Test Bank For Focus on Adult Health -Medical-Surgical Nursing ,1 HarPsc Edition

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Focus on Adult Health -Medical-Surgical Nursing ,1 HarPsc Edition by Linda Honan Pellico Test Bank
1.
A patient tells the nurse that her doctor just told her that she had a “chronic condition.” She asks the nurse what “chronic condition” means. What would be the nurse’s best response?
 
A)
“Chronic conditions are defined as health problems that require management of 3 months or longer.”
 
B)
“Chronic conditions are diseases that come and go.”
 
C)
“Chronic conditions are medical conditions that have disabilities that require hospitalization.”
 
D)
“Chronic conditions require short-term management in extended care facilities.”
 

 

2.
A patient scheduled for dialysis is on a fluid restriction of 1000 mL/day. The nurse sees the patient drinking a 355 mL soft drink after the patient has already reached the maximum intake of fluid for the day. The nurse has instructed the patient on the risks of fluid overload. What action should the nurse take?
 
A)
Take the soft drink away from the patient and inform the dialysis nurse to remove extra fluid from the patient during his next dialysis treatment.
 
B)
Document the patient’s behavior as noncompliant and notify the health care provider.
 
C)
Restrict the patient’s fluid for the following day and communicate this information to the charge nurse.
 
D)
Reinforce the importance of the fluid restriction, and document the teaching and the intake of extra fluid.
 

 

3.
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.
 

 

4.
Research has shown that the incidence of chronic conditions is increasing. What lifestyle factor has been shown to contribute most significantly to this increase?
 
A)
Exercise
 
B)
Obesity
 
C)
Eustress
 
D)
Gastrointestinal disease
 

 

5.
You are the nurse giving palliative care to a patient with a diagnosis of chronic obstructive pulmonary disease (COPD). What is the primary goal of palliative care?
 
A)
Improve the patient’s and family’s quality of life.
 
B)
Support aggressive treatment for cure.
 
C)
Provide physical support for the patient.
 
D)
The patient may develop a separate plan with each discipline of the health care team.
 

 

6.
Your patient has a diagnosis of bladder cancer with metastasis. The patient asks you about hospice. Which principle underlies hospice care?
 
A)
Death must be accepted.
 
B)
Symptoms of terminal illness should not be treated.
 
C)
Each member of the interdisciplinary team develops an individual plan of care for the patient.
 
D)
Terminally ill patients should die in the hospital.
 

 

7.
You are the clinic nurse doing patient teaching for palliative radiotherapy to the spine.  After you complete the patient teaching, your patient continues to ask the same questions that you have already addressed. What can you conclude?
 
A)
The patient is not listening.
 
B)
The patient is not adhering to treatment.
 
C)
The patient may have a learning disability.
 
D)
Learning has not occurred.
 

 

8.
You are part of the health care team at an oncology center. Your patient has been diagnosed with leukemia and the prognosis is poor. The patient is unaware of the prognosis.  How can the bad news best be conveyed to the patient?
 
A)
Family should be given the prognosis first.
 
B)
The prognosis should be delivered with the patient at eye level.
 
C)
The health care provider should deliver the news to the patient alone.
 
D)
The appointment should be scheduled at the end of the day.
 

 

9.
Your patient has just been told that her illness is terminal. The patient states, “I can’t believe I am going to die. Why me?” What is your best response?
 
A)
“I know how you are feeling.”
 
B)
“You have lived a long life.”
 
C)
“This must be very difficult for you.”
 
D)
“Life can be so unfair.”
 

 

10.
A patient is in a hospice receiving palliative care for lung cancer.  The cancer has metastasized to the liver and bones.  The patient is experiencing dyspnea.  What might the nurse do to help to relive the dyspnea the patient is experiencing?
 
A)
A fluid bolus
 
B)
High-flow oxygen to treat low oxygen saturation
 
C)
High doses of opioids
 
D)
Administer corticosteroids as ordered
 

 

11.
Although some people with chronic illness assume what might be called a “sick role” identity, most do not consider themselves to be sick or ill and try to live as normal a life as possible. What event is most likely to cause an individual who has a chronic illness to begin thinking of himself or herself as being disabled?
 
