Foundations and Adult Health Nursing Cooper 7e SM Cooper and Gosnell: Foundations and Adult Health Nursing, 7th Edition. Answer Keys - Critical Thinking Question.

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Foundations and Adult Health Nursing Cooper 7e SM . Chapter 01: The Evolution of Nursing Answer Keys - Open Book Quizzes 1. Bellevue Hospital School of Nursing in New York, Connecticut Traini... ng School in New Haven, and Boston Training School at Massachusetts General Hospital. 2. The nursing practice is affected by the following societal factors: demographics of population, women’s health care issues, men in nursing, rising numbers of persons with fewer socioeconomic advantages seeking health care, and bioterrorism threats. 3. These two organizations set standards for practical/vocational nursing practice, promote and protect the interests of LPN/LVNs, and educate and inform the general public about practical/vocational nursing. 4. An approved program is one that meets the minimum standards set by the respective state agency responsible for overseeing educational programs. Accreditation is a higher standard, which signifies that the accrediting organization has judged that a program has met its preestablished criteria. 5. Articulation is a procedure that allows nursing programs to work together to plan their curricula to decrease duplication of learning experiences. 6. The major goal of the health care system is to achieve optimal levels of health care for a defined population through adequate and appropriate health care services. 7. Holistic medicine is an approach to patient care that considers all factors such as the physical, emotional, social, economic, and spiritual needs of a person. 8. The term technologist refers to those who have a baccalaureate degree, whereas the term technician refers to those who have an associate degree or less. 9. Rising health care costs, our aging population, advancement of technology, health care insurance, malpractice insurance, and a significant number of people without health care. 10. Being a responsible and accountable, and an effective member of the health care team; maintaining a current license; practicing within the scope of the nurse practice act; practicing under the supervision of a medical physician, registered nurse, osteopathic physician, or dentist; meeting patient needs; maintaining professional appearance; promoting and maintaining health; preventing disease and encouraging rehabilitation; performing within legal and ethical parameters; participating in professional activities; and assisting in development of the role of the LPN/LVN of tomorrow. Chapter 07: Asepsis and Infection Control Nursing Care Plan 7-1: The Patient with an Infection 1. Mr. R. has a peripheral IV infusing and reports discomfort at the site of insertion. What should the nurse do? site. 2. Mr. R. has a urinary catheter connected to continuous drainage. He reports burning at the site of insertion and the nurse notes dark, concentrated urine in the tubing. What should the nurse do next? 3. The nurse notes on the sheet of laboratory results for Mr. R. that his WBC count is 524. Why is this a concern, and what is recommended as a precautionary measure? Chapter 8: Body Mechanics and Patient Mobility Nursing Care Plan 8-1: The Patient with Activity Intolerance 1. The nurse is in the process of transferring Mr. D. from his bed to a chair using a mechanical lift. The nurse has prepared the chair and placed it near the bed. The nurse turns Mr. D. to his side, places the sling under Mr. D. to ensure adequate support of his head, returns Mr. D. to his back, and slowly begins to lift Mr. D. from his bed. What has the nurse forgotten to do, and why is it important? 2. The patient has a trapeze bar across the bed, trochanter rolls, and a footboard. Explain the rationale for each of these devices in maintaining proper body alignment. Chapter 9: Hygiene and Care of the Patient’s Environment Nursing Care Plan 9-1: The Patient Needing Skin Care 1. Mr. P. has a poor appetite and his chemistry profile reveals low protein, low albumin, and a low anion gap (A/G) ratio. Explain why poor nutrition predisposes the patient to impairment of skin integrity and poor tissue healing. Proteins, which are synthesized by the liver, are required for tissue repair and proper immune system function. The only source of proteins is through dietary intake. If a patient is undernourished, he will be unable to produce adequate protein for metabolic processes, such as tissue repair and healing, and fighting infection. 