TESTBANK-Focus on Adult Health Medical Surgical Nursing 2nd Edition PDF

TESTBANK-Focus on Adult Health Medical Surgical Nursing 2nd Edition COMPLETE Honan Test Bank 1. The public health nurse is presenting a health promotion class to a group of new mothers. How should the nurse best define health? A) Being disease free or having existing diseases stabilized B) The state of having fulfillment in all domains of life C) Possessing psychological and physiologic harmony D) The state of being connected in body, mind, and spirit 2. A nurse is speaking to a group of prospective nursing students about what it is like to be a nurse. What characteristic should the nurse cite as necessary to possess to be an effective nurse? A) Sensitivity to cultural differences B) Ability to problem-solve independently C) Strict adherence to routine D) Ability to face criticism without being affected by it 3. The nurse has been asked to speak to members of a self-cabairrbe.ceodmu/tecsattion program. What topic should the nurse most likely address? A) Adequate prenatal care B) Government advocacy and lobbying C) Judicious use of online communities D) Management of illness 4. The home health nurse is assisting a client and his family in planning the client's return to work after surgery and the development of postsurgical complications. The nurse is preparing a plan of care that addresses the client's multifaabcierbt.ecodmn/teesetds. To which level of Maslow hierarchy of basic needs does the client's need for self-fulfillment relate? A) Physiologic B) Transcendence C) Love and belonging D) Self-actualization 5. The view that health and illness are not static states but that they exist on a continuum is central to professional health care systems. When planning care, this view aids the nurse in understanding what fact? A) Care should focus primarily on the treatment of diseaabisrbe..com/test B) A person's state of health is ever-changing. C) A person can transition from health to illness rapidly. D) Care should focus on the client's compliance with inatbeirrbv.ceonmt/i teosnt s. Page 1 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan COMPLETE AND UPDATED Test Bank 6. A nurse is leading a community health clinic. What should the nurse emphasize in order to promote disease prevention? A) It is best achieved through attending self-help groups. B) It is best achieved by reducing psychological stress. C) It is best achieved by being an active participant in the community. D) It is best achieved by exhibiting behaviors that promote health. 7. A nurse on a medical-surgical unit has asked to represent the unit on the hospital's quality committee. When describing quality improvement programs to nursing colleagues and members of other health disciplines, whaatbcirhb.acroamc/tteesrtistic should the nurse cite? A) These programs establish consequences for health care professionals' actions. B) These programs emphasize the need for evidence-baabsierbd.copmra/tc esttice. C) These programs identify specific incidents related to quality. D) These programs seek to justify health care costs and systems. 8. Nurses in acute care settings must work with other health care team members to maintain quality care while facing pressures to care for clients who are hospitalized for shorter periods of time than in the past. To ensure positivaebirhb.ecaol mth /tesotutcomes when clients return to their homes, what action should the nurse prioritize? A) Promotion of health literacy during hospitalization B) Close communication with primary providers C) Thorough and evidence-based discharge planning D) Participation in continuing education initiatives 9. The nurse is admitting a client to the medical unit after the client has been transferred from the emergency department. What is the nurse's priority action at this time? A) Identifying the immediate needs of the client B) Checking the admitting physician's prescriptions C) Obtaining a baseline set of vital signs D) Allowing the family to be with the client 10. A nurse practicing in an oncology clinic has the goal of improving client outcomes and nursing care by influencing the client, the nurse, and the health care system. What is this nurse's most likely role? A) Nursing care expert B) Clinical nurse specialist C) Nurse manager D) Staff nurse Page 2 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank 11. Nursing continues to recognize and participate in collaboration with other health care disciplines to meet the complex needs of the client. Which of the following is the best example of a collaborative practice model? A) The nurse and the physician jointly making clinicaladbeirbc.icsoimo/ntess.t B) The nurse accompanying the physician on rounds. C) The nurse making a referral on behalf of the client. D) The nurse attending an appointment with the client. 12. A hospice nurse is caring for a client who is dying of lymphoma. According to Maslow hierarchy of needs, what dimension of care should the nuarbsireb.ccoomn/tseisdt er primary in importance when caring for a dying client? A) Spiritual B) Social C) Physiologic D) Emotional 13. A nurse is planning a medical client's care with consideration of Maslow hierarchy of needs. Within this framework of understanding, what should the nurse prioritize? A) Allowing the family to see a newly admitted client B) Ambulating the client in the hallway C) Administering pain medication D) Teaching the client to self-administer insulin safely 14. A medical-surgical nurse is aware of the scope of practice as defined in the jurisdiction where the nurse provides care. When exploring the legalabbiarbs.ic somfo/terstthe scope of practice, the nurse should consult: A) codes of ethics. B) a code of nursing conduct. C) the nurse practice act in the nurse's jurisdiction. D) client preferences and norms within the profession. 15. Nursing has adapted to meet both the expectations and the changing health needs of populations. What is one factor that has impacted the need for certified nurse practitioners (CNPs)? A) The increased need for primary providers B) The need to improve client diagnostic services C) The need to promote institutional excellence D) The need to decrease the number of medical errors aabnirdb.econms/uterset quality care Page 3 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank 16. Professional nursing expands and grows because of factors driven by the changing needs of health care consumers. Which of the following is a factor that nurses should reflect in the planning and provision of health care? A) Decreased access to health care information by indiavbiidrbu.caolms/test B) Gradual increases in the cultural unity of the population C) Increasing mean and median age of the population D) Decreasing consumer expectations related to healthacbairbre.coomu/ttecsot mes 17. A public health nurse has been commissioned to draft a health promotion program that meets the health care needs and expectations of the commabuirbn.ict oym./tWesthat factor is most likely to influence the nurse's choice of interventions? A) Management of chronic conditions and disability B) Increasing need for self-care among a younger popualbairtbi.oconm/test C) A shifting focus to disease management D) An increasing focus on acute conditions and rehabilitation 18. A registered nurse will be collaborating with a certified nurse practitioner (CNP). Which of the following activities should the nurse expect the CNP to perform? Select all that apply. A) Educating clients and family members B) Coordinating care with other disciplines C) Using direct provision of interventions D) Educating registered nurses and practical nurses E) Coordinating payment plans for clients 19. There are central characteristics of nursing practice that are applicable across the wide variety of contexts in which nurses practice. A nurse can best demonstrate these principles by performing which of the following actions? A) Teaching the public about the role of nursing B) Taking action to control the costs of health care C) Ensuring that all of their actions exemplify caring D) Making sure to carry adequate liability insurance 20. A nurse has accepted a position as a clinical nurse leader (CNL). In this role, the nurse should prioritize which of the following activities? A) Acting as a spokesperson for the nursing profession B) Generating and disseminating new nursing knowledge C) Diagnosing and treating health problems that have aabpirrbe.cdoimc/tteasbtle course D) Helping clients to navigate the health care system Page 4 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank 21. With the changing population of health care consumers, it has become necessary for nurses to work more closely with other nurses, as when acute care nurses collaborate with public health and home health nurses. What nursing function has increased in importance because of this phenomenon? A) Prescribing medication B) Performing discharge planning C) Promoting family involvement D) Forming collegial relationships 22. Over the past several decades, nursing roles have changeadbirabn.cdome/xtepstanded in many ways. Which of the following factors has provided the strongest impetus for this change? A) The need to decrease the cost of health care B) The need to improve the quality of nursing educatioanbirb.com/test C) The need to increase the number of nursing jobs available D) The need to increase the public perception of nursing 23. Advanced practice nursing roles have grown in number and in visibility in recent years. What characteristic sets these nurses apart from the registered nurse? A) Collaboration with other health care providers B) Education that goes beyond that of the RN C) Advanced documentation skills D) Ability to provide care in the surgical context 24. CNPs are educated as specialists in areas such as family care, pediatrics, or geriatrics. In most jurisdictions, what right do CNPs have that RNs do abnirobt.cpomo/stessetss? A) Perform health interventions independently B) Make referrals to members of other health disciplines C) Prescribe medications D) Perform surgery independently 25. A nurse is aware that an increasing emphasis is being plaacbeirbd.coomn/theestalth, health promotion, wellness, and self-care. Which of the following activities would best demonstrate the principles of health promotion? A) A discharge planning initiative between acute care and community care nurses B) Collaboration between several schools of nursing inabairnb.u cormb/atenstarea C) Creation of a smoking prevention program undertaken in a middle school D) Establishment of a website where clients can check emergency department wait-times Page 5 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank Answer Key 1. D 2. A 3. D 4. D 5. B 6. D 7. B 8. C 9. A 10. B 11. A 12. C 13. C 14. C 15. A 16. C 17. A 18. A, B, C 19. C 20. D 21. B 22. A 23. B 24. C 25. C Page 6 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank 1. A nurse has been working with a client whose poorly controlled type 1 diabetes has led to numerous health problems. Over the past several years the client has had several admissions to the hospital medical unit, and the nurse has often carried out health promotion interventions. Who is ultimately responsible fao brirbm.caomin/tteas itning and promoting this client's health? A) The medical nurse B) The community health nurse who has also worked wabiitrhb.ctohme/tecsltient C) The client's primary care provider D) The client 2. An elderly female client has come to the clinic for a scheduled follow-up appointment. The nurse learns from the client's daughter that the client is not following the instructions she received upon discharge from the hospit aablirlba.csotmm/teosnt th. What is the most likely factor causing the client not to adhere to her therapeutic regimen? A) Ethnic background of health care provider B) Costs of the prescribed regimen C) Presence of a learning disability D) Personality of the primary provider 3. A gerontologic nurse has observed that clients often fail to adhere to their therapeutic regimen. What strategy should the nurse adopt to best assist an older adult in adhering to a therapeutic regimen involving wound care? A) Demonstrate a dressing change and allow the clientatboirbp.croamc/tti ecste. B) Provide