Chapter 9 Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13Th Edition

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Chapter 9  Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13Th Edition

 

 

Complete Chapter Questions And Answers
 

Sample Questions

 

1. An elderly patient has presented to the clinic with a new diagnosis of osteoarthritis. The patient’s daughter is accompanying him and you have explained why the incidence of chronic diseases tends to increase with age. What rationale for this phenomenon should you describe?

  1. A)  With age, biologic changes reduce the efficiency of body systems.
  2. B)  Older adults often have less support and care from their family, resulting in illness.
  3. C)  There is an increased morbidity of peers in this age group, and this leads to the older

    adult’s desire to also assume the “sick role.”

  4. D)  Chronic illnesses are diagnosed more often in older adults because they have more

    contact with the health care system.

Ans: A

Feedback:

Causes of the increasing number of people with chronic conditions include the following: longer lifespans because of advances in technology and pharmacology, improved nutrition, safer working conditions, and greater access (for some people) to health care. Also, biologic conditions change in the aged population. These changes reduce the efficiency of the body’s systems. Older adults usually have more support and care from their family members. Assuming the “sick role” can be a desire in any age group, not just the elderly.

2. A patient tells the nurse that her doctor just told her that her new diagnosis of rheumatoid arthritis is considered to be a “chronic condition.” She asks the nurse what “chronic condition” means. What would be the nurse’s best response?

  1. A)  “Chronic conditions are defined as health problems that require management of several months or longer.”
  2. B)  “Chronic conditions are diseases that come and go in a relatively predictable cycle.”
  3. C)  “Chronic conditions are medical conditions that culminate in disabilities that require

    hospitalization.”

  4. D)  “Chronic conditions are those that require short-term management in extended-care

    facilities.”

Ans: A

Feedback:

Chronic conditions are often defined as medical conditions or health problems with associated symptoms or disabilities that require long-term management (3 months or longer). Chronic diseases are usually managed in the home environment. They are not always cyclical or predictable.

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3. A medical-surgical nurse is teaching a patient about the health implications of her recently diagnosed type 2 diabetes. The nurse should teach the patient to be proactive with her glycemic control in order to reduce her risk of what health problem?

  1. A)  Arthritis
  2. B)  Renal failure
  3. C)  Pancreatic cancer
  4. D)  Asthma

Ans: B

Feedback:

One chronic disease can lead to the development of other chronic conditions. Diabetes, for example, can eventually lead to neurologic and vascular changes that may result in visual, cardiac, and kidney disease and erectile dysfunction. Diabetes is not often linked to cancer, arthritis, or asthma.

4. A patient who undergoes hemodialysis three times weekly is on a fluid restriction of 1000 mL/day. The nurse sees the patient drinking a 355-mL (12 ounce) soft drink after the patient has already reached the maximum intake of fluid for the day. What action should the nurse take?

  1. A)  Take the soft drink away from the patient and inform the dialysis nurse to remove extra fluid from the patient during the next dialysis treatment
  2. B)  Document the patient’s behavior as noncompliant and notify the physician
  3. C)  Further restrict the patient’s fluid for the following day and communicate this information

    to the charge nurse

  4. D)  Reinforce the importance of the fluid restriction and document the teaching and the

    intake of extra fluid

Ans: D

Feedback:

Management of chronic conditions includes learning to live with symptoms or disabilities and coming to terms with identity changes resulting from having a chronic condition. It also consists of carrying out the lifestyle changes and regimens designed to control symptoms and to prevent complications. Although it may be difficult for nurses and other health care providers to stand by while patients make unwise decisions about their health, they must accept the fact that the patient has the right to make his or her own choices and decisions about lifestyle and health care.

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5. A patient with end-stage lung cancer has been admitted to hospice care. The hospice team is meeting with the patient and her family to establish goals for care. What is likely to be a first priority in goal setting for the patient?

  1. A)  Maintenance of activities of daily living
  2. B)  Pain control
  3. C)  Social interaction
  4. D)  Promotion of spirituality

Ans: B

Feedback:

Once the phase of illness has been identified for a specific patient, along with the specific medical problems and related social and psychological problems, the nurse helps prioritize problems and establish the goals of care. Identification of goals must be a collaborative effort, with the patient, family, and nurse working together, and the goals must be consistent with the abilities, desires, motivations, and resources of those involved. Pain control is essential for patients who have a terminal illness. If pain control is not achieved, all activities of daily living are unattainable. This is thus a priority in planning care over the other listed goals.

6. An international nurse has noted that a trend in developing countries is a decrease in mortality from some acute conditions. This has corresponded with an increase in the incidence and prevalence of chronic diseases. What has contributed to this decrease in mortality from some acute conditions?

  1. A)  Improved nutrition
  2. B)  Integration of alternative health practices
  3. C)  Stronger international security measures
  4. D)  Decrease in obesity

Ans: A

Feedback:

In developing countries, chronic conditions have become the major cause of health- related problems due to improved nutrition, immunizations, and prompt and aggressive management of acute conditions. The integration of alternative health practices has not contributed to a decrease in mortality. Stronger international security measures have not contributed to a decrease in mortality. Obesity has not decreased, even in developing countries.

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