Chapter 9 Medical Surgical Nursing Preparation For Practice 2nd Edition

Chapter 9  Medical Surgical Nursing Preparation For Practice 2nd Edition

Complete Chapter Questions And Answers
 

Sample Questions

Question 1
Type: MCSA
A patient is admitted after being bitten by a dog and tells the nurse he feels fine except for the bite. The nurse assesses that this patient is functioning within which phase of the general adaptation syndrome?
1. Transaction
2. Resistance
3. Alarm
4. Exhaustion
Correct Answer: 2
Rationale 1: There is no transaction stage within the general adaptation syndrome.
Rationale 2: In this stage, the body attempts to cope with the stressor by minimizing the stressor’s impact as much as possible. The patient’s statement is an attempt to return to normal as soon as possible.
Rationale 3: The alarm stage is the first stage of the general adaptation syndrome, when the fight-or-flight response is initiated.
Rationale 4: The exhaustion stage is the final stage, in which the adaptation the body made during the second stage cannot be maintained. This stage occurs only if the stress becomes overwhelming or is not removed.
Global Rationale:

Cognitive Level: Analyzing
Client Need: Psychosocial Integrity
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 9-1

Question 2
Type: MCSA
While being assessed, a patient tells the nurse that she has many stresses in her life. Which statement would the nurse evaluate as indicating external stress?
1. “I am a workaholic.”
2. “My job has many rigid rules.”
3. “I feel like I have to please everyone.”
4. ”I drink several cups of coffee in the morning and then switch to cola drinks in the afternoon.”
Correct Answer: 2
Rationale 1: Being a workaholic is a stress that comes from within the patient and is an internal stressor.
Rationale 2: External stressors originate outside the body and are precipitated by changes in the external environment. They can be triggered by the actual physical environment, the social environment, the organizational environment, major life events, and trauma. Having to work within a set of rigid rules would be an external stressor.
Rationale 3: The need to please everyone comes from within and is an internal stressor.
Rationale 4: Using caffeine to excess can be an internal stressor or a response to stress.
Global Rationale:

Cognitive Level: Analyzing
Client Need: Psychosocial Integrity
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 9-4

Question 3
Type: MCSA
The nurse is caring for a burn patient. Because of the amount of stress the patient is experiencing, the nurse realizes that the patient would benefit from which intervention?
1. An increase in activity
2. An increased supply of protein
3. Fluid restriction
4. Antinausea medication
Correct Answer: 2
Rationale 1: Increased activity is not a good stress-relieving option for this patient at this time.
Rationale 2: In the hypothalamus-pituitary-adrenal response to stress, the body stimulates the production of cortisol. Cortisol stimulates protein catabolism. The patient with burns undergoing surgery is experiencing a significant level of stress and would benefit from protein supplementation.
Rationale 3: Fluid restriction is not useful for the patient coping with severe stress. Patients who have been burned need fluid resuscitation, not restriction.
Rationale 4: The patient may need antinausea medication for another reason, but not as a treatment for stress.
Global Rationale:

Cognitive Level: Analyzing
Client Need: Physiological Integrity
Client Need Sub: Physiological Adaptation
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 9-3

Question 4
Type: MCSA
The nurse is reviewing the serum laboratory values of a patient just admitted with traumatic injuries. Which laboratory value might be abnormally elevated because of the trauma?
1. Potassium
2. Hemoglobin
3. Glucose
4. Sodium
Correct Answer: 3
Rationale 1: There is no evidence to support that traumatic injuries cause an immediate increase in potassium levels.
Rationale 2: The patient’s hemoglobin might be low, depending on the amount of blood loss from the injuries.
Rationale 3: Stimulation of both the adrenal medulla and cortex in response to stress results in an increased blood glucose level.
Rationale 4: There is no evidence to support that traumatic injuries cause an immediate increase in sodium levels.
Global Rationale:

Cognitive Level: Analyzing
Client Need: Physiological Integrity
Client Need Sub: Physiological Adaptation
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 9-3