a detailed pamphlet on a dressing change. C) Verbally instruct the client how to change a dressing and check for comprehension. D) Delegate the dressing change to a trusted family meambirbbe.cro.m/test 4. A 20-year-old man newly diagnosed with type 1 diabetes needs to learn how to self-administer insulin. When planning the appropriate eadbuircba.ctoimo/nteas lt interventions and considering variables that will affect his learning, the nurse should prioritize what factor? A) Client's expected lifespan B) Client's gender C) Client's occupation D) Client's culture Page 1 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank 5. The nurse is planning to teach a 75-year-old client with coronary artery disease about administering her prescribed antiplatelet medication. How can the nurse best enhance the client's ability to learn? A) Provide links to websites that contain evidence-baseadbiribn.c foomr/mtesattion. B) Exclude family members from the session to prevent distraction. C) Use color-coded materials that are succinct and engaging. D) Make the information directly relevant to the client'asbcirbo.n codmi/ttieosn t. 6. A group of nursing students have been asked to break into groups of four and complete a health-promotion teaching project and present a report atboirbth.ceomir/tfeestllow students. What project most clearly demonstrates the principles of health promotion teaching? A) Demonstrating an injection technique to a client for anticoagulant therapy B) Explaining the side effects of a medication to an aduablt irbc.clioemn/ttest C) Discussing the importance of preventing sexually transmitted infections (STI) to a group of high school students D) Instructing an adolescent client about safe and nutritious food preparation 7. The nursing profession and nurses as individuals have a responsibility to promote activities that foster well-being. What factor has most infalbuirebn.ccomed/tensturses' abilities to play this vital role? A) Nurses are seen as nurturing professionals. B) Nurses possess a baccalaureate degree as the entry to practice. C) Nurses possess an authentic desire to help others. D) Nurses have long-established credibility with the public. 8. The nurse is planning to teach tracheostomy care to a client who will be discharged home following a spinal cord injury. When preparing to teach, which component of the teaching plan should the nurse prioritize? A) Citing the evidence that underlies each of the teachianbgirbp.coomin/ttesst B) Alleviating the client's guilt associated with not knowing appropriate self-care C) Determining the client's readiness to learn new information D) Including several nursing colleagues in the planningabpirrbo.ccoems/tsest 9. A public health nurse is preparing to hold a series of health promotion classes for middle-aged adults that will address a variety of topics. Wabihrbi.cchoml/otecsat tion would best meet the learning needs of this population? A) A well-respected physician's office B) A large, local workplace C) The local hospital D) An ambulatory clinic Page 2 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank 10. A public health nurse understands that health promotion should continue across the lifespan. When planning health promotion initiatives, when in the lifespan should health promotion begin? A) Adolescence B) School age C) Preschool D) Before birth 11. A nurse is working with a teenage boy who was recently diagnosed with asthma. During the current session, the nurse has taught the boy how to aadbimrb.ic noims/tteesrthis bronchodilator by metered-dose inhaler. How should the nurse best evaluate the teaching–learning process? A) Ask the boy specific questions about his medicationa.birb.com/test B) Ask the boy whether he now understands how to use his inhaler. C) Directly observe the boy using his inhaler to give himself a dose. D) Assess the boy's respiratory health at the next scheduled visit. 12. A nurse has just come on duty and has received the end-of-shift report. One of the nurse's clients newly diagnosed with diabetes was admittaebdirbw.coimth/teds itabetic ketoacidosis. Which behavior best demonstrates this client's willingness to learn? A) The client requests a visit from the hospital's diabetic educator. B) The client sets aside a dessert brought in by a family member. C) The client wants a family member to meet with the adbiie rbt.iccoima/ntestto discuss meals. D) The client readily allows the nurse to measure his blood glucose level. 13. A nursing student is collaborating with a public health nurse on a local health promotion initiative and they recognize the need for a common understanding of health. How should the student and the nurse best define health? A) Health is the effort to systematically maximize wellanbeirsbs.c.om/test B) Health is a state that is characterized by a lack of disease. C) Health is a condition that enables people to function at their optimal potential. D) Health is deliberate attempt to mitigate the effects oafbd irbi.sceoams/tee.st 14. An occupational health nurse is in the planning stages of a new health promotion campaign in the workplace. When appraising the potentiaablirbb.ec nomef/tietsst of the program, the nurse should consider that success depends most on participants': A) desire to expand knowledge. B) self-awareness. C) skills at time- and task-management. D) taking responsibility for themselves. Page 3 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank 15. A public health nurse is assessing the nutritional awareness of a group of women who are participating in a prenatal health class. What outcome would most clearly demonstrate that the women possess nutritional awareness? A) The women demonstrate an understanding of the imapbiorbr.tcaonmc/te esot f a healthy diet. B) The women are able to describe the importance of vitamin supplements during pregnancy. C) The women can list the minerals nutrients that shoualb dirbb.ecocmo/tnes stumed daily. D) The women can interpret the nutrition facts listed on food packaging. 16. Positive client outcomes are the ultimate goal of nurse–calb ieirn b.tcoimnt/teersat ctions, regardless of the particular setting. Which of the following factors has the most direct influence on positive health outcomes? A) Client's age B) Client's ethnic heritage C) Health education D) Outcome evaluation 17. A nurse recognizes that individuals of different ages have specific health promotion needs. When planning to promote health among young aadbuirlbt.sco, mw/thesatt subject is most likely to meet this demographic group's learning needs? A) Family planning B) Management of risky behaviors C) Physical fitness D) Relationship skills training 18. Middle-aged adults are part of an age group that is known to be interested in health and health promotion, and the nurse is planning health promotion activities accordingly. To what suggestions do members of this age group usually respond with enthusiasm? Select all that apply. A) How lifestyle practices can improve health B) How to eat healthier C) How exercise can improve your life D) Strategies for adhering to prescribed therapy E) Exercise for the aging Page 4 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank 19. A community health nurse has been asked to participate in a health fair that is being sponsored by the local senior center. The nurse should select educational focuses in the knowledge that older adults benefit most from what kind of activities? A) Those that help them eat well B) Those that help them maintain independence C) Those that preserve their social interactions D) Those that promote financial stability 20. A nurse who provides care at the campus medical clinic of a large university focuses much effort on health promotion. What purpose of healthabpirr bo.cmomo/tt eisotn should guide the nurse's efforts? A) To teach people how to act within the limitations of their health B) To teach people how to grow in a holistic manner C) To change the environment in ways that enhance cultural expectations D) To influence people's behaviors in ways that reduce risks 21. An experienced nurse finds that she spends an increasing proportion of time on health promotion. Which of the following factors has most influenced the growing emphasis on health promotion? A) A changing definition of health B) An awareness that wellness exists C) An expanded definition of chronic illness D) A belief that disease is preventable 22. A nurse is working with a client who has recently receiveabdirba.cdoi ma/gtenstosis of human immunodeficiency virus (HIV). When performing client education during discharge planning, what goal should the nurse prioritize? A) Encourage the client to exercise within his limitations. B) Encourage the client to adhere to his therapeutic regaibmirbe.cno.m/test C) Appraise the client's level of nutritional awareness. D) Encourage a disease-free state. 23. The nurse is providing client education to a teenage girl who was diagnosed 6 months ago with type 1 diabetes. Her hemoglobin A1c results suggest she has not been adhering to her prescribed treatment regimen. What variables shouab ldirbt.choemn/teusrtse assess to help this client better adhere to her treatment regimen? Select all that apply. A) Variables that affect the client's ability to obtain resources B) Variables that affect the client's ability to teach her afr biirebn.cdoms/atebso t ut diabetes C) Variables that affect the client's ability to cure her disease D) Variables that affect the client's ability to maintain a healthy social environment E) Variables that affect the client's ability to adopt specific behaviors Page 5 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank 24. The nurse working in a gerontology clinic recognizes that some elderly people do not adhere to therapeutic regimens because of chronic illnesses that require long-term treatment by several health care providers. What is the maobisrbt.c imomp/toesrttant consideration when dealing with this segment of the population? A) Health care professionals must know all the dietary supplements the client is taking. B) Health care professionals must work together to provide coordinated care. C) Health care professionals may negate the efforts of another health care provider. D) Health care professionals must have a peer witness their interactions with the client. 25. An adult client will be receiving outpatient intravenous aanbtiribb.c ioo mti/ctesttherapy for the treatment of endocarditis. The nurse is preparing to perform health education to ensure the client's adherence to the course of treatment. What assessment should be the nurse's immediate priority? A) Client's understanding of the teaching plan B) Quality of the client's relationships C) Client's previous medical history D) Characteristics of the client's culture Page 6 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank Answer Key 1. D 2. B 3. A 4. D 5. D 6. C 7. D 8. C 9. B 10. D 11. C 12. A 13. C 14. D 15. A 16. C 17. A 18. A, B, C 19. B 20. D 21. A 22. B 23. A, D, E 24. B 25. D Page 7 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank 1. The nurse is caring for a patient who has been recently diagnosed with late stage pancreatic cancer. The patient refuses to accept the diagnosis and refuses to adhere to treatment. What is the most likely psychosocial purpose of this patient's strategy? A) The patient may be trying to protect loved ones fromabitrhb.ecoemm/teosttional effects of the illness. B) The patient is being noncompliant in order to assert power over caregivers. C) The patient may be skeptical of the benefits of the Wabeirs b.tceormn/tb es itomedical model of health. D) The patient thinks that treatment does not provide him comfort. 2. An adult oncology patient has a diagnosis of bladder cancer with metastasis and the patient has asked the nurse about the possibility of hospice care. Which principle is central to a hospice setting? A) The patient and family should be viewed as a single unit of care. B) Persistent symptoms of terminal illness should not be treated. C) Each member of the interdisciplinary team should develop an individual plan of care. D) Terminally ill patients should die in the hospital whenever possible. 