2. With Mr. P.’s history of diarrhea, explain the possible complication that could evolve if dry, intact skin develops an open lesion. Chapter 10: Safety Nursing Care Plan 10-1: Patient Safety 1. The nurse walking down the hall hears a patient calling out for help. The nurse assesses the situation and realizes that the patient does not remember how to use the call light. What factors could contribute to the patient’s inability to remember, and how should the nurse teach the patient to use the call bell? 2. The nurse enters the patient’s room to answer the call bell and sees the patient frantically pointing to the trash can next to the bed. The nurse smells smoke and sees small flames. What can be done to help prevent fires, and what should the nurse do in this situation? Chapter 15: Specimen Collection and Diagnostic Testing Nursing Care Plan 15-1: Specimen Collection or Diagnostic Examination 1. A male patient has been very quiet during his morning care. When you attempt a conversation, he is obviously not interested. What is a way the nurse might initiate a conversation to encourage him to relate his concerns regarding his upcoming bronchoscopy? 2. The patient is scheduled for an intravenous pyelogram (IVP). During the nurse’s preparation of this patient, he remarks that he once had a reaction while eating shellfish. What should the nurse do next? 3. The patient is obviously quite anxious about his upcoming magnetic resonance imaging (MRI) scan. He breaks out in a cold sweat, is breathing rapidly, and when assessing his pulse the nurse notes tachycardia. How should the nurse respond to this patient? Chapter 15: Specimen Collection and Diagnostic Testing Nursing Care Plan 15-1: Specimen Collection or Diagnostic Examination 1. A male patient has been very quiet during his morning care. When you attempt a conversation, he is obviously not interested. What is a way the nurse might initiate a conversation to encourage him to relate his concerns regarding his upcoming bronchoscopy? 2. The patient is scheduled for an intravenous pyelogram (IVP). During the nurse’s preparation of this patient, he remarks that he once had a reaction while eating shellfish. What should the nurse do next? 3. The patient is obviously quite anxious about his upcoming magnetic resonance imaging (MRI) scan. He breaks out in a cold sweat, is breathing rapidly, and when assessing his pulse the nurse notes tachycardia. How should the nurse respond to this patient? Chapter 16: Care of Patients Experiencing Urgent Alterations in Health Nursing Care Plan 16-1: The Patient with a Laceration 1. Ms. T.’s wound was superficial. In contrast, what would be the nurse’s actions if the wound appeared to be deep or was spurting blood? 2. What safety measures are indicated to ensure Ms. T. is not injured again? Chapter 17: Complementary and Alternative Therapies Nursing Care Plan 17-1: The Patient Using Complementary and Alternative Therapies 1. Ms. L. complains of feeling fatigued and tense. List some nonpharmacologic methods of bringing about a state of physical and mental tranquility that may be helpful. Why might each of these methods be helpful for Ms. L.? 2. Ms. L. turns on her light and she is crying. She complains of feeling helpless and inadequate to assume responsibility for caring for her children and husband when she is discharged. What are some therapeutic interventions that will promote her feelings of stability and validation of her anxiety? Chapter 18: Pain Management, Comfort, Rest, and Sleep Nursing Care Plan 18-1: The Patient with Chronic Pain 1. During the morning ADLs, Mr. J. states, “I feel so useless. I can’t even place the urinal for myself.” What would be the nurse’s most therapeutic response? 2. What would be the most useful nursing intervention to achieve the goal of reduced pain during Mr. J.’s assisted ambulation? 3. Which comfort measures could the nurse perform to ensure that Mr. J. has several hours of restorative sleep? 