Chapter 69 Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13Th Edition

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Chapter 69  Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13Th Edition

 

 

Complete Chapter Questions And Answers
 

Sample Questions

 

1. A patient with possible bacterial meningitis is admitted to the ICU. What assessment finding would the nurse expect for a patient with this diagnosis?

  1. A)  Pain upon ankle dorsiflexion of the foot
  2. B)  Neck flexion produces flexion of knees and hips
  3. C)  Inability to stand with eyes closed and arms extended without swaying
  4. D)  Numbness and tingling in the lower extremities

Ans: B

Feedback:

Clinical manifestations of bacterial meningitis include a positive Brudzinski’s sign. Neck flexion producing flexion of knees and hips correlates with a positive Brudzinski’s sign. Positive Homan’s sign (pain upon dorsiflexion of the foot) and negative Romberg’s sign (inability to stand with eyes closed and arms extended) are not expected assessment findings for the patient with bacterial meningitis. Peripheral neuropathy manifests as numbness and tingling in the lower extremities. Again, this would not be an initial assessment to rule out bacterial meningitis.

2. The nurse is planning discharge education for a patient with trigeminal neuralgia. The nurse knows to include information about factors that precipitate an attack. What would the nurse be correct in teaching the patient to avoid?

  1. A)  Washing his face
  2. B)  Exposing his skin to sunlight
  3. C)  Using artificial tears
  4. D)  Drinking large amounts of fluids

Ans: A

Feedback:

Washing the face should be avoided if possible because this activity can trigger an attack of pain in a patient with trigeminal neuralgia. Using artificial tears would be an appropriate behavior. Exposing the skin to sunlight would not be harmful to this patient. Temperature extremes in beverages should be avoided.

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3. The nurse is caring for a patient with multiple sclerosis (MS). The patient tells the nurse the hardest thing to deal with is the fatigue. When teaching the patient how to reduce fatigue, what action should the nurse suggest?

  1. A)  Taking a hot bath at least once daily
  2. B)  Resting in an air-conditioned room whenever possible
  3. C)  Increasing the dose of muscle relaxants
  4. D)  Avoiding naps during the day

Ans: B

Feedback:

Fatigue is a common symptom of patients with MS. Lowering the body temperature by resting in an air-conditioned room may relieve fatigue; however, extreme cold should be avoided. A hot bath or shower can increase body temperature, producing fatigue. Muscle relaxants, prescribed to reduce spasticity, can cause drowsiness and fatigue. Planning for frequent rest periods and naps can relieve fatigue. Other measures to reduce fatigue in the patient with MS include treating depression, using occupational therapy to learn energy conservation techniques, and reducing spasticity.

4. A patient with Guillain-Barré syndrome has experienced a sharp decline in vital capacity. What is the nurse’s most appropriate action?

  1. A)  Administer bronchodilators as ordered.
  2. B)  Remind the patient of the importance of deep breathing and coughing exercises.
  3. C)  Prepare to assist with intubation.
  4. D)  Administer supplementary oxygen by nasal cannula.

Ans: C

Feedback:

For the patient with Guillain-Barré syndrome, mechanical ventilation is required if the vital capacity falls, making spontaneous breathing impossible and tissue oxygenation inadequate. Each of the other listed actions is likely insufficient to meet the patient’s oxygenation needs.

5. A patient diagnosed with Bell’s palsy is being cared for on an outpatient basis. During health education, the nurse should promote which of the following actions?

  1. A)  Applying a protective eye shield at night
  2. B)  Chewing on the affected side to prevent unilateral neglect
  3. C)  Avoiding the use of analgesics whenever possible
  4. D)  Avoiding brushing the teeth

Ans: A

Feedback:

Corneal irritation and ulceration may occur if the eye is unprotected. While paralysis lasts, the involved eye must be protected. The patient should be encouraged to eat on the unaffected side, due to swallowing difficulties. Analgesics are used to control the facial pain. The patient should continue to provide self-care including oral hygiene.

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