A)
Referral to a medical specialist or a clinical nurse specialist
 
B)
Involvement of family members or close friends in the planning of care
 
C)
Decreased ability to perform activities of daily living
 
D)
Qualifying for Medicare or Medicaid
 

 

12.
The incidence and prevalence of chronic illnesses have increased in recent decades, and this trend is expected to continue in the near future. What factor has contributed most significantly to this trend?
 
A)
Decreasing availability of nutritious food
 
B)
Misinformation about the relationship between health and wellness
 
C)
Antibiotic resistance and increases in nosocomial (hospital-acquired) infections
 
D)
Increases in lifespan and the accompanying changes in physiology
 

 

13.
A diabetes nurse is performing health education with a 44-year-old woman who has recently learned that she has type 2 diabetes. The nurse is teaching the patient the importance of adhering to her prescribed treatment regimen. When providing this health education, the nurse should emphasize:
 
A)
The patient’s independent responsibility for making informed changes to her treatment regimen
 
B)
The fact that adherence to a prescribed treatment regimen usually requires careful planning
 
C)
The fact that well-intending friends and family members usually challenge the validity of the treatment regimen
 
D)
The need to avoid online information sources because they tend to contradict evidence-based regimens
 

 

14.
A 71-year-old woman with a longstanding diagnosis of emphysema developed community-acquired pneumonia 3 weeks ago and was admitted to the hospital for treatment. A combination of respiratory therapy and IV antibiotics has resolved the woman’s infection and she is now preparing to return to the home she shares with her husband. What phase in the trajectory model of chronic illness is this patient currently experiencing?
 
A)
Unstable
 
B)
Crisis
 
C)
Acute
 
D)
Comeback
 

 

15.
Mr. Romanov is a 69-year-old man who was diagnosed with angina pectoris 2 years ago. With adherence to treatment, he has been largely able to maintain his chosen lifestyle. However, in recent weeks, he has been forced to limit his physical activity, take more rests, and refrain from going for walks. What phase in the trajectory model of chronic illness is Mr. Romanov currently experiencing?
 
A)
Trajectory onset
 
B)
Acute
 
C)
Crisis
 
D)
Unstable
 

 

16.
A patient with a recent history of joint stiffness and decreased mobility has received a diagnosis of osteoarthritis. When performing health education with this patient, what subject should the nurse prioritize?
 
A)
The typical prognosis for patients who have osteoarthritis
 
B)
Strategies that the patient can use to maintain her level of function
 
C)
The role of lifestyle in the development of osteoarthritis
 
D)
Strategies for researching her chronic illness and evaluating treatments
 

 

17.
A community health nurse has a large list of patients in the local community, many of whom are living with chronic illnesses. What principle should the nurse prioritize when planning and implementing the care of these patients?
 
A)
The nurse should defer responsibility for decision-making to patients until an exacerbation of their illness.
 
B)
The nurse should facilitate a gradual decrease in patients’ expectations for independence and level of function.
 
C)
The nurse should recognize the cause-and-effect relationship that exists between the patients’ lifestyle choices and the etiology of their diseases.
 
D)
The nurse should adopt a holistic approach that addresses each dimension of the patient’s being.
 

 

18.
A female patient with a diagnosis of breast cancer had a unilateral mastectomy with axillary node biopsy. The results of the biopsy have just come back positive, and the nurse and a coworker are discussing the patient’s possible response to this news. Which of the following statements by the coworker should the nurse correct or respond to with teaching?
 
A)
“If she finds out about this too quickly, she might lose hope in her battle with cancer.”
 
B)
“All considered, it’s best if she’s told this sooner rather than later.”
 
C)
“Ideally, her family will be around when she learns about her biopsy results.”
 
D)
“This will be hard to hear, but she deserves to know as much detail as she wants.”
 

 

19.
Mr. Hosa is a 68-year-old man who is in the end stages of pancreatic cancer. His care team has suggested the possibility of hospice care but Mr. Hosa is opposed, stating, “A hospice is just a place to wait to die.” Which of the following statements should underlie the nurse’s response to Mr. Hosa?
 
A)
Spiritual and emotional needs are more important than physical needs.
 
B)
A hospital setting is an inappropriate place to die.
 
