392302497 Brunner Suddarth Medical Surgical 14th Hinkle Test Bank PDF

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TestBank-Brunner&Suddarth'sTextbookofMedical-SurgicalNursing14e(Hinkle2017)

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Chapter05:AdultHealthandNutritionalAssessment  1.

Aschoolnurseisteachinga14-year-oldgirlofnormalweightsomeofthekeyfactorsnecessaryto maintaingoodnutritioninthisstageofhergrowthanddevelopment.Whatinterventionsshouldthe nursemostlikelyprioritize?

A)

Decreasinghercalorieintakeandencouraginghertomaintainherweighttoavoidobesity

B)

IncreasingherBMI,takingamultivitamin,anddiscussingbodyimage

C)

Increasingcalciumintake,eatingabalanceddiet,anddiscussingeatingdisorders

D)

Obtainingafooddiaryalongwithprovidingclosemonitoringforanorexia

Ans:

C Feedback: Adolescentgirlsareconsideredtobeathighriskfornutritionaldisorders.Increasingcalciumintakeand promotingabalanceddietwillprovidethenecessaryvitaminsandminerals.Ifadolescentsarediagnosed witheatingdisordersearly,therecoverychancesareincreased.Thequestionpresentsnoinformation thatindicatesaneedfordecreasinghercalories.ThereisnoapparentneedforanincreaseinBMI.A fooddiaryisusedforassessingeatinghabits,butthequestionasksforteachingfactorsrelatedtogood nutrition.

2.

Anurseisconductingahealthassessmentofanadultpatientwhenthepatientasks,Whydoyouneedal thishealthinformationandwhoisgoingtoseeit?Whatisthenursesbestresponse?

A)

Pleasedonotworry.Itissafeandwillbeusedonlytohelpuswithyourcare.Itsaccessibletoa widevarietyofpeoplewhoareinvestedinyourhealth.

B)

Itisgoodyouaskedandyouhavearighttoknow;yourinformationhelpsustoprovideyouwith thebestpossiblecare,andyourrecordsareinasecureplace.

C)

YourhealthinformationisplacedonsecureWebsitestoprovideeasyaccesstoanyonewishingto seeyourmedicalrecords.Thisensurescontinuityofcare.

D)

Healthinformationbecomesthepropertyofthehospitalandwewillmakesurethatnooneseesit. Then,in2years,wedestroyallrecordsandtheprocessstartsover.

Ans:

B Feedback:

TestBank-Brunner&Suddarth'sTextbookofMedical-SurgicalNursing14e(Hinkle2017)

Wheneverinformationiselicitedfromapersonthroughahealthhistoryorphysicalexamination,the personhastherighttoknowwhytheinformationissoughtandhowitwillbeused.Forthisreason,itis importanttoexplainwhatthehistoryandphysicalexaminationare,howtheinformationwillbe obtained,andhowitwillbeused.Medicalrecordsallowaccesstohealthcareproviderswhoneedthe informationtoprovidepatientswiththebestpossiblecare,andtherecordsarealwaysheldinasecure environment.Tellingthepatientnottoworryminimizesthepatientsconcernregardingthesafetyofhis orherhealthinformationandawidevarietyofpeopleshouldnothaveaccesstopatientshealth information.HealthinformationshouldnotbeplacedonWebsitesandhealthrecordsarenotdestroyed every2years. 3.

Thenurseisperforminganadmissionassessmentofa72-year-oldfemalepatientwhounderstands minimalEnglish.Aninterpreterwhospeaksthepatientslanguageisunavailableandnomembersofthe careteamspeakthelanguage.Howshouldthenursebestperformdatacollection?

A)

Haveafamilymemberprovidethedata.

B)

Obtainthedatafromtheoldchartandphysiciansassessment.

C)

Obtainthedataonlyfromthepatient,prioritizingaspectsthatthepatientunderstands.