3. The nurse is part of the health care team at an oncology center. A patient has been diagnosed with leukemia and the prognosis is poor, but the patient is not yet aware 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 physician should deliver the news to the patient alone. D) The appointment should be scheduled at the end of athbierb.dcoamy/.test 4. A patient has just been told that her illness is terminal. The patient tearfully states, “I can't believe I am going to die. Why me?” What is your b abeirsbt.croems/pteosn t se? 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.” Page 1 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank 5. The nurse has observed that an older adult patient with a diagnosis of end-stage renal failure seems to prefer to have his eldest son make all of his health care decisions. While the family is visiting, the patient explains to you that this is a cultural practice and very important to him. How should you respond? A) Privately ask the son to allow the patient to make his own health care decisions. B) Explain to the patient that he is responsible for his own decisions. C) Work with the team to negotiate informed consent. D) Avoid divulging information to the eldest son. 6. A medical nurse is providing end-of-life care for a patienatbiwrb.ictohmm/teesttastatic bone cancer. The nurse notes that the patient has been receiving oral analgesics for her pain with adequate effect, but is now having difficulty swallowing the medication. What should the nurse do? A) Request the physician to order analgesics by an alternative route. B) Crush the medication in order to aid swallowing and absorption. C) Administer the patient's medication with the meal tray. D) Administer the medication rectally. 7. A 66-year-old patient is in a hospice receiving palliativeacbairrbe.cofmor /telsutng cancer which has metastasized to the patient's liver and bones. For the past several hours, the patient has been experiencing dyspnea. What nursing action is most appropriate to help to relive the dyspnea the patient is experiencing? A) Administer a bolus of normal saline, as ordered. B) Initiate high-flow oxygen therapy. C) Administer high doses of opioids. D) Administer bronchodilators and corticosteroids, as oabrdirbe.r ce omd/.test 8. The nurse is caring for a patient who has terminal lung cancer and is unconscious. Which assessment finding would most clearly indicate toabtihrbe.co nmu/rtesset that the patient's death is imminent? A) Mottling of the lower limbs B) Slow, steady pulse C) Bowel incontinence D) Increased swallowing Page 2 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank 9. The nurse is assessing a 73-year-old patient who was diagnosed with metastatic prostate cancer. The nurse notes that the patient is exhibiting signs of loss, grief, and intense sadness. Based on this assessment data, the nurse will document that the patient is most likely in what stage of death and dying? A) Depression B) Denial C) Anger D) Resignation 10. You are caring for a 50-year-old man diagnosed with mualbtiirpb.lceomm/teysetloma; he has just been told by the care team that his prognosis is poor. He is tearful and trying to express his feelings, but he is having difficulty. What should you do first? A) Ask if he would like you to sit with him while he coalblierbc.cts omh/tiesstthoughts. B) Tell him that you will leave for now but will be back shortly. C) Offer to call pastoral care or a member of his chosen clergy. D) Reassure him that you can understand how he is feeling. 11. A patient's rapid cancer metastases have prompted a shift from active treatment to palliative care. When planning this patient's care, the nurasbeirbs.hcoomu/tledstidentify what primary aim? A) To prioritize emotional needs B) To prevent and relieve suffering C) To bridge between curative care and hospice care D) To provide care while there is still hope 12. A patient with end-stage heart failure has participated in a family meeting with the interdisciplinary team and opted for hospice care. On what belief should the patient's care in this setting be based? A) Meaningful living during terminal illness requires teabcihrbn.coolmo/g teisct interventions. B) Meaningful living during terminal illness is best supported in designated facilities. C) Meaningful living during terminal illness is best supported in the home. D) Meaningful living during terminal illness is best achaibeirvb.ecodmb/ty estprolonging physiologic dying. Page 3 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank 13. A nurse is caring for an 87-year-old Mexican-American female patient who is in end-stage renal disease. The physician has just been in to see the patient and her family to tell them that nothing more can be done for the patient and that death is not far. The physician offers to discharge the patient home to hospiceabcirabr.ceo,mb/tuetstthe patient and family refuse. After the physician leaves, the patient's daughter approaches you and asks what hospice care is. What would this lack of knowledge about hospice care be perceived as? A) Lack of an American education of the patient and haebrirfba.cmomil/tyest B) A language barrier to hospice care for this patient C) A barrier to hospice care for this patient D) Inability to grasp American concepts of health care 14. Patients who are enrolled in hospice care through Medicare are often felt to suffer unnecessarily because they do not receive adequate attenatbioirbn.c foo mr/tetshteir symptoms of the underlying illness. What factor most contributes to this phenomenon? A) Unwillingness to overmedicate the dying patient B) Rules concerning completion of all cure-focused medical treatment C) Unwillingness of patients and families to acknowledabgireb.tchome/pteasttient is terminal D) Lack of knowledge of patients and families regarding availability of care 15. One of the functions of nursing care of the terminally ill is to support the patient and his or her family as they come to terms with the diagnosis and progression of the disease process. How should nurses support patients and their families during this process? Select all that apply. A) Describe their personal experiences in dealing with end-of-life issues. B) Encourage the patient and family to “keep fighting” as a cure may come. C) Try to appreciate and understand the illness from thaebiprba.ctoiemn/tt e'sst perspective. D) Assist patients with performing a life review. E) Provide interventions that facilitate end-of-life closure. 16. The nurse is admitting a 52-year-old father of four into hospice care. The patient has a diagnosis of Parkinson's disease, which is progressing rapidly. The patient has made clear his preference to receive care at home. What intervaebnirtbi.oconms/tsehstould the nurse prioritize in the plan of care? A) Aggressively continuing to fight the disease process B) Moving the patient to a long-term care facility when it becomes necessary C) Including the children in planning their father's care D) Supporting the patient's and family's values and choices Page 4 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank 17. A hospice nurse is caring for a 22-year-old with a terminal diagnosis of leukemia. When updating this patient's plan of nursing care, what should the nurse prioritize? A) Interventions aimed at maximizing quantity of life B) Providing financial advice to pay for care C) Providing realistic emotional preparation for death D) Making suggestions to maximize family social interactions after the patient's death 18. As a staff member in a local hospice, a nurse deals with death and dying on a frequent basis. Where would be the safe venue for the nurse to express her feelings of frustration and grief about a patient who has recently died? A) In the cafeteria B) At a staff meeting C) At a social gathering D) At a memorial service 19. A hospice nurse is well aware of how difficult it is to deaalbiwrb.ictohmo/tethsters' pain on a daily basis. This nurse should put healthy practices into place to guard against what outcome? A) Inefficiency in the provision of care B) Excessive weight gain C) Emotional exhaustion D) Social withdrawal 20. The hospice nurse is caring for a 45-year-old mother of three young children in the patient's home. During the most recent visit, the nurse has observed that the patient has a new onset of altered mental status, likely resulting from raebicrbe.ncotmly/teds itagnosed brain metastases. What goal of nursing interventions should the nurse identify? A) Helping the family to understand why the patient needs to be sedated B) Making arrangements to promptly move the patient to an acute-care facility C) Explaining to the family that death is near and the paabtiirbe.ncotmn/teeestds around-the-clock nursing care D) Teaching family members how to interact with, and ensure safety for, the patient with impaired cognition Page 5 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank 21. A patient who is receiving care for osteosarcoma has been experiencing severe pain since being diagnosed. As a result, the patient has been receiving analgesics on both a scheduled and PRN basis. For the past several hours, however, the patient's level of consciousness has declined and she is now unresponsivea.bHirbo.cwoms/hteostuld the patient's pain control regimen be affected? A) The patient's pain control regimen should be continued. B) The pain control regimen should be placed on hold aubnirtbi.lcot mh/etepstatient's level of consciousness improves. C) IV analgesics should be withheld and replaced with transdermal analgesics. D) The patient's analgesic dosages should be reduced by approximately one half. 22. A client tells the nurse that her doctor just told her that her new diagnosis of rheumatoid arthritis is considered to be a “chronic condition.” She as kab s irbt.hcoemn/teusrtse what “chronic condition” means. What would be the nurse's best response? A) “Chronic conditions are defined as health problems that require management of several months or longer.” B) “Chronic conditions are diseases that come and go ianbirab.rceom la/tteivstely predictable cycle.” C) “Chronic conditions are medical conditions that culminate in disabilities that require hospitalization.” D) “Chronic conditions are those that require short-term management in extended-care facilities.” 23. A client with end-stage lung cancer has been admitted to hospice care. The hospice team is meeting with the client and her family to establish goals for care. What is likely to be a first priority in goal setting for the client? A) Maintenance of activities of daily living B) Pain control C) Social interaction D) Promotion of spirituality 24. A 37-year-old woman with multiple sclerosis is married aabnirdb.c hoams/teth stree children. The nurse has worked extensively with the woman and her family to plan appropriate care. What is the nurse's most important role with this client? A) Ensure the client adheres to all treatments. B) Provide the client with advice on alternative treatmeanbitrbo.cpom ti/otensst. C) Provide a detailed plan of activities of daily living (ADLs) for the client. D) Help the client develop strategies to implement treatment regimens. Page 6 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank 25. The nurse is caring for a patient diagnosed with cancer of the liver who has chosen to remain in his home as long as he is able. The nurse reviews the care plan for the patient and notes that it focuses on palliative measures. The nurse also notes that over the last 3 weeks, the patient's condition has continued to deteriorataeb.irWb.co hma/tteis st the nurse's best response to this clinical information? A) Recognize that death will most likely occur in the next week. B) Recognize that the patient is in the trajectory phaseaobfirbc.hcormo/nteis ct illness and should be kept pain-free. C) Recognize that the patient is in the downward phase of chronic illness and should be reassessed. D) Recognize that the patient should immediately be adabmirbit.ctoemd/tienstto the hospital. Page 7 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank Answer Key 1. A 2. A 3. B 4. C 5. C 6. A 7. D 8. A 9. A 10. A 11. B 12. C 13. C 14. B 15. C, D, E 16. D 17. C 18. B 19. C 20. D 21. A 22. A 23. B 24. D 25. C Page 8 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank 3 1. You are caring for a