rationale 4: An older patient who was briefly unconscious may have suffered a cardiac or neurologic event, or may have simply fainted. The patient should be evaluated for the reason for the unconsciousness.
Global Rationale:

Cognitive Level: Analyzing
Client Need: Physiological Integrity
Client Need Sub: Physiological Adaptation
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 66-2

Question 2
Type: MCSA
The nurse provides care in a hospital in an inner-city with a large immigrant population. How can the nurse provide the most culturally competent care?
1. Approach the care of every patient in the same manner.
2. Plan to attend educational programs to understand ethnic differences in health values.
3. Discuss with the supervisor the types of patients for whom the nurse feels prepared to provide care.
4. Realize that the best care is standardized care.
Correct Answer: 2
Rationale 1: The nurse should not approach the care of every patient in the same manner but should consider cultural differences.
Rationale 2: There are challenges with providing care to a diverse population. To provide the best culturally sensitive care, the nurse should attend education programs to understand ethnic differences in health values.
Rationale 3: The nurse should provide quality care for all patients, not discuss preferred types of patients with the supervisor.
Rationale 4: The best care is not standardized but rather is individualized.
Global Rationale:

Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 66-1

Question 3
Type: MCSA
A paramedic was asked by family members to take a patient complaining of chest pain to the local hospital. However, the patient is being taken to a hospital that is farther away and harder for the family to reach. The decision to take the patient to a different hospital is the result of which factor?
1. The patient does not have sufficient insurance.
2. The paramedic did not understand the request.
3. The emergency department at the local hospital would not accept the patient.
4. The patient was taken to the care center that provides the optimal care for the problem.
Correct Answer: 4
Rationale 1: The paramedic may or may not be aware of the type of insurance the patient has.
Rationale 2: There is no evidence that the family did not make their wishes known.
Rationale 3: Because of the Emergency Medical Transport and Active Labor Act, the local hospital would not refuse to see the patient.
Rationale 4: One of the Institute of Medicine recommendations for emergency care in the United States is to transport patients to the care center that can provide the optimal care for the patient.
Global Rationale:

Cognitive Level: Analyzing
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 66-3

Question 4
Type: MCSA
The nurse assessing a patient who walked into the emergency department decides the patient is in no acute distress. Which patient condition would support the nurse’s decision?
1. Limping and walking with the assistance of a possible family member or friend
2. Gasping for breath and holding a bloody tissue to the nose
3. Ambulating, breathing without difficulty, possible right arm/shoulder pain because holding arm bent and close to body
4. Calling for help while limping with the use of a cane
Correct Answer: 3
Rationale 1: This patient has an obvious sign of illness or injury.
Rationale 2: This patient has an obvious sign of illness or injury that could progress to a more serious condition such as airway occlusion.
Rationale 3: Of the individuals described, the patient who is able to ambulate, breathe without difficulty, but might have right arm/shoulder discomfort would be the one with the least amount of distress.
Rationale 4: Limping and calling for help indicate the need for immediate assessment.
Global Rationale:

Cognitive Level: Analyzing
Client Need: Physiological Integrity
Client Need Sub: Physiological Adaptation
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 66-3