Medical Surgical Nursing Critical Thinking in Client Care Single Volume 4th Edition By Priscilla T LeMone – Test Bank

Complete Test Bank With Answers

 

 

 

Sample Questions Posted Below

 

 

 

 

 

1. MC The nurse has accepted a change in employment and is found crying in the staff lounge. This nurse is demonstrating:
2. Stress.
3. Relief.
4. Ambivalence.

D.*   Grief.

 

 

 

2. MC The widow of a client is seen wearing dark clothing, dark glasses, and carrying her late husband’s coffee container. The nurse realizes that this client is demonstrating:
3. Exaggerated grief response.

B.*   A healthy response to a loss.

1. Joy.
2. Morbid fixation.

 

 

 

3. MC A client who had a below-the-knee amputation two months ago is seen walking with a new limb prosthesis and returning to work. The nurse realizes that this client:

A.*   Has completed the work of mourning the loss of his leg.

1. Is forgetting about the disease that caused the loss of his limb.
2. Is in denial.
3. Is having difficulty with grief.

 

 

 

4. MC A client who has just lost her spouse asks the nurse how long it will be until she feels like living again. The nurse realizes this client has to work through which of the phases of the grieving process according to Bowlby? (Select all that apply.)
5. Denial

B.*   Despair

C.*   Protest

D.*   Detachment

 

 

 

5. MC The spouse of a former client tells the nurse that he has joined a support group to help with the loss of his wife. The nurse realizes this client is in which phase of Engel’s grief process?
6. Resolution
7. Acute
8. Long-term

D.*   Restitution

 

 

 

6. MC A client tells the nurse, “I dread going on after the divorce is final. I have no idea how I am going to manage financially or emotionally.” The nurse realizes this client is demonstrating which aspect of Caplan’s stress and loss theory?

A.*   Living without the assets and guidance

1. Psychic pain
2. Emotional turmoil
3. Reduced problem-solving ability

 

 

 

7. MC The brother of a terminally ill client states, “I’ll donate money to the hospital that cures my brother.” The nurse realizes this statement is indicative of which phase of Kubler-Ross’s loss stages?

A.*   Bargaining

1. Denial
2. Anger
3. Acceptance

 

 

 

8. MC A client who is a recent widow states, “I wanted to ask him for a divorce and then he died.” The nurse realizes this client is at risk for:
9. Accelerated grief reaction.
10. A typical grief reaction process.

C.*   A dysfunctional grief reaction.

1. Psychosomatic disorders.

 

 

 

9. MC A client tells the nurse, “My husband left me to be with God.” The nurse realizes this client is demonstrating:

A.*   A regional difference in which death is expressed.

1. Coping.
2. A cultural rite related to death.
3. Denial.

 

 

 

10. MC The nurse is assessing a dying client’s spiritual beliefs about death. Which of the following acronyms may be utilized as a method help the nurse with this assessment process?
11. RACE
12. DABDA
13. ABC

D.*   FICA

 

 

 

11. MC The nurse is having difficulty with the spouse of a dying client. Later, it is determined the reason for the difficulty is because the nurse’s spouse died suddenly two year prior. Which of the following would best help this client, the spouse, and the nurse?
12. Discharge the client to be cared for at home by the spouse.
13. Suggest that the nurse access websites to help with the inability to be supportive of the client’s and spouse’s needs at this time.
14. Nothing. This is normal.

D.*   Change the nurse’s assignment.

 

 

 

12. MC The client states, “My husband is the person you should talk with if I am not able to make decisions about my care.” The nurse realizes the spouse has been identified as:
13. Nothing more than the spouse.

B.*   The healthcare surrogate.

1. The person with the durable power of attorney.
2. The person who has the client’s living will.

 

 

 

13. MC The youngest child of a client who passed away continues to receive communication and telephone calls from the hospice organization during the six months after the death. The nurse realizes this child is receiving:
14. Actions requested by the mother before death.

B.*   Bereavement care.

1. Constant reminders of his loss that should stop.
2. Unnecessary phone calls.

 

 

 

14. MC The family of a dying client wants to help with progressive dyspnea. Which of the following can the nurse instruct the family to provide for the client?
15. Lower the head of the bed.