patient who has a diagnosis of syndrome of inappropriate antidiuretic hormone secretion (SIADH). Your patient's plan of care includes assessment of specific gravity every 4 hours. The results of this test will allow the nurse to assess what aspect of the patient's health? A) Nutritional status B) Potassium balance C) Calcium balance D) Fluid volume status 2. You are caring for a patient admitted with a diagnosis ofaabc irbu.cteomk/tiedsnt ey injury. When you review your patient's most recent laboratory reports, you note that the patient's magnesium levels are high. You should prioritize assessment for which of the following health problems? A) Diminished deep tendon reflexes B) Tachycardia C) Cool, clammy skin D) Acute flank pain 3. A patient with a longstanding diagnosis of generalized anabxiribe.tcyomd/tiessot rder presents to the emergency room. The triage nurse notes upon assessment that the patient is hyperventilating. The triage nurse is aware that hyperventilation is the most common cause of which acid–base imbalance? A) Respiratory acidosis B) Respiratory alkalosis C) Increased PaCO2 D) CNS disturbances 4. You are an emergency-room nurse caring for a trauma patient. Your patient has the following arterial blood gas results: pH 7.26, PaCO2 28, aHbiCrbO.com1/t1estmEq/L. How would you interpret these results? A) Respiratory acidosis with no compensation B) Metabolic alkalosis with a compensatory alkalosis C) Metabolic acidosis with no compensation D) Metabolic acidosis with a compensatory respiratory alkalosis Page 1 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank 5. You are making initial shift assessments on your patients. While assessing one patient's peripheral IV site, you note edema around the insertion site. How should you document this complication related to IV therapy? A) Air emboli B) Phlebitis C) Infiltration D) Fluid overload 6. You are performing an admission assessment on an older adult patient newly admitted for end-stage liver disease. What principle should guide ayboirub.rcoams/stees stsment of the patient's skin turgor? A) Overhydration is common among healthy older adults. B) Dehydration causes the skin to appear spongy. C) Inelastic skin turgor is a normal part of aging. D) Skin turgor cannot be assessed in patients over 70. 7. The physician has ordered a peripheral IV to be inserted before the patient goes for computed tomography. What should the nurse do when selecting a site on the hand or arm for insertion of an IV catheter? A) Choose a hairless site if available. B) Consider potential effects on the patient's mobility when selecting a site. C) Have the patient briefly hold his arm over his head before insertion. D) Leave the tourniquet on for at least 3 minutes. 8. A nurse in the neurologic ICU has orders to infuse a hypaebritrbo.ncoimc/s teos ltution into a patient with increased intracranial pressure. This solution will increase the number of dissolved particles in the patient's blood, creating pressure for fluids in the tissues to shift into the capillaries and increase the blood volume. This process is best described as which of the following? A) Hydrostatic pressure B) Osmosis and osmolality C) Diffusion D) Active transport Page 2 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank 9. You are the surgical nurse caring for a 65-year-old female patient who is postoperative day 1 following a thyroidectomy. During your shift assessment, the patient complains of tingling in her lips and fingers. She tells you that she has an intermittent spasm in her wrist and hand and she exhibits increased muscle tone. Wabhirab.tcoemle/tcetsrtolyte imbalance should you first suspect? A) Hypophosphatemia B) Hypocalcemia C) Hypermagnesemia D) Hyperkalemia 10. You are caring for a 65-year-old male patient admitted to your medical unit 72 hours ago with pyloric stenosis. A nasogastric tube placed upon admission has been on low intermittent suction ever since. Upon review of the mornaibnirgb'.scobml/oteosd t work, you notice that the patient's potassium is below reference range. You should recognize that the patient may be at risk for what imbalance? A) Hypercalcemia B) Metabolic acidosis C) Metabolic alkalosis D) Respiratory acidosis 11. The nurse is preparing to insert a peripheral IV catheter into a patient who will require fluids and IV antibiotics. How should the nurse always start the process of insertion? A) Leave one hand ungloved to assess the site. B) Cleanse the skin with normal saline. C) Ask the patient about allergies to latex or iodine. D) Remove excessive hair from the selected site. 12. A patient who is being treated for pneumonia starts complaining of sudden shortness of breath. An arterial blood gas (ABG) is drawn. The ABGahbairbs.ctohme/tfeostllowing values: pH 7.21, PaCO2 64 mm Hg, HCO3 = 24 mm Hg. What does the ABG reflect? A) Respiratory acidosis B) Metabolic alkalosis C) Respiratory alkalosis D) Metabolic acidosis Page 3 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank 13. One day after a patient is admitted to the medical unit, you note that the patient is oliguric. You notify the acute-care nurse practitioner who orders a fluid challenge of 200 mL of normal saline solution over 15 minutes. This intervention will achieve which of the following? A) Help distinguish hyponatremia from hypernatremia B) Help evaluate pituitary gland function C) Help distinguish reduced renal blood flow from decarbeirabs.ceodmr /tees ntal function D) Help provide an effective treatment for hypertension-induced oliguria 14. The community health nurse is performing a home visit taobirabn.co8m4/t-eystear-old woman recovering from hip surgery. The nurse notes that the woman seems uncharacteristically confused and has dry mucous membranes. When asked about her fluid intake, the patient states, “I stop drinking water early in the day becaabuirsbe.coit mi/tses jtust too difficult to get up during the night to go to the bathroom.” What would be the nurse's best response? A) “I will need to have your medications adjusted so you will need to be readmitted to the hospital for a complete workup.” B) “Limiting your fluids can create imbalances in yourab biorbd.c yomth/teastt can result in confusion. Maybe we need to adjust the timing of your fluids.” C) “It is normal to be a little confused following surgery, and it is safe not to urinate at night.” D) “If you build up too much urine in your bladder, it can cause you to get confused, especially when your body is under stress. “ 15. A nurse educator is reviewing peripheral IV insertion with a group of novice nurses. How should these nurses be encouraged to deal with excess hair at the intended site? A) Leave the hair intact. B) Shave the area. C) Clip the hair in the area. D) Remove the hair with a depilatory. 16. You are the nurse evaluating a newly admitted patient's laboratory results, which include several values that are outside of reference rangeasb.irWb.chomic/thesot f the following would cause the release of antidiuretic hormone (ADH)? A) Increased serum sodium B) Decreased serum potassium C) Decreased hemoglobin D) Increased platelets Page 4 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank 17. You are the nurse caring for a 77-year-old male patient who has been involved in a motor vehicle accident. You and your colleague note that the patient's labs indicate minimally elevated serum creatinine levels, which your colleague dismisses. What can this increase in creatinine indicate in older adults? A) Substantially reduced renal function B) Acute kidney injury C) Decreased cardiac output D) Alterations in ratio of body fluids to muscle mass 18. You are the nurse caring for a patient who is to receive IV abirdba.cuomno/tersutbicin, a chemotherapeutic agent. You start the infusion and check the insertion site as per protocol. During your most recent check, you note that the IV has infiltrated so you stop the infusion. What is your main concern with this infiltra atbiiorbn.c ?om/test A) Extravasation of the medication B) Discomfort to the patient C) Blanching at the site D) Hypersensitivity reaction to the medication 19. A medical nurse educator is reviewing a patient's recent aebpiribs.ocodme/teos ft metabolic acidosis with members of the nursing staff. What should the educator describe about the role of the kidneys in metabolic acidosis? A) The kidneys retain hydrogen ions and excrete bicarbonate ions to help restore balance. B) The kidneys excrete hydrogen ions and conserve bicarbonate ions to help restore balance. C) The kidneys react rapidly to compensate for imbalaanbcirebs.coinm/ttehset body. D) The kidneys regulate the bicarbonate level in the intracellular fluid. 20. The nurse in the medical ICU is caring for a patient whoaibsirbin.corme/steps itratory acidosis due to inadequate ventilation. What diagnosis could the patient have that could cause inadequate ventilation? A) Endocarditis B) Multiple myeloma C) Guillain-Barré syndrome D) Overdose of amphetamines Page 5 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank 21. Diagnostic testing has been ordered to differentiate between normal anion gap acidosis and high anion gap acidosis in an acutely ill patient. What health problem typically precedes normal anion gap acidosis? A) Metastases B) Excessive potassium intake C) Water intoxication D) Excessive administration of chloride 22. You are caring for a patient with a diagnosis of pancreatitis. The patient was admitted from a homeless shelter and is a vague historian. The pataibeirnbt.caom pp/teesatrs malnourished and on day 3 of the patient's admission total parenteral nutrition (TPN) has been started. Why would you know to start the infusion of TPN slowly? A) Patients receiving TPN are at risk for hypercalcemiaabiirfb.ccaomlo /treisets are started too rapidly. B) Malnourished patients receiving parenteral nutrition are at risk for hypophosphatemia if calories are started too aggressively. C) Malnourished patients who receive fluids too rapidlaybiarbr.ecoamt/tr eis stk for hypernatremia. D) Patients receiving TPN need a slow initiation of treatment in order to allow digestive enzymes to accumulate 23. You are caring for a patient with a secondary diagnosis of hypermagnesemia. What assessment finding would be most consistent with this diagnosis? A) Hypertension B) Kussmaul respirations C) Increased DTRs D) Shallow respirations 24. A patient's most recent laboratory results show a slight decrease in potassium. The physician has opted to forego drug therapy but has suggeasbtirebd.coin mc/tere stasing the patient's dietary intake of potassium. Which of the following would be a good source of potassium? A) Apples B) Asparagus C) Carrots D) Bananas Page 6 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank 25. The nurse is assessing the patient for the presence of a Chvostek's sign. What electrolyte imbalance would a positive Chvostek's sign indicate? A) Hypermagnesemia B) Hyponatremia C) Hypocalcemia D) Hyperkalemia Page 7 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank Answer Key 1. D 2. A 3. B 4. D 5. C 6. C 7. B 8. B 9. B 10. C 11. C 12. A 13. C 14. B 15. C 16. A 17. A 18. A 19. B 20. C 21. D 22. B 23. D 24. D 25. C Page 8 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank 1. The nurse is performing a preoperative assessment on a patient going to surgery. The patient informs the nurse that he drinks approximately two bottles of wine each day and has for the last several years. What postoperative difficulties can the nurse anticipate for this patient? A) Alcohol withdrawal syndrome immediately following surgery B) Alcohol withdrawal syndrome 2 to 4 days after his last alcohol drink C) Alcohol withdrawal syndrome upon administrationaobfirbg.ceonme/r teas lt anesthesia D) Alcohol withdrawal syndrome 1 week after his last alcohol drink 2. The nurse is preparing a patient for surgery prior to her haybs irbte.croemc/tteosmt y without oophorectomy. The nurse is witnessing the patient's signature on a consent form. Which comment by the patient would best indicate informed consent? A) “I know I'll be fine because the physician said he haasbidrbo.cnoe m/ttehs its procedure hundreds of times.” B) “I know I'll have pain after the surgery but they'll do their best to keep it to a minimum.” C) “The physician is going to remove my uterus and toalbdirbm.ceoma/tbeostut the risk of bleeding.” D) “Because the physician isn't taking my ovaries, I'll still be able to have children.” 