C)
Meaningful living can take place despite terminal illness.
 
D)
Acceptance of mortality can delay physiologic death.
 

 

20.
A patient with amyotrophic lateral sclerosis (ALS) wishes to use his Medicare Hospice Benefit in an effort to maximize his quality of life prior to death. What criterion will determine whether the patient qualifies for this benefit?
 
A)
A life expectancy of less than 6 months
 
B)
Exhaustion of all reasonable treatment options
 
C)
Copayment by a health insurance provider
 
D)
A demonstrated lack of a support system
 

 

21.
A 70-year-old woman is in the end stages of colorectal cancer and has tended to defer decision making to her oldest son, in accordance with the norms of her culture. The woman’s health care provider has discussed the possibility of palliative radiotherapy with the patient and her family, and the patient has asked her son to make the decision whether to pursue or forego this treatment measure. How should the care team best respond?
 
A)
Arrange a family meeting that includes social work and spiritual care.
 
B)
Accommodate the patient’s wishes and elicit a decision from the son.
 
C)
Discuss the matter with the patient at a later time when the son is absent from the bedside.
 
D)
Encourage the patient and her son to make a decision collaboratively.
 

 

22.
A woman who is dying of heart failure has become listless, distracted, and difficult to engage in conversation in recent days despite no obvious changes in her physiologic state. She has admitted to feeling severely depressed and states that this sensation is something new to her. How should her care team best interpret this new onset of depression?
 
A)
The patient should be encouraged to accept her depression and see it as a reasonable response to impending death.
 
B)
The care team should acknowledge the patient’s depression but ensure that physical needs are prioritized over emotional symptoms.
 
C)
The team should understand that depression is a normal stage of the grieving process that precedes death and should be accepted as such.
 
D)
The patient’s depression should be actively treated and not seen as an inevitability.
 

 

23.
A patient with a primary diagnosis of lung cancer developed bone metastases in recent months and experienced excruciating pain. As a result, the patient was treated with a combination of continuous-release and immediate-release morphine delivered by the oral route. Since yesterday, the patient has experienced a decreased level of consciousness and has  become unable to swallow. How should the nurse best manage this patient’s analgesia?
 
A)
Opioids should be discontinued because of the patient’s decreased level of consciousness.
 
B)
The patient should receive similar doses of morphine by alternative routes.
 
C)
The patient’s morphine should be reduced and a nonsteroidal anti-inflammatory (NSAID) introduced.
 
D)
Analgesia should be discontinued because the patient’s decreased level of consciousness indicates that his pain has subsided.
 

 

24.
An elderly female patient who experienced a hemorrhagic stroke has a poor prognosis and multiple functional deficits, including dysphagia. A family meeting has been organized to discuss the possibility of tube feeding, and the patient’s daughter is incredulous that a tube feed has not yet been introduced, stating, “The only thing worse than dying of a stroke would be to starve to death.” What principle should underlie a response to the daughter?
 
A)
There are potential benefits to withholding artificial hydration and nutrition.
 
B)
The food energy derived from artificial hydration and nutrition can exacerbate disease processes.
 
C)
It is unethical to withhold artificial hydration and nutrition unless it is physiologically impossible.
 
D)
Unconscious patients are unable to metabolize nutrients that are derived from tube feeds or parenteral nutrition.
 

 

25.
A nurse who provides care on a palliative unit of a busy urban hospital performs numerous task and roles in the provision of holistic care to patients and their families. Which of the following tasks is essential for nurses to manage patients at the end of life? Select all that apply.
 
A)
Obtain informed consent for palliative treatment measures.
 
B)
Educate patients and families about end-of-life decision making.
 
C)
Contribute to a coordinated, interdisciplinary plan of care.
 
D)
Manage pain and symptoms.
 
E)
Determine patients’ qualifications for hospice care.
 

 

 

Answer Key

 

1.
A
2.
D
3.
D
4.
B
5.
A
6.
A
7.
D
8.
B
9.
C
10.
D
11.
C
12.
D
13.
B
14.
D
15.
D
16.
B
17.
D
18.
A
19.
C
20.
A
21.
B
22.
D
23.
B
24.
A
25.
B, C, D
 
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