B.*   Raise the head of the bed.

1. Perform chest physiotherapy.
2. Suction the client as much as possible.

 

 

 

15. MC The family of a dying client states, “She has to be in pain because all she does is moan.” The nurse realizes the family is:
16. Overreacting.
17. Considering this to be a sign the client is recovering.
18. Asking for more pain medication for the client.

D.*   Not understanding that moaning can be agitation in the client.

 

 

 

16. MC A dying client tells the nurse, “Don’t let my family leave me.” The nurse realizes this client is demonstrating:
17. The desire to prolong life.
18. The anticipation of improving in health.
19. The need for the family to see them improve.

D.*   Fear of dying alone.

 

 

 

17. MC The nurse who provided care to a terminally ill client does not want to spend any time with the grieving family and begins to provide care to another client. This nurse is demonstrating:
18. Over-emotionality.

B.*   Blunting.

1. Empathy.
2. Apathy.

 

 

 

18. MC A client who has recently loss his spouse states, “I just can’t cry.” The nurse realizes this client is at risk for developing:

A.*   Somatic symptoms.

1. Over-emotionality.
2. Depression.
3. Psychological issues.

 

 

 

19. MC A preoperative client says to the nurse, “I hope I wake up after surgery. I don’t know what my family would do if I didn’t.” The nurse realizes this client is demonstrating which nursing diagnosis?
20. Death anxiety
21. Chronic sorrow

C.*   Anticipatory grieving

1. Coping

 

 

1. MC The nurse measures a client’s blood pressure as 144/88 mm Hg. Which of the following interventions would be most appropriate for this client?
2. Provide stress-reduction techniques.
3. Offer the client a glass of water.

C.*   Re-measure the blood pressure in a few minutes.

1. Inform the physician so anti-hypertensive medication can be prescribed.

 

 

 

2. MC A client with diabetes is beginning treatment for hypertension. The nurse shares with the client that the blood pressure reading goal is:
3. 135/85 mm Hg.
4. 140/90 mm Hg.
5. 120/80 mm Hg.

D.*   130/80 mm Hg.

 

 

 

3. MC The nurse is instructing a client with hypertension about lifestyle modifications. Which of the following would be appropriate to include in the teaching for this client? (Select all that apply.)

A.*   Review the DASH diet.

1. Eliminate dairy products from the diet.
2. Restrict fluid intake.
3. Plan a weight lifting regimen.

E.*   Begin a walking program, and progress to 30 minutes 5 to 6 days each week.

 

 

 

4. MC A client is being started on enalapril (Vasotec). The most common complaint from clients who routinely take this medication is:
5. Sore throat.
6. Reduced urine output.

C.*   Persistent cough.

1. Increased thirst.

 

 

 

5. MC A client’s blood pressure continues to be elevated despite being prescribed an ACE inhibitor for several weeks. Which of the following would be most appropriate for the nurse to do at this time?
6. Realize the client is anxious because of the diagnosis.

B.*   Ask if the client is taking the prescribed medication.

1. Schedule the client to have the blood pressure checked again in a week.
2. Suggest to the physician that another medication be added.

 

 

 

6. MC A client is undergoing diagnostic testing to determine the cause of hypertension. Which of the following would be included if a secondary cause for this disorder is suspected?

A.*   Intravenous pyelogram

1. Abdominal CT scan
2. MRI of the carotid arteries
3. Serum electrolytes

 

 

 

7. MC During the abdominal assessment of an elderly client, the nurse palpates a mass in the mid-abdomen. Which of the following should the nurse do next?
8. Get the physician.

B.*   Auscultate the mass.