D)

Collectallpossibledatafromthepatientandhavethefamilysupplementmissingdetails.

Ans:

D Feedback: Theinformant,orthepersonprovidingtheinformation,maynotalwaysbethepatient.Thenursecan gaininformationfromthepatientandhavethefamilyprovideanymissingdetails.Thenurseshould alwaysobtainasmuchinformationaspossibledirectlyfromthepatient.Inthiscase,itisnotlikely possibletogetalltheinformationneededonlyfromthepatient.

4.

Youarethenurseassessinga28-year-oldwomanwhohaspresentedtotheemergencydepartmentwith vaguecomplaintsofmalaise.Younotebruisingtothepatientsupperarmthatcorrespondtotheoutline offingersaswellasyellowbruisingaroundherlefteye.Thepatientmakesminimaleyecontactduring theassessment.Howmightyoubestinquireaboutthebruising?

A)

Isanyonephysicallyhurtingyou?

B)

Tellmeaboutyourrelationships.

C)

Doyouwanttoseeasocialworker?

D)

Istheresomethingyouwanttotellme?

Ans:

A Feedback:

TestBank-Brunner&Suddarth'sTextbookofMedical-SurgicalNursing14e(Hinkle2017)

Fewpatientswilldiscussthetopicofabuseunlesstheyaredirectlyasked.Therefore,itisimportantto askdirectquestions,suchas,Isanyonephysicallyhurtingyou?Theotheroptionsareincorrectbecause theyarenotthebestwaytoillicitinformationaboutpossibleabuseinadirectandappropriatemanner. 5.

Youarethenurseperformingahealthassessmentofanadultmalepatient.Themanstates,Thedoctor hasalreadyaskedmeallthesequestions.Whyareyouaskingthemalloveragain?Whatisyourbest response?

A)

Thishistoryhelpsusdeterminewhatyourneedsmaybefornursingcare.

B)

Youareright;thismayseemredundantandImsurethatitsfrustratingforyou.

C)

Iwanttomakesureyourdoctorhascoveredeverythingthatsimportantforyourtreatment.

D)

Iamamemberofyourhealthcareteamandwewanttomakesurethatnothingfallsthroughthe cracks.

Ans:

A Feedback: Regardlessoftheassessmentformatused,thefocusofnursesduringdatacollectionisdifferentfrom thatofphysiciansandotherhealthteammembers.Explainingtothepatientthepurposeofthenursing assessmentcreatesabetterunderstandingofwhatthenursedoes.Italsogivesthepatientanopportunity toaddhisorherowninputintothepatientscareplan.Thenurseshouldaddressthepatientsconcerns directlyandavoidcastingdoubtonthethoroughnessofthephysician.

6.

Youaretakingahealthhistoryonanadultpatientwhoisnewtotheclinic.Whileperformingyour assessment,thepatientinformsyouthathermotherhastype1diabetes.Whatistheprimarysignificance ofthisinformationtothehealthhistory?

A)

Thepatientmaybeatriskfordevelopingdiabetes.

B)

Thepatientmayneedteachingontheeffectsofdiabetes.

C)

Thepatientmayneedtoattendasupportgroupforindividualswithdiabetes.

D)

Thepatientmaybenefitfromadietaryregimenthattracksglucoseintake.

Ans:

A Feedback: Nursesincorporateageneticsfocusintothehealthassessmentsoffamilyhistorytoassessforgeneticsrelatedriskfactors.Theinformationaidsthenurseindeterminingifthepatientmaybepredisposedto

TestBank-Brunner&Suddarth'sTextbookofMedical-SurgicalNursing14e(Hinkle2017)

diseasesthataregeneticinorigin.Theresultsofdiabetestestingwoulddeterminewhetherdietary changes,supportgroupsorhealtheducationwouldbeneeded. 7.