4. Mr. J. complains of his eyes burning and feeling dry and the lights annoying him. What measures are most likely to help relieve his symptoms? Chapter 24: Loss, Grief, Dying, and Death Nursing Care Plan 24-1: The Patient Experiencing Complicated Grieving (Unresolved Grief) 1. Ms. S. is admitted to the medical unit for severe weakness, weight loss, and chronic depression. She is reluctant to get out of bed to dress and have meals. How could the nurse facilitate progression through the grieving process? 2. Ms. S. appears thin, with poor tissue turgor. How could the nurse and dietitian encourage improvement of her nutritional status? 3. The nursing assessment for Ms. S. revealed a flat affect, little verbalization, and poor personal hygiene. Which therapeutic nursing interventions would help achieve patient goals/expected outcomes? Nursing Care Plan 10-2: The Patient Facing Death 1. Ms. B. complains of severe bone pain and nausea. She appears cachexic and extremely weak. What are some nursing interventions to decrease Ms. B.’s symptoms? 2. “I want to go home to die. I don’t want to stay in the hospital. All I want to do is go home and be with my family,” says Ms. B. How can the hospice team most beneficially assist the patient? 3. When the nurse enters Ms. B.’s room to begin ADLs, she notes the patient’s extreme fatigue and lethargy. What are some nursing interventions to conserve Ms. B.’s strength? Chapter 25: Health Promotion and Pregnancy Nursing Care Plan 25-1: The Patient with a Normal Pregnancy 1. How should the nurse respond to Ms. P. if she expresses concern about her dietary practices and their effect on her baby? What suggestions can the nurse give her to ensure that her diet is adequate to support the pregnancy? 2. Ms. P. states that she is concerned about having to reduce her activity schedule, particularly tennis, which she enjoys. She is worried she will begin to resent her baby because of the need to alter her activities. How should the nurse respond to her concerns? What suggestions should the nurse give her? Chapter 26: Labor and Delivery Nursing Care Plan 26-1: The Patient with Spontaneous Rupture of Membranes 1. Ms. G.’s labor is progressing normally with continuous monitoring. Suddenly the fetal heart rate drops to 90 bpm with late decelerations with each contraction. What should the nurse do now? Explain the reason for these actions. 2. Ms. G. and her coach have been working well together to manage her labor, using a focal point, breathing techniques, and guided imagery. Suddenly she becomes irritable and tells her coach, “Don’t touch me!” Her coach is bewildered by this change in behavior. How should the nurse explain Ms. G.’s behavior to her coach? How can the nurse help the coach continue to be effective during this time? Chapter 27: Care of the Mother and Newborn Nursing Care Plan 27-1: The Mother with a Newborn 1. Even though Baby C. is nursing well at each feeding, Ms. P. is anxious about her ability to successfully breastfeed. She asks how she will know whether Baby C. is getting enough breast milk and whether she should supplement with formula, juice, or cereal. How should the nurse answer her? 2. A Gomco circumcision is performed on Baby C. After the procedure is completed, Baby C. is returned to his mother’s room. What do you tell Ms. P. in response to her questions regarding diaper changes and care of the circumcision? How should the nurse describe the expected appearance of the circumcised penis? Chapter 31: Care of the Child with a Physical and Mental or Cognitive Disorder Nursing Care Plan 31-1: The Child with a Congenital Heart Disease 1. The nurse enters Baby D.’s room and notices her mother sitting at her bedside crying. She states, “I don’t know how I will deal with her having heart surgery.” What would be an appropriate initial response to Ms. B.? 2. Ms. B. states that D. has a very poor appetite. What might be two helpful suggestions to educate the mother? 3. Ms. B. mentions that she is concerned Baby D. will get an infection and become acutely ill. What are two therapeutic nursing interventions for patient teaching? Nursing Care Plan 31-2: The Child Who Attempts Suicide 1. Upon entering the patient S.’s room, the nurse notices that she is crying. She states, “I can’t live without my mother, I want to be with her.” What is an appropriate initial response? 