3. The nurse is caring for a hospice patient who is scheduled for a surgical procedure to reduce the size of his spinal tumor in an effort to relieve his pain. The nurse should plan this patient care with the knowledge that his surgical proacbeirdbu.croem/itsesct lassified as which of the following? A) Diagnostic B) Laparoscopic C) Curative D) Palliative 4. A nurse is providing preoperative teaching to a patient who will soon undergo a cardiac bypass. The nurse's teaching plan includes exercises of the extremities. What is the purpose of teaching a patient leg exercises prior to surge arybi?rb.com/test A) Leg exercises increase the patient's muscle mass postoperatively. B) Leg exercises improve circulation and prevent venous thrombosis. C) Leg exercises help to prevent pressure sores to the sacrum and heels. D) Leg exercise help increase the patient's level of cons abciirb o.ucosmn/etessst after surgery. Page 1 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank 5. The nurse is preparing a patient for surgery. The patient states that she is very nervous and really does not understand what the surgical procedure is for or how it will be performed. What is the most appropriate nursing action for the nurse to take? A) Have the patient sign the informed consent and placaebiribt.cinomt/hteestchart. B) Call the physician to review the procedure with the patient. C) Explain the procedure clearly to the patient and her family. D) Provide the patient with a pamphlet explaining the pab roirbc.ecodmu/r tees.t 6. The nurse is caring for a patient in the postoperative period following an abdominal hysterectomy. The patient states, “I don't want to use myabpirabi.ncomm/teedsts because they'll make me dependent and I won't get better as fast.” Which response is most important when explaining the use of pain medication? A) “You will need the pain medication for at least 1 weaebikrb.tcoomh/etelspt in your recovery. What do you mean you feel you won't get better faster?” B) “Pain medication will help to decrease your pain and increase your ability to breath. Dependency is a risk with pain medication, but you are young and won't have any problems.” C) “Pain medication can be given by mouth to prevent the risk of dependency that you are worried about. The pain medication has not been shown to affect your risk of a slowed recovery.” D) “You will move more easily and heal more quickly with decreased pain. Dependence only occurs when it is administered for an extended period of time.” 7. The nurse admitting a patient who is insulin dependent to the same-day surgical suite for carpal tunnel surgery. How should this patient's diagnosis of type 1 diabetes affect the care that the nurse plans? A) The nurse should administer a bolus of dextrose IV solution preoperatively. B) The nurse should keep the patient NPO for at least 8 hours preoperatively. C) The nurse should initiate a subcutaneous infusion of long-acting insulin. D) The nurse should assess the patient's blood glucose albeivrbe.closmv/tiegs itlantly. 8. One of the things a nurse has taught to a patient during parbeio rbp.ceorma/tteivste teaching is to have nothing by mouth for the specified time before surgery. The patient asks the nurse why this is important. What is the most appropriate response for the patient? A) “You will need to have food and fluid restricted before surgery so you are not at risk for choking.” B) “The restriction of food or fluid will prevent the development of pneumonia related to decreased lung capacity.” C) “The presence of food in the stomach interferes withabt irhb.ecoamb/tseostrption of anesthetic agents.” D) “By withholding food for 8 hours before surgery, you will not develop constipation in the postoperative period.” Page 2 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank 9. The policies and procedures on a preoperative unit are being amended to bring them closer into alignment with the focus of the Surgical Care Improvement Project (SCIP). What intervention most directly addresses the priorities o afbirtbh.ceomS/CteIsPt ? A) Actions aimed at increasing participation of families in planning care B) Actions aimed at preventing surgical site infections C) Actions aimed at increasing interdisciplinary collabaobrirabt.icoomn/test D) Actions aimed at promoting the use of complementary and alternative medicine (CAM) 10. A clinic nurse is conducting a preoperative interview with an adult patient who will soon be scheduled to undergo cardiac surgery. What interview question most directly addresses the patient's safety? A) “What prescription and nonprescription medications do you currently take?” B) “Have you previously been admitted to the hospital, either for surgery or for medical treatment?” C) “How long do you expect to be at home recoveringaabfirtbe.r coymo/tuesrt surgery?” D) “Would you say that you tend to eat a fairly healthy diet?” 11. A circulating nurse provides care in a surgical department that has multiple surgeries scheduled for the day. The nurse should know to monitor which patient most closely during the intraoperative period because of the increased risk for hypothermia? A) A 74-year-old woman with a low body mass index B) A 17-year-old boy with traumatic injuries C) A 45-year-old woman having an abdominal hysterectomy D) A 13-year-old girl undergoing craniofacial surgery 12. An OR nurse is participating in an interdisciplinary audit of infection control practices in the surgical department. The nurse should know that aabbirabs.c iocmg/tues idt eline for maintaining surgical asepsis is what? A) Sterile surfaces or articles may touch other sterile surfaces. B) Sterile supplies can be used on another patient if theabpirab.cckomag/teesst are intact. C) The outer lip of a sterile solution is considered sterile. D) The scrub nurse may pour a sterile solution from a nonsterile bottle. Page 3 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank 13. Verification that all required documentation is completed is an important function of the intraoperative nurse. The intraoperative nurse should confirm that the patient's accompanying documentation includes which of the following? A) Discharge planning B) Informed consent C) Analgesia prescription D) Educational resources 14. The recovery room nurse is admitting a patient from the OR following the patient's successful splenectomy. What is the first assessment thatabtihrbe.c nomu/rtsee st should perform on this newly admitted patient? A) Heart rate and rhythm B) Skin integrity C) Core body temperature D) Airway patency 15. An adult patient is in the recovery room following a nephrectomy performed for the treatment of renal cell carcinoma. The patient's vital signs and level of consciousness stabilized, but the patient then complains of severe nauseaabirabn.cdomb/teegstins to retch. What should the nurse do next? A) Administer a dose of IV analgesic. B) Apply a cool cloth to the patient's forehead. C) Offer the patient a small amount of ice chips. D) Turn the patient completely to one side. 16. The perioperative nurse is preparing to discharge a female patient home from day surgery performed under general anesthetic. What instruction should the nurse give the patient prior to the patient leaving the hospital? A) The patient should not drive herself home. B) The patient should take an OTC sleeping pill for 2 nights. C) The patient should attempt to eat a large meal at home to aid wound healing. D) The patient should remain in bed for the first 48 houar bsirbp.coosmt/otepsterative. Page 4 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank 17. The nurse is caring for a 79-year-old man who has returned to the postsurgical unit following abdominal surgery. The patient is unable to ambulate and is now refusing to wear an external pneumatic compression stocking. The nurse should explain that refusing to wear external pneumatic compression stockinagbisrbi.cnocmr/eteasstes his risk of what postsurgical complication? A) Sepsis B) Infection C) Pulmonary embolism D) Hematoma 18. An adult patient has just been admitted to the PACU following abdominal surgery. As the patient begins to awaken, he is uncharacteristically restless. The nurse checks his skin and it is cold, moist, and pale. The nurse concernedatbhireb.pcoamti/teenstt may be at risk for what? A) Hemorrhage and shock B) Aspiration C) Postoperative infection D) Hypertension and dysrhythmias 19. The nursing instructor is discussing postoperative care with a group of nursing students. A student nurse asks, “Why does the patient go to the PACU instead of just going straight up to the postsurgical unit?” What is the nursing instructor's best response? A) “The PACU allows the patient to recover from anesatbhirebs.c ioami/ntesat stimulating environment to facilitate awakening and reorientation.” B) “The PACU allows the patient to recover from the effects of anesthesia, and the patient stays in the PACU until he or she is orienteda,bhirba.s cosmt/atebs lte vital signs, and is without complications.” C) “Frequently, patients are placed in the medical–surgical unit to recover, but hospitals are usually short of beds, and the PACU is an excellent place to triage patients.” D) “Patients remain in the PACU for a predetermined time because the surgeon will often need to reinforce or alter the patient's incision in the hours following surgery.” 20. The nurse is caring for a patient who is postoperative day 2 following a colon resection. While turning him, wound dehiscence with evisceration aobcircbu.crosm./tWesthat should be the nurse's first response? A) Return the patient to his previous position and call the physician. B) Place saline-soaked sterile dressings on the wound. C) Assess the patient's blood pressure and pulse. D) Pull the dehiscence closed using gloved hands. Page 5 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank 21. The nurse is admitting a patient to the medical–surgical unit from the PACU. What should the nurse do to help the patient clear secretions and help prevent pneumonia? A) Encourage the patient to eat a balanced diet that is high in protein. B) Encourage the patient to limit his activity for the firasbtir7b.2cohmo/tuesrts. C) Encourage the patient to take his medications as ordered. D) Encourage the patient to use the incentive spirometer every 2 hours. 22. A patient underwent an open bowel resection 2 days ago and the nurse's most recent assessment of the patient's abdominal incision reveals that it is dehiscing. What factor should the nurse suspect may have caused the dehiscence ab ?irb.com/test A) The patient's surgical dressing was changed yesterday and today. B) The patient has vomited three times in the past 12 hours. C) The patient has begun voiding on the commode instaebairdb.coofma/tebstedpan. D) The patient used PCA until this morning. 23. The dressing surrounding a mastectomy patient's Jacksonab-P irbr.acottmd/tersatin has scant drainage on it. The nurse believes that the amount of drainage on the dressing may be increasing. How can the nurse best confirm this suspicion? A) Describe the appearance of the dressing in the electraobinrbi.ccohme/taes ltth record. B) Photograph the patient's abdomen for later comparison using a smartphone. C) Trace the outline of the drainage on the dressing for future comparison. D) Remove and weigh the dressing, reapply it, and then repeat in 8 hours. 