Aregisterednurseisperformingtheadmissionassessmentofa37-year-oldmanwhowillbetreatedfor pancreatitisonthemedicalunit.Duringthenursingassessment,thenurseasksthepatientquestions relatedtohisspirituality.Whatistheprimaryrationaleforthisaspectofthenursesassessment?

A)

Thepatientsspiritualenvironmentcanaffecthisphysicalactivity.

B)

Thepatientsspiritualenvironmentcanaffecthisabilitytocommunicate.

C)

Thepatientsspiritualenvironmentcanaffecthisqualityofsexualrelationships.

D)

Thepatientsspiritualenvironmentcanaffecthisresponsetoillness.

Ans:

D Feedback: Illnessmaycauseaspiritualcrisisandcanplaceconsiderablestressesonapersonsinternalresources. Thetermspiritualenvironmentreferstothedegreetowhichapersonhascontemplatedhisorherown existence.Theotherlistedoptionsmayberight,buttheyarenotthemostimportantreasonsforanurse toassessapatientsspiritualenvironment.

8.

Anurseonamedicalunitisconductingaspiritualassessmentofapatientwhoisnewlyadmitted.Inthe courseofthisassessment,thepatientindicatesthatshedoesnoteatmeat.Whichofthefollowingisthe mostlikelysignificanceofthispatientsstatement?

A)

Thepatientdoesnotunderstandtheprinciplesofnutrition.

B)

Thisisanaspectofthepatientsreligiouspractice.

C)

ThisconstitutesanursingdiagnosisofRiskforImbalancedNutrition.

D)

Thisisanexampleofthepatientscopingstrategies.

Ans:

B Feedback: Becausethisdatumwasobtainedduringaspiritualassessment,itcouldbethatthisisanaspectofthe patientsreligiouspractice.Itisindeedapersonalchoice,butthisisnottheprimarysignificanceofthe statement.Thispracticemaynotberelatedtohealth-seekingifitisinfactareligiouspractice.Thisdoes notnecessarilyconstituteariskformalnutritionoramisunderstandingofnutrition.

9.

Youarebeginningyourshiftonamedicalunitandareperformingassessmentsappropriatetoeach patientsdiagnosisandhistory.Whenassessingapatientwhohasanacutestaphylococcalinfection,what

TestBank-Brunner&Suddarth'sTextbookofMedical-SurgicalNursing14e(Hinkle2017)

isthemosteffectivetechniqueforassessingthelymphnodesofthepatientsneck? A)

Inspection

B)

Auscultation

C)

Palpation

D)

Percussion

Ans:

C Feedback: Palpationisapartoftheassessmentthatallowsthenursetoassessabodypartthroughtouch.Many structuresofthebody(superficialbloodvessels,lymphnodes,thyroidgland,organsoftheabdomen, pelvis,andrectum),althoughnotvisible,maybeassessedthroughthetechniquesoflightanddeep palpation.Theotheroptionsareincorrectbecauselymphnodesarenotassessedthroughinspection, auscultation,orpercussion.

10. Inyourroleasaschoolnurse,youareworkingwithafemalehighschooljuniorwhoseBMIis31.When planningthisgirlscare,youshouldidentifywhatgoal? A)

Continuationofcurrentdietandactivitylevel

B)

Increaseinexerciseandreductionincalorieintake

C)

Possiblereferraltoaneatingdisorderclinic

D)

Increaseindailycalorieintake

Ans:

B Feedback: ABMIof31isconsideredclinicallyobese;dietaryandexercisemodificationswouldbeindicated. PeoplewhohaveaBMIlowerthan24(orwhoare80%orlessoftheirdesirablebodyweightforheight) areatincreasedriskforproblemsassociatedwithpoornutritionalstatus.ThosewhohaveaBMIof25to 29.9areconsideredoverweight;thosewithaBMIof30orgreaterareconsideredtobeobese.