2. Patient S.’s father is concerned about taking his daughter home after discharge. What are two therapeutic nursing interventions for patient and family teaching? 3. Patient S. begins to express interest in others and unit activities. What nursing interventions would be appropriate to encourage her? Chapter 34: Care of the Patient with a Psychiatric Disorder Nursing Care Plan 34-1: The Patient with Depression 1. Mr. W. is admitted to the psychiatric unit and placed on suicidal precautions. Mr. W. sits stoically staring out the window and does not respond to the nurse’s greeting. What safety interventions should the team incorporate into Mr. W.’s care while in suicide precautions? 2. Mr. W. sleeps poorly, approximately 2 to 3 hours a night. What therapeutic interventions should be used to correct his sleep pattern disturbance? 3. Mr. W. has had a weight loss of 32 lb. What are some options for the staff to help Mr. W. meet adequate nutritional requirements? Chapter 35: Care of the Patient with an Addictive Personality Nursing Care Plan 35-1: The Patient Who Abuses Alcohol 1. During Mr. J.’s assessment, the nurse notes that he has tremors, is agitated, and verbalizes visual hallucinations. What therapeutic interventions are appropriate to perform to prevent injury to the patient? 2. As Mr. J.’s physical condition improves, he discloses his hopelessness and lack of desire to continue living. What would be an appropriate response by the nurse? 3. During group therapy, Mr. J. states, “Now that I am physically better, I know I will be able to stop drinking. I don’t need any help. There really isn’t anything wrong with me.” What is the appropriate staff intervention at this time? Chapter 38: Rehabilitation Nursing Nursing Care Plan 38-1: The Patient with Spinal Cord Injury 1. Describe the stimuli or precipitating factors associated with bowel functioning or management that have potential to cause autonomic dysreflexia and the appropriate interventions if it does occur. 2. A patient is a C-5 quadriplegic. How is it possible to lessen the patient’s potential for developing orthostatic hypotension? 3. While explaining orthostatic hypotension to a new UAP, what commonly occurring signs and symptoms should the nurse describe, and what instructions should be given to the UAP? Nursing Care Plan 38-2: The Patient with Traumatic Brain Injury 1. Deficits with socialization, motivation, and sexual behaviors seen after brain injury are a result of damage to which portion of the brain? Discuss appropriate nursing interventions for a patient with this type of injury. 2. A patient recovering from a traumatic brain injury has problems telling the difference between objects that have a similar shape. What is this type of deficit, and what nursing interventions are appropriate for a patient with this deficit? 3. What interventions are most appropriate to begin establishing communication with a patient who is just emerging from a coma following a brain injury? Chapter 39: Hospice Care Nursing Care Plan 39-1: The Hospice Patient with Metastatic Prostate Cancer 1. Mr. B.’s wife complains to the hospice nurse that her husband has not had a bowel movement in 3 days. What would be included in an appropriate nursing intervention that would provide relief for Mr. B.? 2. The nurse notes that Mr. B. is restless and notes dyspnea. She performs an oximetry check on Mr. B. and notes an 83% oxygen saturation. List three nursing interventions to improve his respiratory distress. Chapter 41: Care of the Surgical Patient Nursing Care Plan 41-1: The Postoperative Patient 1. On the second postoperative day, Mr. S. is taking shallow breaths and having difficulty complying with coughing and deep breathing. His temperature is 101.8° F (38.8° C), and he has adventitious breath sounds bilaterally in the bases. What should be included in the respiratory assessment completed on Mr. S? What nursing interventions may be performed to assist Mr. S. 2. In his third postoperative day Mr. S. has an erythematous incision with moderate amounts of purulent exudate from the Penrose drain site. List the correct nursing interventions. 