Test Bank Medical Surgical Nursing 10th Edition Smeltzer
Chapter 1: Health Care Delivery and Nursing Practice
1. Health may be defined as:
A) Being disease free
B) Having fulfilling relationships
C) Having a clean drinking source and nutritious food
D) Being connected in body, mind, and spirit
2. Which of the following characteristics would an effective nurse have?
A) Sensitivity to cultural differences
B) Mainly team nursing approach
C) Strict adherence to routine
D) One set cultural practice
3. What is the most common type of health problem seen in the health care system?
A) Poor prenatal care
B) Lack of information available to patients
D) Increased rate of chronic disease
4. The need for self-fulfillment fits in which level of Maslow’s Hierarchy of basic needs?
B) Safety and security
C) Love and belonging
5. What has been the traditional focus of health care providers?
A) Treatment of disease
D) Treatment of childhood disease
6. Which of the following is the best type of disease prevention?
B) Yearly physicals
C) Community social events
D) Behavior that promotes health
7. Continuous quality programs exist for what purpose?
A) To establish accountability on the part of health care professionals
B) To focus on the process used to provide care
C) To identify incidents rather than processes
D) To justify health care costs
8. Managed health care has what effect on the hospital’s patient population?
A) Patients are in the hospital for a longer period of time.
B) Pre-negotiated payment rates have remained unchanged.
C) Patients with high home care needs are being discharged into the community.
D) Use of ambulatory care has decreased.
9. The Patient’s Bill of Rights includes the patient’s right to privacy. When might the nurse break this right?
A) When the patient has threatened to harm himself or herself
B) When the patient has been diagnosed with a terminal disease
C) If a family member has called to inquire about the patient’s condition
D) There are no circumstances when this rule may be broken.
10. In order for the nurse to implement the interventions in a clinical pathway, what first must be done?
A) Interventions must have a signed physician’s order.
B) The plan must be implemented postoperatively.
C) The unit must approve the document.
D) The nurse must sign the document prior to initiating.
Chapter 2: Community-Based Nursing Practice
1. Nurses who deliver community-based care must have which of the following qualities?
B) Ability to be self-directed
C) Tolerance of various lifestyles
D) All of the above
2. A nurse has scheduled a hypertension clinic. This service would be an example of which of the following types of health care?
A) Tertiary prevention
B) Secondary prevention
C) Primary prevention
3. Which of the following are the most frequent users of home care services?
A) Postpartum patients
B) Postoperative patients
C) Terminally ill patients
D) Elderly patients
4. Patients’ lifestyles in the home may vary greatly from the nurse’s own beliefs. To work successfully with the patient, the nurse must:
A) Ask for another assignment if there is a conflict of interest
B) Ask the patient to come to the agency to receive treatment
C) Convey respect for the patient’s beliefs
D) Adapt the patient’s home to a hospital-like environment
5. When providing care in a home, how might the nurse best implement infection control?
A) Cleanse the hands before and after giving direct patient care
B) Remove the patient’s wound dressings from the home
C) Dispose of patient’s syringes in the patient’s garbage
D) Disinfect all work areas in the patient’s home
6. The patient is ready to be discharged from the hospital. When should discharge planning begin?
A) The day prior to discharge
B) The day of estimated discharge
C) The day the patient is admitted
D) Once the nurse determines care needs
7. During the home care nurse’s initial visit to a patient’s home, it is important to provide the patient and family with which of the following information?
A) Other available community resources to meet their needs
B) Information of other patients in the area with similar health care needs
C) The nurse’s home address and phone number
D) All scheduled home care visits
8. The home health nurse has received a referral from the hospital for a patient who needs a home visit. After reading the referral, the nurse should:
A) Apply for prepayment
B) Evaluate the patient’s medical coverage
C) Call the patient to obtain permission to visit
D) Schedule the patient’s treatment
9. The nurse should inform the health care agency of daily schedules and phone numbers of the patients that are scheduled. The purpose of this is that it:
A) Allows the agency to keep track for payment of the nurse
B) Supports suggested safety precautions for the nurse when making a home care visit
C) Allows easy accessibility of the nurse for changes in assignments
D) Allows the patient to cancel appointments with minimal inconvenience
10. The nurse’s initial assessment during the home visit of the patient should include which of the following?
A) The supplies the nurse will need
B) Directions to the patient’s home
C) Quality of nursing care needed
D) Careful documentation of the patient’s homebound status and the need for skilled professional nursing care
Chapter 3: Critical Thinking, Ethical Decision Making, and the Nursing Process
1. A nurse is applying at a clinic that offers therapeutic abortions. This procedure contradicts the nurse’s personal beliefs. The nurse feels unable to care for these patients objectively. What is the nurse’s ethical obligation to these patients?