24. The nurse is caring for an 88-year-old patient who is recovering from an ileac-femoral bypass graft. The patient is day 2 postoperative and has baebierbn.c mome/tnestat lly intact, as per baseline. When the nurse assesses the patient, it is clear that he is confused and has been experiencing disturbed sleep patterns and impaired psychomotor skills. What should the nurse suspect is the problem with the patient? A) Postoperative delirium B) Postoperative dementia C) Senile dementia D) Senile confusion 25. The surgeon's preoperative assessment of a patient has identified that the patient is at a high risk for venous thromboembolism. Once the patient aibsirba.cdomm/itt etsetd to the postsurgical unit, what intervention should the nurse prioritize to reduce the patient's risk of developing this complication? A) Maintain the head of the bed at 45 degrees or highera.birb.com/test B) Encourage early ambulation. C) Encourage oral fluid intake. D) Perform passive range-of-motion exercises every 8 hours. Page 6 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank Page 7 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank Answer Key 1. B 2. C 3. D 4. B 5. B 6. D 7. D 8. A 9. B 10. A 11. A 12. A 13. B 14. D 15. D 16. A 17. C 18. A 19. B 20. B 21. D 22. B 23. C 24. A 25. B Page 8 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank 1. The public health nurse is presenting a health-promotion class to a group at a local community center. Which intervention most directly addresses the leading cause of cancer deaths in North America? A) Monthly self-breast exams B) Smoking cessation C) Annual colonoscopies D) Monthly testicular exams 2. The school nurse is teaching a nutrition class in the local high school. One student states that he has heard that certain foods can increase the incidaebnirbc.ecoomf/tecsat ncer. The nurse responds, “Research has shown that certain foods indeed appear to increase the risk of cancer.” Which of the following menu selections would be the best choice for potentially reducing the risks of cancer? A) Smoked salmon and green beans B) Pork chops and fried green tomatoes C) Baked apricot chicken and steamed broccoli D) Liver, onions, and steamed peas 3. Traditionally, nurses have been involved with tertiary caanbcirebr.copmre/tv esetntion. However, an increasing emphasis is being placed on both primary and secondary prevention. What would be an example of primary prevention? A) Yearly Pap tests B) Testicular self-examination C) Teaching patients to wear sunscreen D) Screening mammograms 4. The nurse is caring for a 39-year-old woman with a family history of breast cancer. She requested a breast tumor marking test and the results have come back positive. As a result, the patient is requesting a bilateral mastectomy. Tahbiis rb.scuomrg/teesrty is an example of what type of oncologic surgery? A) Salvage surgery B) Palliative surgery C) Prophylactic surgery D) Reconstructive surgery Page 1 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank 5. The nurse is caring for a patient who is to begin receiving external radiation for a malignant tumor of the neck. While providing patient education, what potential adverse effects should the nurse discuss with the patient? A) Impaired nutritional status B) Cognitive changes C) Diarrhea D) Alopecia 6. While a patient is receiving IV doxorubicin hydrochloride for the treatment of cancer, the nurse observes swelling and pain at the IV site. The naubirrbs.ecosmh/toeustld prioritize what action? A) Stopping the administration of the drug immediately B) Notifying the patient's physician C) Continuing the infusion but decreasing the rate D) Applying a warm compress to the infusion site 7. A patient newly diagnosed with cancer is scheduled to begin chemotherapy treatment and the nurse is providing anticipatory guidance about potential adverse effects. When addressing the most common adverse effect, what should abtihrbe.conmu/rtesset describe? A) Pruritis (itching) B) Nausea and vomiting C) Altered glucose metabolism D) Confusion 8. A patient on the oncology unit is receiving carmustine, aacbihrbe.c momo/tte hsetrapy agent, and the nurse is aware that a significant side effect of this medication is thrombocytopenia. Which symptom should the nurse assess for in patients at risk for thrombocytopenia? A) Interrupted sleep pattern B) Hot flashes C) Epistaxis (nose bleed) D) Increased weight 9. The nurse is orienting a new nurse to the oncology unit. When reviewing the safe administration of antineoplastic agents, what action should the nurse emphasize? A) Adjust the dose to the patient's present symptoms. B) Wash hands with an alcohol-based cleanser following administration. C) Use gloves and a lab coat when preparing the medication. D) Dispose of the antineoplastic wastes in the hazardouasbirwb.caosmte/tersetceptacle. Page 2 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank 10. A nurse provides care on a bone marrow transplant unit and is preparing a female patient for a hematopoietic stem cell transplantation (HSCT) the following day. What information should the nurse emphasize to the patient's family and friends? A) “Your family should likely gather at the bedside in a cbairsbe.ctohme/trees 'ts a negative outcome.” B) “Make sure she doesn't eat any food in the 24 hours before the procedure.” C) “Wear a hospital gown when you go into the patienat'bsirr bo.coomm/t.e”st D) “Do not visit if you've had a recent infection.” 11. The nurse on a bone marrow transplant unit is caring foraabirpba.ctoimen/tetswt ith cancer who is preparing for HSCT. What is a priority nursing diagnosis for this patient? A) Fatigue related to altered metabolic processes B) Altered nutrition: less than body requirements relateadbirtbo.coamn/oterset xia C) Risk for infection related to altered immunologic response D) Body image disturbance related to weight loss and anorexia 12. An oncology nurse is caring for a patient who has developed erythema following radiation therapy. What should the nurse instruct the patient to do? A) Periodically apply ice to the area. B) Keep the area cleanly shaven. C) Apply petroleum jelly to the affected area. D) Avoid using soap on the treatment area. 13. The nurse is caring for a patient has just been given a 6-month prognosis following a diagnosis of extensive stage small-cell lung cancer. The apbairtbi.ec nomt /stetasttes that he would like to die at home, but the team believes that the patient's care needs are unable to be met in a home environment. What might you suggest as an alternative? A) Discuss a referral for rehabilitation hospital. B) Panel the patient for a personal care home. C) Discuss a referral for acute care. D) Discuss a referral for hospice care. Page 3 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank 14. The clinic nurse is caring for a 42-year-old male oncology patient. He complains of extreme fatigue and weakness after his first week of radiation therapy. Which response by the nurse would best reassure this patient? A) “These symptoms usually result from radiation theraabpiryb.;cohmo/wtesetver, we will continue to monitor your laboratory and x-ray studies.” B) “These symptoms are part of your disease and are an unfortunately inevitable part of living with cancer.” C) “Try not to be concerned about these symptoms. Every patient feels this way after having radiation therapy.” D) “Even though it is uncomfortable, this is a good sign. It means that only the cancer cells are dying.” 15. A 16-year-old female patient experiences alopecia result ainbigrb.fcroomm/tescthemotherapy, prompting the nursing diagnoses of disturbed body image and situational low self-esteem. What action by the patient would best indicate that she is meeting the goal of improved body image and self-esteem? A) The patient requests that her family bring her makeuabpirba.ncodmw/teisgt. B) The patient begins to discuss the future with her family. C) The patient reports less disruption from pain and discomfort. D) The patient cries openly when discussing her diseasaeb.irb.com/test 16. A 50-year-old man diagnosed with leukemia will begin chemotherapy. What would the nurse do to combat the most common adverse effects of acbhirebm.coomt/hteesrtapy? A) Administer an antiemetic. B) Administer an antimetabolite. C) Administer a tumor antibiotic. D) Administer an anticoagulant. 17. An oncology nurse educator is providing health educatio anbitrbo.caomp/atets itent who has been diagnosed with skin cancer. The patient's wife has asked about the differences between normal cells and cancer cells. What characteristic of a cancer cell should the educator cite? A) Malignant cells contain more fibronectin than normal body cells. B) Malignant cells contain proteins called tumor-specific antigens. C) Chromosomes contained in cancer cells are more durable and stable than those of normal cells. D) The nuclei of cancer cells are unusually large, but regularly shaped. Page 4 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank 18. A patient's most recent diagnostic imaging has revealed that his lung cancer has metastasized to his bones and liver. What is the most likely mechanism by which the patient's cancer cells spread? A) Hematologic spread B) Lymphatic circulation C) Invasion D) Angiogenesis 19. A public health nurse has formed an interdisciplinary team that is developing an educational program entitled Cancer: The Risks and WhaabtirYb.ocuomC/teasnt Do About Them. Participants will receive information, but the major focus will be screening for relevant cancers. This program is an example of what type of health promotion activity? A) Disease prophylaxis B) Risk reduction C) Secondary prevention D) Tertiary prevention 20. You are caring for a patient who has just been told that her stage IV colon cancer has recurred and metastasized to the liver. The oncologist offaebr irsb.cthome/tpes attient the option of surgery to treat the progression of this disease. What type of surgery does the oncologist offer? A) Palliative B) Reconstructive C) Salvage D) Prophylactic 21. The nurse is caring for a patient with an advanced stage of breast cancer and the patient has recently learned that her cancer has metastasized. The nurse enters the room and finds the patient struggling to breath and the nurse's rapidabairb s.sceosms/tmeset nt reveals that the patient's jugular veins are distended. The nurse should suspect the development of what oncologic emergency? A) Increased intracranial pressure B) Superior vena cava syndrome (SVCS) C) Spinal cord compression D) Metastatic tumor of the neck Page 5 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank 22. The nurse is admitting an oncology patient to the unit prior to surgery. The nurse reads in the electronic health record that the patient has just finished radiation therapy. With knowledge of the consequent health risks, the nurse should prioritize assessments related to what health problem? A) Cognitive deficits B) Impaired wound healing C) Cardiac tamponade D) Tumor lysis syndrome 23. The hospice nurse has just admitted a new patient to the apbrirobg.croamm/te.sWt hospice care? hat principle guides A) Care addresses the needs of the patient as well as the needs of the family. B) Care is focused on the patient centrally and the famailb yirbp.ceormip/tehs et rally. C) The focus of all aspects of care is solely on the patient. D) The care team prioritizes the patient's physical needs and the family is responsible for the patient's emotional needs. 24. A 60-year-old patient with a diagnosis of prostate cancer is scheduled to have an interstitial implant for high-dose radiation (HDR). What asbairfbe.ctoym m/teestasure should the nurse include in this patient's subsequent plan of care? A) Limit the time that visitors spend at the patient's bedside. B) Teach the patient to perform all aspects of basic care independently. C) Assign male nurses to the patient's care whenever paobsirsbi.bcolme./test D) Situate the patient in a shared room with other patients receiving brachytherapy. 25. An oncology patient has begun to experience skin reactions to radiation therapy, prompting the nurse to make the diagnosis Impaired Skin Integrity: erythematous reaction to radiation therapy. What intervention best addresses this nursing diagnosis? A) Apply an ice pack or heating pad PRN to relieve paainbirab.ncodmp/treustritis B) Avoid skin contact with water whenever possible C) Apply phototherapy PRN D) Avoid rubbing or scratching the affected area Page 6 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank Answer Key 1. B 2. C 3. C 4. C 5. A 6. A 7. B 8. C 9. D 10. D 11. C 12. D 13. D 14. A 15. A 16. A 17. B 18. B 19. C 20. A 21. B 22. B 23. A 24. A 25. D Page 7 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank 1. The nurse who is a member of the palliative care team is assessing a patient. The patient indicates that he has been saving his PRN analgesics until the pain is intense because his pain control has been inadequate. What teaching should the nurse do with this patient? A) Medication should be taken when pain levels are low abirsbo.cotmhe/tepstain is easier to reduce. B) Pain medication can be increased when the pain becomes intense. C) It is difficult to control chronic pain, so this is an ine abviribt.ac bomle/tepsat rt of the disease process. D) The patient will likely benefit more from distraction than pharmacologic interventions. 