11. Duringyourintegumentaryassessmentofanadultfemalepatient,younotethatthepatienthasdry,dull, brittlehairanddry,flakyskinwithpoorturgor.Whenplanningthispatientsnursingcare,youshould prioritizeinterventionsthataddresswhatproblem? A)

Inadequatephysicalactivity

TestBank-Brunner&Suddarth'sTextbookofMedical-SurgicalNursing14e(Hinkle2017)

B)

Ineffectivepersonalhygiene

C)

Deficientnutritionalstatus

D)

Exposuretoenvironmentaltoxins

Ans:

C Feedback: Signsofpoornutritionincludedry,dull,brittlehairanddry,flakyskinwithpoorturgor.Thesefindings donotindicatealackofphysicalactivity,poorpersonalhygiene,ordamagefromanenvironmental cause.

12. Ahomecarenurseisteachingmeal-planningtoapatientssonwhoiscaringforhismotherduringher recoveryfromhipreplacementsurgery.Whichofthefollowingmealsindicatesthatthesonunderstands theconceptofnutrition,basedontheU.S.DepartmentofAgriculturesMyPlate? A)

Cheeseburger,carrotsticks,andmushroomsoupwithwholewheatcrackers

B)

Spaghettiandmeatsaucewithgarlicbreadandasalad

C)

Chickenandpepperstirfryonabedofrice

D)

Hamsandwichwithtomatoonryebreadwithpeachesandyogurt

Ans:

D Feedback: ThismenuhasachoicefromeachofthefoodgroupsidentifiedinMyPlate:grains,vegetables,fruits, dairy,andprotein.Theotherselectionsareincompletechoices.

13. Youareassessingan80-year-oldpatientwhohaspresentedbecauseofanunintendedweightlossof10 poundsoverthepast8weeks.Duringtheassessment,youlearnthatthepatienthasill-fittingdentures andalimitedintakeofhigh-fiberfoods.Youwouldbeawarethatthepatientisatriskforwhatproblem? A)

Constipation

B)

Deficientfluidvolume

C)

Malabsorptionofnutrients

D)

Excessiveintakeofconveniencefoods

TestBank-Brunner&Suddarth'sTextbookofMedical-SurgicalNursing14e(Hinkle2017)

Ans:

A Feedback: Patientswithill-fittingdenturesareatapotentialriskforaninadequateintakeofhigh-fiberfoods.The elderlyarealreadyatanincreasedriskforconstipationbecauseofotherdevelopmentalfactorsandthe potentialforadecreasedactivitylevel.Ill-fittingdenturesdonotputapatientatriskfordehydration, malabsorptionofnutrients,orarelianceonconveniencefoods.

14. Youareteachinganutritioneducationclassthatisbeingheldforagroupofolderadultsatasenior center.Whenplanningyourteaching,youshouldbeawarethatindividualsatthispointinthelifespan havewhichofthefollowing? A)

Adecreasedneedforcalcium

B)

Anincreasedneedforglucose

C)

Anincreasedneedforsodium

D)

Adecreasedneedforcalories

Ans:

D Feedback: Theolderadulthasadecreasedmetabolism,andabsorptionofnutrientshasdecreased.Theolderadult hasanincreasedneedforsoundnutritionbutadecreasedneedforcalories.Theotheroptionsare incorrectbecausethereisnodecreasedneedforcalciumandnoincreasedneedforeitherglucoseor sodium.

15. Youaretheemergencydepartmentnurseobtainingahealthhistoryfromapatientwhohasearliertold thetriagenursethatsheisexperiencingintermittentabdominalpain.Whatquestionshouldyouaskto elicittheprobablereasonforthevisitandidentifyherchiefcomplaint? A)

Whydoyouthinkyourabdomenispainful?

B)

Whereexactlyisyourabdominalpainandwhendiditstart?

C)

Whatbringsyoutothehospitaltoday?

D)

Whatiswrongwithyoutoday?