A) The nurse is required by law to continue service to these patients.
B) The nurse should make the choice to decline this position.
C) The nurse may discriminate between patients and refuse to care for the patient.
D) The nurse may express his or her opinion and provide another option to terminating the pregnancy.
2. The nurse is caring for a terminally ill patient. The physician has ordered a large dose of narcotic per IV infusion. The patient’s respiratory rate has decreased from 16 breaths/min to 10 breaths/min. What action should the nurse take?
A) Decrease the IV infusion
B) Stimulate the patient
C) Report the decreased respiratory rate to the physician
D) Allow the patient to rest comfortably
3. A terminally ill patient has requested a “do not resuscitate” (DNR) order. The family of the patient is strongly opposed to the patient’s request. What is the responsibility of the nurse?
A) Initiate further communication with the family and physician
B) Honor the request of the patient
C) Continue to provide required nursing care
D) All of the above
4. Which of the following would correctly define a living will?
A) A legal document that is always honored.
B) A legal document that specifies the patient’s wishes before hospitalization.
C) A legal document that is binding for the duration of the patient’s life.
D) A legal document drawn by the patient’s family to determine DNR status.
5. Which of the following would be considered a nursing implementation?
A) The patient will ambulate twice a day.
B) The patient appears diaphoretic.
C) The patient is at risk for aspiration.
D) Monitor for peripheral edema twice a day.
6. Which of the following would be considered a contradiction to the nurse’s duty of nonmaleficence?
A) Provide comfort measures for a terminally ill patient.
B) Assist the patient with ADLs.
C) Refuse to administer pain medication as ordered.
D) Provide all information related to procedures.
7. The physician has arranged an amniocentesis for an 18-year-old woman. The patient is 34 weeks’ gestation and does not want this procedure. The physician is insistent the patient has the procedure. This would be an example of which of the following?
8. Which of the following would be an example of the nurse practicing fidelity? The nurse:
A) Regulates visitors
B) Stays with the patient during his or her death as promised
C) Withholds information as requested
D) Provides continuity of care
9. The patient has been given the wrong medication and asks the nurse if there has been an error made in the medication. Which of the following principles would apply if the nurse gives an accurate response?
10. When using restraints in a long-term care setting, what ethical dilemma does this pose?
A) Limits personal safety
B) Increases confusion
C) Threatens autonomy
D) Prevents self-directed care
Chapter 4: Health Education and Promotion
1. Nurses play an important role in providing health education to patients. Who is ultimately responsible to maintain and promote health?
A) Classroom teachers
2. Which of the following would be a factor in a patient not adhering to his or her therapeutic regimen?
A) Ethnic background of health care provider
B) Costs of prescribed regimen
C) Wellness state
D) Personality of the physician
3. Non-adherence to a therapeutic regimen is a significant problem for elderly people. Which factor would best be implemented to assist the elderly in adhering to a therapeutic regimen?
A) Demonstrate a dressing change and allow the patient to practice.
B) Provide a pamphlet on a dressing change.
C) Verbally instruct the patient how to change a dressing.
D) Have a family member change the dressing.
4. A nurse is preparing to teach a patient how to administer an insulin injection. One of the major variables that influences a patient’s readiness to learn is:
5. Which of the following behaviors shows a patient’s willingness to learn?
A) The patient requests a visit from the diabetic educator.
B) The patient declines a slice of pie at lunch.
C) The patient has a family member meet with the dietician to discuss meals.
D) The patient allows the nurse to take daily blood sugar.
6. When the nurse plans to teach a 75-year-old patient about medication administration, the nurse can enhance the patient’s ability to learn by:
A) Providing reading material to support the medication administration
B) Excluding family members from the session
C) Using color-coded materials
D) Making the information relevant
7. Which of the following assessments should be made when educating the patient?
A) What are the patient’s expectations?
B) Is the learner ready to learn?
C) What psychosocial adaptations is the patient making?
D) All of the above
8. Teaching is an integral intervention implied by all nursing diagnoses. In which of the following nursing diagnoses would education of the patient be a priority?
