Brunner Test Bank 15th Edition: Textbook of Medical Surgical Nursing Updated 2024

Brunner Test Bank 15th Edition: Textbook of Medical Surgical Nursing Chapter 3 Health Education and Health Promotion 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, ìWhy do you need all this health information and who is going to see it?î What is the nurse's best response? A) ìPlease do not worry. It is safe and will be used only to help us with your care. It's accessible to a wide variety of people who are invested in your health.î B) ìIt 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.î C) ìYour 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.î D) ìHealth 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.î Ans: B Feedback: 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 ìnot to worryî minimizes the patient's concern regarding the safety of his or her health information and ìa wide variety of peopleî 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 patient's 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 physician's 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 patient's 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) ìIs anyone physically hurting you?î B) ìTell me about your relationships.î C) ìDo you want to see a social worker?î D) ìIs there something you want to tell me?î Ans: A Feedback: Few patients will discuss the topic of abuse unless they are directly asked. Therefore, it is important to ask direct questions, such as, ìIs anyone physically hurting you?î 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, ìThe doctor has already asked me all these questions. Why are you asking them all over again?î What is your best response? A) ìThis history helps us determine what your needs may be for nursing care.î B) ìYou are right; this may seem redundant and I'm sure that it's frustrating for you.î C) ìI want to make sure your doctor has covered everything that's important for your treatment.î D) ìI am a member of your health care team and we want to make sure that nothing falls through the cracks.î 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 patient's care plan. The nurse should address the patient's 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 genetics-related risk factors. The information aids the nurse in determining if the patient may be predisposed to 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 nurse's assessment? A) The patient's spiritual environment can affect his physical activity. B) The patient's spiritual environment can affect his ability to communicate. C) The patient's spiritual environment can affect his quality of sexual relationships. D) The patient's spiritual environment can affect his response to illness. Ans: D Feedback: Illness may cause a spiritual crisis and can place considerable stresses on a person's 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 patient's 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 patient's statement? A) The patient does not understand the principles of nutrition. B) This is an aspect of the patient's religious practice. C) This constitutes a nursing diagnosis of Risk for Imbalanced Nutrition. D) This is an example of the patient's coping strategies. Ans: B Feedback: Because this datum was obtained during a spiritual assessment, it could be that this is an aspect of the patient's 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 patient's diagnosis and history. When assessing a patient who has an acute staphylococcal infection, what is the most effective technique for assessing the lymph nodes of the patient's 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 girl's 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