2. Two patients on your unit have recently returned to the postsurgical unit after knee arthroplasty. One patient is reporting pain of 8 to 9 on a 0ab-itrob.-c1om0/tpeastin scale, whereas the other patient is reporting a pain level of 3 to 4 on the same pain scale. What is the nurse's most plausible rationale for understanding the patients' different perceptions of pain? A) Endorphin levels may vary between patients, affectianbg irb.tchoem/pteesrtception of pain. B) One of the patients is exaggerating his or her sense of pain. C) The patients are likely experiencing a variance in vasoconstriction. D) One of the patients may be experiencing opioid tolearbairnbc.ceo.m/test 3. You are frequently assessing an 84-year-old woman's pain after she suffered a humeral fracture in a fall. When applying the nursing process in paabiirnb.c moman /teasgt ement for a patient of this age, what principle should you best apply? A) Monitor for signs of drug toxicity due to a decrease in metabolism. B) Monitor for an increase in absorption of the drug duaebirtbo.caomge /te-srtelated changes. C) Monitor for a paradoxical increase in pain with opioid administration. D) Administer analgesics every 4 to 6 hours as ordered to control pain. 4. The nurse is assessing a patient's pain while the patient awaits a cholecystectomy. The patient is tearful, hesitant to move, and grimacing. When asked, the patient rates his pain as a 2 at this time using a 0-to-10 pain scale. How shouldabtihrbe.conmu/rtesset best respond to this assessment finding? A) Remind the patient that he is indeed experiencing pain. B) Reinforce teaching about the pain scale number system. C) Reassess the patient's pain in 30 minutes. D) Administer an analgesic and then reassess. Page 1 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank 5. The nurse is caring for a 51-year-old female patient whose medical history includes chronic fatigue and poorly controlled back pain. These medical diagnoses should alert the nurse to the possibility of what consequent health problem? A) Anxiety B) Skin breakdown C) Depression D) Hallucinations 6. Your patient is 12-hours post ORIF right ankle. The patient is asking for a breakthrough dose of analgesia. The pain-medication orders are writtenabairbs.caomco/temstbination of an opioid analgesic and a nonsteroidal anti-inflammatory drug (NSAID) given together. What is the primary rationale for administering pain medication in this manner? A) To prevent respiratory depression from the opioid B) To eliminate the need for additional medication during the night C) To achieve better pain control than with one medication alone D) To eliminate the potentially adverse effects of the opioid 7. The nurse is caring for a patient with metastatic bone cancer. The patient asks the nurse why he has had to keep getting larger doses of his pain mab eidrbi.ccoamti/otenst, although they do not seem to affect him. What is the nurse's best response? A) “Over time you become more tolerant of the drug.” B) “You may have become immune to the effects of the drug.” C) “You may be developing a mild addiction to the druagbi.r”b.com/test D) “Your body absorbs less of the drug due to the cancer.” 8. A 52-year-old female patient is receiving care on the oncology unit for breast cancer that has metastasized to her lungs and liver. When addressing the patient's pain in her plan of nursing care, the nurse should consider what characteristic of cancer pain? A) Cancer pain is often related to the stress of the patieanbtirbk.c noomw/teis ntg she has cancer and requires relatively low doses of pain medications along with a high dose of anti-anxiety medications. B) Cancer pain is always chronic and challenging to treabaitr,b.scoomd/tiessttraction is often the best intervention. C) Cancer pain can be acute or chronic and it typically requires comparatively high doses of pain medications. D) Cancer pain is often misreported by patients becausaebiorbf.ccoomn/tf eustsion related to their disease process. Page 2 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank 9. The nurse caring for a 79-year-old man who has just returned to the medical–surgical unit following surgery for a total knee replacement received report from the PACU. Part of the report had been passed on from the preoperative assessment where it was noted that he has been agitated in the past following opioid admabiinrbi.sctorma/tteiostn. What principle should guide the nurse's management of the patient's pain? A) The elderly may require lower doses of medication and are easily confused with new medications. B) The elderly may have altered absorption and metabolism, which prohibits the use of opioids. C) The elderly may be confused following surgery, which is an age-related phenomenon unrelated to the medication. D) The elderly may require a higher initial dose of pain medication followed by a tapered dose. 10. You are the nurse in a pain clinic caring for an 88-year-old man who is suffering from long-term, intractable pain. At this point, the pain team feels that first-line pharmacological and nonpharmacological methods of pa aibnirbre.c loimef /tehstave been ineffective. What recommendation should guide this patient's subsequent care? A) The patient may want to investigate new alternative pain management options that are outside the United States. B) The patient may benefit from referral to a neurologist or neurosurgeon to discuss pain-management options. C) The patient may want to increase his exercise and activities significantly to create distractions. D) The patient may want to relocate to long-term care in order to have his ADL needs met. 11. You are the home health nurse caring for a homebound client who is terminally ill. You are delivering a patient-controlled analgesia (PCA) pump to the patient at your visit today. The family members will be taking care of the pataibeirnbt.c.oWm/theastt would your priority nursing interventions be for this visit? A) Teach the family the theory of pain management and the use of alternative therapies. B) Provide psychosocial family support during this emotional experience. C) Provide patient and family teaching regarding the operation of the pump, monitoring the IV site, and knowing the side effects of the medication. D) Provide family teaching regarding use of morphine,ab reirbc.ocogmn/itezs itng morphine overdose, and offering spiritual guidance. Page 3 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank 12. The mother of a cancer patient comes to the nurse concerned with her daughter's safety. She states that her daughter's morphine dose that she needs to control her pain is getting “higher and higher.” As a result, the mother is afraid that her daughter will overdose. The nurse educates the mother about what aspect of her pabaiirbn.cmoma/tneastgement? A) The dose range is higher with cancer patients, and the medical team will be very careful to prevent addiction. B) Frequently, female patients and younger patients neaebdirbh.c iogmh/eterstdoses of opioids to be comfortable. C) The increased risk of overdose is an inevitable risk of maintaining adequate pain control during cancer treatment. D) There is no absolute maximum opioid dose and heradbairbu.gcohmte/ters its becoming more tolerant to the drug. 13. You have just received report on a 27-year-old woman who is coming to your unit from the emergency department with a torn meniscus. You review her PRN medications and see that she has an NSAID (ibuprofen) ordered every 6 hours. If you wanted to implement preventive pain measures when the patient araribvirbe.scotmo/tyesotur unit, what would you do? A) Use a pain scale to assess the patient's pain, and let the patient know ibuprofen is available every 6 hours if she needs it. B) Do a complete assessment, and give pain medication based on the patient's report of pain. C) Check for allergies, use a pain scale to assess the patient's pain, and offer the ibuprofen every 6 hours until the patient is discharg aebdir.b.com/test D) Provide medication as per patient request and offer relaxation techniques to promote comfort. 14. An unlicensed nursing assistant (NA) reports to the nurse that a postsurgical patient is complaining of pain that she rates as 8 on a 0-to-10 point scale. The NA tells the nurse that he thinks the patient is exaggerating and does not neaebdirbp.caoimn/tmestedication. What is the nurse's best response? A) “Pain often comes and goes with postsurgical patients. Please ask her about pain again in about 30 minutes.” B) “We need to provide pain medications because it is the law, and we must always follow the law.” C) “Unless there is strong evidence to the contrary, we should take the patient's report at face value.'“ D) “It's not unusual for patients to misreport pain to get our attention when we are busy.” Page 4 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank 15. The home health nurse is developing a plan of care for a patient who will be managing his chronic pain at home. Using the nursing process, on which concepts should the nurse focus the patient teaching? A) Self-care and safety B) Autonomy and need C) Health promotion and exercise D) Dependence and health 16. You are the emergency department (ED) nurse caring for an adult patient who was in a motor vehicle accident. Radiography reveals an ulnar fraacbtiurbr.ceo. mW/tehstat type of pain are you addressing when you provide care for this patient? A) Chronic B) Acute C) Intermittent D) Osteopenic 17. You are the nurse caring for the 25-year-old victim of a motor vehicle accident with a fractured pelvis and a ruptured bladder. The nurse's aide (NA) tells you that she is concerned because the patient's resting heart rate is 110 baebiarbt.scopme/r tes mt inute, her respirations are 24 breaths per minute, temperature is 99.1°F axillary, and the blood pressure is 125/85 mm Hg. What other information is most important as you assess this patient's physiologic status? A) The patient's understanding of pain physiology B) The patient's serum glucose level C) The patient's white blood cell count D) The patient's rating of her pain 18. You are the nurse coming on shift in a rehabilitation unit. You receive information in report about a new patient who has fibromyalgia and hasabdiirbf.fc iocmu/ltetyst with her ADLs. The off-going nurse also reports that the patient is withdrawn, refusing visitors, and has been vacillating between tears and anger all afternoon. What do you know about chronic pain syndromes that could account for your new patient's beha abviribo.cro?m/test A) Fibromyalgia is not a chronic pain syndrome, so further assessment is necessary. B) The patient is likely frustrated because she has to be in the hospital. C) The patient likely has an underlying psychiatric disorder. D) Chronic pain can cause intense emotional responsesa.birb.com/test Page 5 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank 19. A 74-year-old woman was diagnosed with rheumatoid arthritis 1 year ago, but has achieved adequate symptom control through the regular use of celecoxib (Celebrex), a COX-2 selective NSAID. The nurse should recognize that this drug, like other NSAIDs, influences what aspect of the pathophysiology of nocicep abtiirvbe.copma/i tens ?t A) Distorting the action potential that is transmitted along the A-delta () and C fibers B) Diverting noxious information from passing through the dorsal root ganglia and synapses in the dorsal horn of the spinal cord C) Blocking modulation by limiting the reuptake of serotonin and norepinephrine D) Inhibiting transduction by blocking the formation of prostaglandins in the periphery 20. A patient's intractable neuropathic pain is being treated on an inpatient basis using a multimodal approach to analgesia. After administering aarbeircbe.c nomtl/ytes itncreased dose of IV morphine to the patient, the nurse has returned