A) Risk for impaired mobility related to joint pain
B) Incontinence related to surgical repair of bladder
C) Altered range of movement related to contractures
D) Risk for ineffective management of therapeutic regimen
9. Which of the following would be considered health promotion?
A) Blood pressure clinic
B) Family planning clinic
C) Immunization clinic
D) Work place health and safety seminar
10. A nurse has taught an asthmatic patient how to administer his daily inhaler. The nurse should evaluate the teaching-learning process by:
A) Using teaching aides
B) Identifying teaching strategies
C) Directly observing the patient taking his inhaler
D) Documenting the teaching session in the patient’s record
Chapter 5: Health Assessment
1. The nurse is performing an admission assessment on a 72-year-old female informant who speaks Spanish and broken English. How might the nurse best collect the data?
A) Have a family member provide the data.
B) Obtain the data from the old chart and physician’s assessment.
C) Obtain the data from the patient.
D) Collect the data from the patient and have the family provide any missing details.
2. The nurse is assessing an 18-year-old woman. The nurse notes bruising to the patient’s upper arm that appears as fingerprints and yellow bruising to the lower eye. The patient makes minimal eye contact during the assessment. How might the nurse best inquire about the bruising?
A) “Is anyone physically hurting you?”
B) “Tell me about your relationships.”
C) Wait until the patient provides rationale for the bruising.
D) “Is there something you want to tell me?”
3. During a physical health assessment, what is the most personal part of the history for most people?
A) Sexual history
B) Gastrointestinal history
C) Breast examination
D) Menstrual patterns
4. The nurse is taking a detailed assessment of a male. The patient states, “The doctor has already asked me all these questions. Why are you repeating them?” What is the nurse’s best response?
A) “Taking this history allows us to determine what your needs may be for nursing care.”
B) “You are right; this may seem redundant.”
C) “I want to make sure your doctor has covered everything.”
D) “I am a member of your health care team.”
5. During the health history, the patient informs the nurse that her mother has diabetes. What is the significance of this information to the health history?
A) The patient may be at risk for developing diabetes.
B) The patient may need teaching on preventing diabetes.
C) The information is irrelevant to the history.
D) This may affect the patient’s diet during hospitalization.
6. Spiritual environment can affect patients’ lives in which of the following areas:
A) Nutritional intake
B) Ability to communicate
C) Quality of sexual relationships
D) Responses to illness
7. During the spiritual assessment, the patient indicates that he or she does not eat meat. This would be considered a:
A) Personal choice
B) Religious practice
C) Risk for malnutrition
D) Lifestyle choice
8. While assessing the patient, the nurse performs a palpation of the abdomen. This would be:
A) Applying physical force into sound
B) Listening to sounds in the body
C) Touching parts of the body
D) Visualizing areas of the body
9. A female patient is 23 years old, weighs 175 lb, and is 5 ft 3 in. Her body mass index is 31. She would be considered:
A) Average weight
10. During the health assessment, the nurse notes that the patient has dry, dull, brittle hair and dry, flaky skin with poor turgor. What might this indicate?
A) Low socioeconomic standing
B) Cultural differences
C) Poor nutritional status
D) Damage from an environmental cause
Chapter 6: Homeostasis, Stress, and Adaptation
1. Chronic stress is a problem in today’s society. Which of the following stressors causes the greatest impact on health?
A) Day-to-day hassles
B) Technologic changes
2. A vital 75-year-old woman has been hospitalized with a myocardial infarction. Her condition is critical. She is extremely stressed from her hospitalization in the intensive care unit. This may be due primarily from:
B) Loss of privacy
D) Interruption in personal rituals
3. Which of the following is an immediate response to stress?
A) The digestive system slows down.
B) The lungs become more susceptible to colds and infections.
C) Sleep can be disrupted.
D) Frontal headache occurs.
4. Your patient has just had an argument with his spouse. You can expect that his sympathetic nervous system has stimulated his adrenal gland to release which of the following?
5. A person best deals with a stressful life event through which of the following?
A) Change in environment
B) Promoting a healthy lifestyle
C) Eliminating all stress
D) Experiencing anger
6. Your patient is having a mastectomy. What dietary supplement will the patient need?
A) Vitamin B12
7. Your patient is a 45-year-old man with a type A personality. He has been admitted with hypertension. You know potentially this patient is at an increase risk for:
A) Myocardial infarction
B) Crone’s disease
C) Lung disease
8. An expected outcome for a patient who has a nursing diagnosis of Ineffective coping mechanisms related to stress is:
A) Patient will adapt relaxation techniques to reduce stress.
B) Patient will be stress free.
C) Patient will avoid stressful situations.
D) Patient will start anti-anxiety agent.
9. When assessing the patient, the nurse learns that the patient has recently been married. The nurse is aware that:
A) This has no effect on the patient’s stress level.
B) The patient will have better coping skills.
C) Happy events do not cause stress.
D) Marriage causes transition, which in turn causes stress.
