Chapter 67 Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13Th Edition


Pay And Download The Complete Chapter Questions And Answers

Chapter 67  Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13Th Edition



Complete Chapter Questions And Answers

Sample Questions


1. A patient has had an ischemic stroke and has been admitted to the medical unit. What action should the nurse perform to best prevent joint deformities?

  1. A)  Place the patient in the prone position for 30 minutes/day.
  2. B)  Assist the patient in acutely flexing the thigh to promote movement.
  3. C)  Place a pillow in the axilla when there is limited external rotation.
  4. D)  Place patient’s hand in pronation.

Ans: C


A pillow in the axilla prevents adduction of the affected shoulder and keeps the arm away from the chest. The prone position with a pillow under the pelvis, not flat, promotes hyperextension of the hip joints, essential for normal gait. To promote venous return and prevent edema, the upper thigh should not be flexed acutely. The hand is placed in slight supination, not pronation, which is its most functional position.

2. A patient diagnosed with transient ischemic attacks (TIAs) is scheduled for a carotid endarterectomy. The nurse explains that this procedure will be done for what purpose?

  1. A)  To decrease cerebral edema
  2. B)  To prevent seizure activity that is common following a TIA
  3. C)  To remove atherosclerotic plaques blocking cerebral flow
  4. D)  To determine the cause of the TIA

Ans: C


The main surgical procedure for select patients with TIAs is carotid endarterectomy, the removal of an atherosclerotic plaque or thrombus from the carotid artery to prevent stroke in
patients with occlusive disease of the extracranial arteries. An endarterectomy does not decrease cerebral edema, prevent seizure activity, or determine the cause of a TIA.

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3. The nurse is discharging home a patient who suffered a stroke. He has a flaccid right arm and leg and is experiencing problems with urinary incontinence. The nurse makes a referral to a home health nurse because of an awareness of what common patient response to a change in body image?

  1. A)  Denial
  2. B)  Fear
  3. C)  Depression
  4. D)  Disassociation

Ans: C


Depression is a common and serious problem in the patient who has had a stroke. It can result from a profound disruption in his or her life and changes in total function, leaving the patient with a loss of independence. The nurse needs to encourage the patient to verbalize feelings to assess the effect of the stroke on self-esteem. Denial, fear, and disassociation are not the most common patient response to a change in body image, although each can occur in some patients.

4. When caring for a patient who had a hemorrhagic stroke, close monitoring of vital signs and neurologic changes is imperative. What is the earliest sign of deterioration in a patient with a hemorrhagic stroke of which the nurse should be aware?

  1. A)  Generalized pain
  2. B)  Alteration in level of consciousness (LOC)
  3. C)  Tonic–clonic seizures
  4. D)  Shortness of breath

Ans: B


Alteration in LOC is the earliest sign of deterioration in a patient after a hemorrhagic stroke, such as mild drowsiness, slight slurring of speech, and sluggish papillary reaction. Sudden headache may occur, but generalized pain is less common. Seizures and shortness of breath are not identified as early signs of hemorrhagic stroke.

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5. The nurse is performing stroke risk screenings at a hospital open house. The nurse has identified four patients who might be at risk for a stroke. Which patient is likely at the highest risk for a hemorrhagic stroke?

  1. A)  White female, age 60, with history of excessive alcohol intake
  2. B)  White male, age 60, with history of uncontrolled hypertension
  3. C)  Black male, age 60, with history of diabetes
  4. D)  Black male, age 50, with history of smoking

Ans: B


Uncontrolled hypertension is the primary cause of a hemorrhagic stroke. Control of hypertension, especially in individuals over 55 years of age, clearly reduces the risk for hemorrhagic stroke. Additional risk factors are increased age, male gender, and excessive alcohol intake. Another high-risk group includes African Americans, where the incidence of first stroke is almost twice that as in Caucasians.

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