1. Percuss the mass.
2. Ask the client to cough.

 

 

 

8. MC The nurse suspects a client who is recovering from an abdominal aortic aneurysm repair is experiencing graft leaking. Which of the following are indications of this event? (Select all that apply.)
9. Respiratory rate 16 and regular

B.*   Complaint of back discomfort

1. Urine output 45 cc/hr

D.*   Complaint of groin pain

1. Abdominal dressing dry and intact

 

 

 

9. MC The nurse suspects that a client is experiencing the effects of peripheral atherosclerosis. Which of the following did the nurse most likely assess in this client?
10. Rubor with extremity elevation

B.*   Complaints of leg pain upon rest

1. Normal hair distribution bilaterally over lower extremities
2. Peripheral pulses present bilaterally

 

 

 

10. MC A client is having segmental pressure measurements conducted to help diagnose peripheral vascular disease. Which of the following would indicate the presence of this disorder?
11. Calf pressure higher than the arm
12. No difference between the arm or leg
13. Thigh pressure higher than the arm

D.*   Calf pressure lower than the arm

 

 

 

11. MC A client is demonstrating signs of ineffective peripheral tissue perfusion. Which of the following interventions would be appropriate for this client?
12. Assist with pillow placement under knees.

B.*   Discuss smoking cessation techniques.

1. Encourage client to reduce level of exercise.
2. Keep extremities cool.

 

 

 

12. MC A male client is diagnosed with thromboangiitis obliterans. Appropriate teaching for this client includes:
13. Medications are the only cure.
14. Nothing can help manage this disorder.

C.*   Management depends upon the client’s willingness to stop smoking.

1. Surgical procedures can be performed to cure this disorder.

 

 

 

13. MC A client is being discharged on long-term oral anticoagulant therapy for arterial thrombus formation in the lower extremity. Which of the following should be included in this client’s discharge instructions?
14. Take two doses of the prescribed anticoagulant if a dose is missed one day.

B.*   Contact the physician’s office for follow-up laboratory studies.

1. Slight bleeding from the nose is expected.
2. Pain in the limb is a sign of healing.

 

 

 

14. MC A client is demonstrating signs of thrombophlebitis. With this disorder, the nurse realizes that three mechanisms occur, which include: (Select all that apply.)
15. Elevated systemic blood pressure.

B.*   Blood hypercoagulation.

C.*   Sluggish blood flow.

D.*   Vessel damage.

1. Pooling of blood in the vessel.

 

 

 

15. MC A client is seen for increasing edema in his left lower extremity and pain in the limb with ambulation. Which of the following disorders do these symptoms suggest?
16. Arterial occlusion
17. Varicose veins
18. Superficial vein thrombosis (SVT)

D.*   Deep vein thrombosis

 

 

 

16. MC A client with a deep vein thrombosis (DVT) is going to be weaned from intravenous heparin. The nurse anticipates that oral warfarin sodium should be prescribed:
17. The same day as the heparin is started.

B.*   Four to 5 days before the heparin is discontinued.

1. The day before the heparin is discontinued.
2. The same day the heparin is discontinued.

 

 

 

17. MC The nurse is planning care for a client who was diagnosed with deep vein thrombosis (DVT). Which of the following should be included in this plan of care?
18. Activity as tolerated.
19. Assist client with putting on tight-fitting pants.

C.*   Measure and apply graduated compression stockings.

1. Encourage the client to sit out of bed several hours every day.

 

 

 

18. MC A client who is being treated for a deep vein thrombosis (DVT) complains of chest pain and shortness of breath. Which of the following should the nurse do first?
19. Assess the extremity with the thrombosis.
20. Assess the pulses on the extremity with the thrombosis.
21. Measure the client’s blood pressure.

D.*   Elevate the head of the bed and begin oxygen therapy.

 

 

 

19. MC A 75-year-old female is diagnosed with chronic venous insufficiency. Which of the following instructions are appropriate for this client?
20. Keep legs in a dependent position as much as possible.
21. Limit ambulation.
22. Dangle legs over the side of the bed several times per day.

D.*   Avoid the use of knee-high hose or girdles.

 

 

 

20. MC An elderly male client is prescribed elastic graduated compression stockings. The nurse should instruct this client to:
21. Wear the stockings primarily while sleeping.

B.*   Remove the stockings once per day and while sleeping.

1. Wear the stockings continuously, except when showering.
2. Expect areas of skin breakdown under the stockings.