10. Stress is:
A) An external force
B) An internal state of arousal
C) The physical response of the body to various demands
D) All of the above
Chapter 7: Individual and Family Considerations Related to Illness
1. Which of the following would be considered a holistic approach to health?
A) Physical, emotional, and spiritual well-being
B) Emotional and sexual contact
C) Healthy work environment
D) Financial success and post-secondary education
2. The nurse is completing an initial health assessment of a patient. Which of the following behaviors would be indicative of an emotionally healthy attitude?
A) Setting goals
B) Having a sense of humor
C) Resolving conflict
D) All of the above
3. A patient is a business executive in a large corporation who has indicated drinking 7 to 8 oz of scotch every evening. Which of the following is the best indicator of the patient’s ability to cope?
A) Maladaptive stress management
B) Inability to satisfy basic needs
C) Behaving in a realistic manner
D) Engaging in rewarding behavior
4. A 25-year-old patient has been diagnosed with testicular cancer. Which developmental tasks may be affected?
A) Achieving self-actualization
B) Marrying and starting a family
C) Reviewing life’s accomplishments
D) Establishing financial security
5. A nurse is caring for a patient who has just been diagnosed with multiple sclerosis. After hearing this news, the nurse anticipates that the patient will most likely experience which emotional symptom?
C) Lack of interest
6. A patient has been involved in an automobile accident. The patient’s passenger has died. The patient arrives in the clinic with complaints of nightmares, inability to concentrate, and impaired memory. The patient is most likely experiencing which of the following?
A) Posttraumatic stress disorder
B) Developmental difficulties
C) Drug addiction
D) Mild stress
7. Which of the following patients would be at an increased risk of suicide?
A) A 35-year-old man with anxiety
B) A person with a family history of suicide
C) A person with an inability to form trusting relationships
D) A person with loss of interest in career
8. Which of the following would be considered a codependent behavior?
A) Calling in sick at work on behalf of a hung-over spouse
B) Bathing a child
C) A desire to end a marriage
D) Refusing to change a shift with a co-worker
9. A nurse is caring for a terminally ill patient who says to the nurse, “If only I could live until my granddaughter has her first birthday.” The nurse assesses this patient to be in the stage of grief termed:
10. Which of the following is a basic goal of the grieving process?
A) Healing the self
B) Acknowledging the void
C) Encouraging sadness and depression
D) Effectively role-modeling loss for offspring
Chapter 8: Perspectives in Transcultural Nursing
1. When communicating with a patient who speaks another language than the nurse, how might the nurse communicate with that patient?
A) Speak in a loud voice.
B) Conduct the conversation quickly to avoid misinterpretation.
C) Use short simple sentences.
D) Avoid repetition.
2. Hispanic people living in an area that is heavily populated by white people would be an example of a:
3. A nurse that has an awareness of transcultural techniques will:
A) Maintain eye contact at all times.
B) Always expect the patient to be prompt.
C) Use touch when communicating.
D) Encourage a patient to bring ethnic food from home if the hospital diet allows it.
4. While assessing a patient, the nurse may maintain direct eye contact. Which cultural group would consider the direct eye contact impolite?
D) Native Americans
5. A male nurse is required to do a neurologic examination on a patient. Which ethnic group would require an alternative approach for this exam?
B) Asian American
D) African American
6. The nurse notes on the dietary menu that pork chops are planned for the supper meal on the ward. Which of the following cultural groups would require an alternative meal choice?
7. The nurse has planned a discharge teaching session with an Asian patient to change his or her dressing. The patient speaks very little English. How might the nurse effectively evaluate this patient?
A) Ask the patient to repeat the instructions.
B) Write the procedure out for the patient.
C) Demonstrate the dressing change to the patient.
D) Have the patient demonstrate the dressing change.
8. A Native American is critically ill. The unit allows two visitors per patient. Which of the following would be considered culturally competent nursing care?
A) Allow the patient two visitors only.
B) Allow the patient’s immediate family only to visit.
C) Allow adults to visit but restrict children.
D) Allow flexibility of visitors at the patient’s discretion.
9. A nurse is caring for a patient who has recently immigrated to the United States from Mexico. When assessing the patient’s culture, the nurse would assess:
A) Support systems
B) Marital status
D) Communication style
10. The family of a terminally ill patient has requested to hold a spiritual ceremony during which they will be using incense. The nurse would:
A) Discourage the use of incense in the hospital.
B) Ask the family to have the ceremony off the unit.
C) Arrange for the ceremony to occur after notifying all departments affected.
D) Refuse the ceremony because it may affect other patients in the unit.