Ans:

C Feedback:

TestBank-Brunner&Suddarth'sTextbookofMedical-SurgicalNursing14e(Hinkle2017)

Thechiefcomplaintshouldclearlyaddresswhathasbroughtthepatienttoseethehealthcareprovider; anopen-endedquestionbestservesthispurpose.ThequestionWhatbringsyoutothehospital?allows thepatientsufficientlatitudetoprovideananswerthatexpressesthepriorityissue.Focusingsolelyon abdominalpainwouldbetoospecifictoserveasthefirstquestionregardingthechiefcomplaint. Asking,Whatiswrongwithyoutoday?isanopen-endedquestionbutstilldirectsthepatienttowardthe factthatthereisaproblem. 16. YouarethenursecaringforapatientwhoisNativeAmericanwhoarrivesattheclinicfortreatment relatedtotype2diabetes.Whichquestionwouldbestprovideyouwithinformationabouttheroleof foodinthepatientsculturalpracticesandidentifyhowthepatientsfoodpreferencescouldberelatedto hisproblem? A)

Doyoufeelanyofyourculturalpracticeshaveanegativeimpactonyourdiseaseprocess?

B)

Whattypesoffoodsareservedasapartofyourculturalpractices,andhowaretheyprepared?

C)

Asanonnative,Iamunawareofyourculturalpractices.Couldyouteachmeafewpracticesthat mayaffectyourcare?

D)

Tellmeaboutfoodsthatareimportantinyourcultureandhowyoufeeltheyinfluenceyour diabetes.

Ans:

D Feedback: Thebeliefsandpracticesthathavebeensharedfromgenerationtogenerationareknownasculturalor ethnicpatterns.Foodplaysasignificantroleinbothculturalpracticesandtype2diabetes.Byaskingthe question,Tellmeaboutthefoodsthatareimportantinyourcultureandhowyoufeeltheyinfluence yourdiabetes,thenursedemonstratesaculturalawarenesstotheclientandallowsanopen-ended discussionofthediseaseprocessanditsrelationshiptoculturalpractice.Anoveremphasisonnegatives caninhibitassessmentandcommunication.Assessingthetypesandpreparationoffoodsspecificto culturalpracticeswithoutrelatingittodiabetesisinadequate.Thequestion,Asanonnative,Iam unawareofyourculturalpractices.Couldyouteachmeafewpracticesthatmayaffectyourcare? focusesoncareandfailstoaddressthesignificanceoffoodinculturalpracticeordiabetes.

17. An89-year-oldmalepatientiswheelchairboundfollowingahemorrhagicstrokeandhasbeenlivingin anursinghomesinceleavingthehospital.Hereturnstotheadjacentprimarycareclinicbywheelchair forfollow-upcareofhypertensionandotherhealthproblems.Thenursewouldmodifyhishealthhistory toincludewhichquestion? A)

Tellmeaboutyourmedications:Howdoyouusuallygetthemeachday?

B)

Tellmeaboutwhereyoulive:Doyoufeelyourneedsarebeingmet,anddoyoufeelsafe?

C)

Yourwheelchairwouldseemtolimityourabilitytomovearound.Howdoyoudealwiththat?

D)

Whatlimitationsareyoudealingwithrelatedtoyourhealthandbeinginawheelchair?

TestBank-Brunner&Suddarth'sTextbookofMedical-SurgicalNursing14e(Hinkle2017)

Ans:

B Feedback: Thequestion,Tellmeaboutwhereyoulive:Doyoufeelyourneedsarebeingmetanddoyoufeelsafe? seekstoexplorethespecificissueofthesafetyinthehomeenvironment.Peoplewhoareolder,havea disability,andliveinthecommunitysettingareatagreaterriskforabuse.Anexplicitfocuson limitationsmaybecounterproductive.

18. A30-year-oldmanisintheclinicforayearlyphysical.Hestates,Ifoundoutthattwoofmyuncleshad heartattackswhentheywereyou...