to assess the patient and finds the patient unresponsive to verbal and physical stimulation with a respiratory rate of five breaths per minute. The nurse has called a code blue and should anticipate the administration of what drug? A) Acetylcysteine B) Naloxone C) Celecoxib D) Acetylsalicylic acid 21. The nurse caring for a 91-year-old patient with osteoartharbit iribs.c iosmr/teevstiewing the patient's chart. This patient is on a variety of medications prescribed by different care providers in the community. In light of the QSEN competency of safety, what is the nurse most concerned about with this patient? A) Depression B) Chronic illness C) Inadequate pain control D) Drug interactions 22. You are caring for a patient with sickle cell disease in hearbhirbo.c mome/.teOstver the years, there has been joint damage, and the patient is in chronic pain. The patient has developed a tolerance to her usual pain medication. When does the tolerance to pain medication become the most significant problem? A) When it results in inadequate relief from pain B) When dealing with withdrawal symptoms resulting from the tolerance C) When having to report the patient's addiction to her physician D) When the family becomes concerned about increasianbgirbd.coosma/tgeset Page 6 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank 23. A medical nurse is appraising the effectiveness of a patient's current pain control regimen. The nurse is aware that if an intervention is deemed ineffective, goals need to be reassessed and other measures need to be considered. What is the role of the nurse in obtaining additional pain relief for the patient? A) Primary caregiver B) Patient advocate C) Team leader D) Case manager 24. The nurse is accepting care of an adult patient who has baebeirnb.ceoxmp/teer s itencing severe and intractable pain. When reviewing the patient's medication administration record, the nurse notes the presence of gabapentin (Neurontin). The nurse is justified in suspecting what phenomenon in the etiology of the patient's pain? A) Neuroplasticity B) Misperception C) Psychosomatic processes D) Neuropathy Page 7 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank Answer Key 1. A 2. A 3. A 4. B 5. C 6. C 7. A 8. C 9. A 10. B 11. C 12. D 13. C 14. C 15. A 16. B 17. D 18. D 19. D 20. B 21. D 22. A 23. B 24. D Page 8 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank 1. A patient is having her tonsils removed. The patient asks the nurse what function the tonsils normally serve. Which of the following would be the most accurate response? A) “The tonsils separate your windpipe from your throat when you swallow.” B) “The tonsils help to guard the body from invasion oafboirbr.gcoamn/itsemst s.” C) “The tonsils make enzymes that you swallow and which aid with digestion.” D) “The tonsils help with regulating the airflow down into your lungs.” 2. The nurse is assessing a patient who frequently coughs after eating or drinking. How should the nurse best follow up this assessment finding? A) Obtain a sputum sample. B) Perform a swallowing assessment. C) Inspect the patient's tongue and mouth. D) Assess the patient's nutritional status. 3. The ED nurse is assessing a patient complaining of dyspnea. The nurse auscultates the patient's chest and hears wheezing throughout the lung fi aeblirdbs.c. oWm/thesatt might this indicate? A) The patient has a narrowed airway. B) The patient has pneumonia. C) The patient needs physiotherapy. D) The patient has a hemothorax. 4. The nurse is caring for a patient admitted with an acute eaxbairbc.ecorbma/tteisot n of chronic obstructive pulmonary disease. During assessment, the nurse finds that the patient is experiencing increased dyspnea. What is the most accurate measurement of the concentration of oxygen in the patient's blood? A) A capillary blood sample B) Pulse oximetry C) An arterial blood gas (ABG) study D) A complete blood count (CBC) 5. The nurse is caring for a patient who has returned to the aubniribt.cfoo ml/lto eswt ing a bronchoscopy. The patient is asking for something to drink. Which criterion will determine when the nurse should allow the patient to drink fluids? A) Presence of a cough and gag reflex B) Absence of nausea C) Ability to demonstrate deep inspiration D) Oxygen saturation of 92% Page 1 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank 6. A patient with chronic lung disease is undergoing lung function testing. What test result denotes the volume of air inspired and expired with a normal breath? A) Total lung capacity B) Forced vital capacity C) Tidal volume D) Residual volume 7. In addition to heart rate, blood pressure, respiratory rate, and temperature, the nurse needs to assess a patient's arterial oxygen saturation (SaO2). What procedure will best accomplish this? A) Incentive spirometry B) Arterial blood gas (ABG) measurement C) Peak flow measurement D) Pulse oximetry 8. A patient is undergoing testing to see if he has a pleural eab ffirub.sc ioo mn/t.esWt hich of the nurse's respiratory assessment findings would be most consistent with this diagnosis? A) Increased tactile fremitus, egophony, and a dull sound upon percussion of the chest wall B) Decreased tactile fremitus, wheezing, and a hyperresonant sound upon percussion of the chest wall C) Lung fields dull to percussion, absent breath sounds, and a pleural friction rub D) Normal tactile fremitus, decreased breath sounds, anabdirba.croems/otenstant sound upon percussion of the chest wall 9. The nurse doing rounds at the beginning of a shift notices a sputum specimen in a container sitting on the bedside table in a patient's room. The nurse asks the patient when he produced the sputum specimen and he states that the specimen is about 4 hours old. What action should the nurse take? A) Immediately take the sputum specimen to the laboratory. B) Discard the specimen and assist the patient in obtaining another specimen. C) Refrigerate the sputum specimen and submit it onceabiitrbi.scocmh/tiels let d. D) Add a small amount of normal saline to moisten the specimen. 10. The nurse is assessing a newly admitted medical patient aabnirdb.c noomt/etesstthere is a depression in the lower portion of the patient's sternum. This patient's health record should note the presence of what chest deformity? A) A barrel chest B) A funnel chest C) A pigeon chest D) Kyphoscoliosis Page 2 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank 11. A medical nurse has admitted a patient to the unit with a diagnosis of failure to thrive. The patient has developed a fever and cough, so a sputum specimen has been obtained. The nurse notes that the sputum is greenish and that thereabiirsb.acolma/rtegset quantity of it. The nurse notifies the patient's physician because these symptoms are suggestive of what? A) Pneumothorax B) Lung tumors C) Infection D) Pulmonary edema 12. A patient has been diagnosed with heart failure that has not yet responded to treatment. What breath sound should the nurse expect to assess on auscultation? A) Expiratory wheezes B) Inspiratory wheezes C) Rhonchi D) Crackles 13. While assessing an acutely ill patient's respiratory rate, the nurse assesses four normal breaths followed by an episode of apnea lasting 20 seconadbs irb..Hcoomw/tessthould the nurse document this finding? A) Eupnea B) Apnea C) Biot's respiration D) Cheyne-Stokes 14. While assessing a patient who has pneumonia, the nurse has the patient repeat the letter E while the nurses auscultates. The nurse notes that the patient's voice sounds are distorted and that the letter A is audible instead of the letter E. How should this finding be documented? A) Bronchophony B) Egophony C) Whispered pectoriloquy D) Sonorous wheezes Page 3 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank 15. The clinic nurse is caring for a patient who has been diagnosed with emphysema and who has just had a pulmonary function test (PFT) ordered. The patient asks, “What exactly is this test for?” What would be the nurse's best response? A) “A PFT measures how much air moves in and out oafby irbo.cuorml/utenstgs when you breathe.” B) “A PFT measures how much energy you get from the oxygen you breathe.” C) “A PFT measures how elastic your lungs are.” D) “A PFT measures whether oxygen and carbon dioxide move between your lungs and your blood.” 16. The nurse is performing a respiratory assessment of an adult patient and is attempting to distinguish between vesicular, bronchovesicular, and bronchial (tubular) breath sounds. The nurse should distinguish between these normal breatahbirsbo.cuonmd/tessot n what basis? A) Their location over a specific area of the lung B) The volume of the sounds C) Whether they are heard on inspiration or expiration D) Whether or not they are continuous breath sounds 17. A patient has been diagnosed with pulmonary hypertensiaobnirb,.c inomw/tehs itch the capillaries in the alveoli are squeezed excessively. The nurse should recognize a disturbance in what aspect of normal respiratory function? A) Acid–base balance B) Perfusion C) Diffusion D) Ventilation 18. A patient is scheduled to have excess pleural fluid aspirated with a needle in order to relieve her dyspnea. The patient inquires about the normal function of pleural fluid. What should the nurse describe? A) It allows for full expansion of the lungs within the thoracic cavity. B) It prevents the lungs from collapsing within the thoracic cavity. C) It limits lung expansion within the thoracic cavity. D) It lubricates the movement of the thorax and lungs. 19. The nurse is performing a respiratory assessment of a paatibeirnb.tcowmh/to esthas been experiencing episodes of hypoxia. The nurse is aware that this is ultimately attributable to impaired gas exchange. On what factor does adequate gas exchange primarily depend? A) An appropriate perfusion–diffusion ratio B) An adequate ventilation–perfusion ratio C) Adequate diffusion of gas in shunted blood D) Appropriate blood nitrogen concentration Page 4 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank 20. A gerontologic nurse is analyzing the data from a patient's focused respiratory assessment. The nurse is aware that the amount of respiratory dead space increases with age. What is the effect of this physiological change? A) Increased diffusion of gases B) Decreased diffusion capacity for oxygen C) Decreased shunting of blood D) Increased ventilation 21. A sputum study has been ordered for a patient who has daebvirbe.lcoopme/td estcoarse chest crackles and a fever. At what time should the nurse best collect the sample? A) Immediately after a meal B) First thing in the morning C) At bedtime D) After a period of exercise 22. The ED nurse is assessing the respiratory function of a teenage girl who presented with acute shortness of breath. Auscultation reveals continuous wheezes during inspiration and expiration. This finding is most suggestive what? A) Pleurisy B) Emphysema C) Asthma D) Pneumonia 23. The nurse is caring for a patient who has been scheduledaf boirbr.caomb/rto es ntchoscopy. How should the nurse prepare the patient for this procedure? A) Administer a bolus of IV fluids. B) Arrange for the insertion of a peripherally inserted central catheter. C) Administer nebulized bronchodilators every 2 hoursabuirnb.tciolmth/teesttest. D) Withhold food and fluids for several hours before the test. 24. The nurse is completing a patient's health history with regard to potential risk factors for lung disease. What interview question addresses the most significant risk factor for respiratory diseases? A) “Have you ever been employed in a factory, smeltera,biorbr.c momil /tle?s”t B) “Does anyone in your family have any form of lung disease?” C) “Do you currently smoke, or have you ever smoked?” D) “Have you ever lived in an area that has high levelsaobifrba.ciormp/toeslltution?” Page 5 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank 25. A patient on the medical unit has told the nurse that he is experiencing significant dyspnea, despite that he has not recently performed any physical activity. What assessment question should the nurse ask the patient while preparing to perform a physical assessment? A) “On a scale from 1 to 10, how bad would rate y

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