Chapter 9: Genetics Perspectives in Nursing
1. Which of the following would be an example of a person’s phenotype?
A) Gene for breast cancer
B) Brown eyes
C) B and D are correct.
2. Diagnostic testing for adult-onset conditions is most frequently used with autosomal dominant conditions, such as:
A) Sickle cell anemia
C) Huntington’s disease
D) Cystic fibrosis
3. The male sperm contains how many chromosomes?
4. The patient may be offered susceptibility screening for which of the following?
A) Ovarian cancer
C) Migraine headaches
D) Prostate cancer
5. Nursing practice in genetics-related health care should include which of the following?
A) Identify genetic markers.
B) Gather relevant family and medical history information.
C) Provide advice on termination of pregnancy.
D) Discourage females to conceive after the age of 40 years.
6. Each person is born with how many pairs of chromosomes?
7. Which of the following test is a type of genetic newborn screening?
A) Blood sugar
B) Umbilical cord blood gas
D) Phenylketonuria (PKU)
8. What is the chance a female carrier for a gene mutation on her X chromosome for hemophilia will pass the gene mutation on to her son who would be affected?
9. What are the statistical chances that two parents with two recessive genes each for six toes will have a child with six toes?
10. Which of the following is a true statement?
A) Genetic interaction is a very simple process.
B) Polygenic interaction is the only complexity in the relationship between genotype and phenotype.
C) Environmental influences modify every individual’s phenotype.
D) In the dominant-recessive pattern of gene interaction, both genes are reflected in the phenotype.
Chapter 10: Chronic Illness
1. Why does the incidence of chronic disease increase with age?
A) Biologic changes reduce the efficiency of body systems.
B) The aged spend less time in the hospital.
C) There is an increased mortality of friends in this age group.
D) Normal aging increases the circulation of the heart.
2. Chronic conditions affect the lives of many people in many ways. Which of the following consequences could be related to the unmet needs of the patient?
A) Skin breakdown
B) Missed medical appointments
C) Poor personal hygiene
D) All of the above
3. A patient has diabetes. To what other chronic disease can diabetes lead?
B) Renal failure
4. A patient is scheduled for dialysis and is on a fluid restriction of 1000 mL/d. The nurse sees the patient drinking a 55 mL soft drink. The patient has already reached the maximum intake of fluid for the day. The patient is aware of the risk for fluid overload. What would be the nurse’s response?
A) Take the soft drink away from the patient.
B) Acknowledge the patient’s behavior as noncompliant.
C) Restrict the patient’s fluid for the following day.
D) Teach the patient the importance of the fluid restriction, and document the teaching and the intake of extra fluid.
5. When planning home care for a patient with terminal cancer, what is likely to be a first priority in goal setting for the patient?
A) Morning care
B) Pain control
C) Clean living space
D) Meal preparation
6. As mortality in developing countries decreases, the incidence of chronic disease increases. Which of the following has contributed to a decrease in mortality?
A) Improved nutrition
B) Community initiatives
C) Greater police numbers
D) Decrease in obesity
7. A 37-year-old woman has been diagnosed with multiple sclerosis. She is married and has three children. What is the nurse’s most important role with this patient?
A) Ensure the patient is compliant with all treatments.
B) Provide the patient with advice on treatment options.
C) Provide a detailed plan of activities of daily living for the patient.
D) Help the patient develop strategies to implement treatment regimens.
8. A patient has recently been diagnosed with diabetes. The patient is clinically obese and is sedentary. How can the nurse best ensure potential success to increase activity in this patient?
A) Set up appointment times at a local fitness center for the patient to attend.
B) Have a family member ensure the patient follows a suggested exercise plan.
C) Construct an exercise program and have the patient follow it.
D) Identify barriers with the patient that will inhibit change.
9. A home care nurse has been assigned a palliative patient with cancer of the liver. The nurse notes that over the last 3 weeks, the patient’s condition has deteriorated despite attempts to control the course through a proper treatment regimen. The nurse is aware of which of the following?
A) Death will occur in the next week.
B) The patient is in the trajectory phase of chronic illness.
C) The patient is in the downward phase of chronic illness and should be reassessed.
D) The patient should immediately be admitted into the hospital.
10. A home care nurse visits a 68-year-old man to find him tearful and withdrawn. He lives alone and has no family. The patient has been managing well at home up until this time. The nurse would take which of the following actions?
A) Reassess the patient’s psychosocial status and make the necessary referrals.
B) Have the patient volunteer in the community for social contact.
C) Arrange for him to be reassessed by his physician.
D) Encourage joining a group that plays cards every week.
AND MUCH MORE