3. What signs and symptoms would the nurse note when assessing Mr. S. for dehydration secondary to elevated temperature and decreased fluid intake? Chapter 42: Care of the Patient with an Integumentary Disorder Nursing Care Plan 42-1: The Patient with Herpes Zoster 1. Ms. L. turns on her call light. She is crying and states that she is in severe pain. She describes the pain as a burning, stabbing pain over her left forehead and eye. She rates her pain at a 7 on the pain scale of 0 to 10. She also complains of pruritus. What would be the most appropriate nursing interventions to provide comfort and pain control for Ms. L.? 2. Ms. L. tells the nurse that a friend told her she could not visit because she has not had chickenpox. Her friend is afraid she might “catch chickenpox” from Ms. L.’s shingles. Give the accurate patient teaching in response to Ms. L.’s statements. Nursing Care Plan 42-2: The Patient with Systemic Lupus Erythematosus 1. Ms. T. has painful, edematous joints that greatly decrease her mobility. She has 4+ pitting edema of the lower extremities secondary to the loss of protein through her kidney. What are the most appropriate nursing interventions to decrease Ms. T.’s pain level and to increase her mobility? 2. On entering the room, the nurse notes Ms. T is crying. She verbalizes that her lifestyle is severely altered because she is unable to be in the sun to work in her beloved garden. What nursing interventions would be most beneficial? 3. Ms. T. confides that she fears this severe increase in her symptoms will lead to an early death. What initial response to this statement would be of greatest assistance? Chapter 43: Care of the Patient with a Musculoskeletal Disorder Nursing Care Plan 43-1: The Patient with a Fractured Hip 1. The first postoperative evening, Ms. D. is restless and disoriented. What nursing interventions are needed to prevent dislocation of her bipolar hip prosthesis? 2. Ms. D. is in her third postoperative day and the nurse notes an erythematous area on her coccyx. What therapeutic measures can prevent skin impairment? 3. On Ms. D.’s third postoperative day, she complains of pain in her right calf. During the assessment redness is noted in the calf area. What is the most appropriate immediate action by the nurse? Chapter 44: Care of the Patient with a Gastrointestinal Disorder Nursing Care Plan 44-1: The Patient with Gastrointestinal Bleeding 1. Mr. D. has an NG tube connected to wall suction that is draining sanguineous fluid. He complains of severe fatigue and epigastric pain. He is pale and drawn, with a hemoglobin level of 5.1 g/dL. Mr. D. puts his call light on and requests the nurse to assist him to the bathroom for a bowel movement. What appropriate interventions will ensure Mr. D.’s safety? 2. During assessment of Mr. D., what signs and symptoms would indicate deficient fluid volume? 3. Mr. D. says to the nurse that he fears he may die. He appears anxious and tremulous. What is the most therapeutic approach to help decrease his fears? Chapter 45: Care of the Patient with a Gallbladder, Liver, Biliary Tract, or Exocrine Pancreatic Disorder Nursing Care Plan 45-1: The Patient with Cirrhosis of the Liver 1. Mr. K. is thrashing about in his bed and has attempted to climb over the side rails. He is disoriented to time and place. What appropriate nursing interventions will ensure Mr. K.’s safety? 2. Mrs. K. notes that her husband has a low-protein diet. She confides to the nurse that she thinks he needs more meat, eggs, and cottage cheese to improve his nutrition. What is the most appropriate response? Chapter 46: Care of the Patient with a Blood or Lymphatic Disorder Nursing Care Plan 46-1: The Patient with Leukemia 1. What should the nurse do if a visitor with an obvious upper respiratory infection is seen approaching Ms. M.’s room? 2. What nursing interventions would be most appropriate in providing therapeutic oral hygiene for Ms. M.? 3. What kind of a bath and ADLs would be most beneficial for Ms. M.? Chapter 47: Care of the Patient with a Cardiovascular or a Peripheral Vascular Disorder Nursing Care Plan 47-1: The Patient with Heart Failure 1. Mr. D. is experiencing severe dyspnea, with the presence of crackles bilaterally in all lung fields. His pulse is 108 bpm, and respirations are 33 breaths/min. When performing his morning ADLs, what nursing interventions would be most beneficial? 2. On assessing Mr. D.’s skin, the nurse notes 4+ pitting edema in his lower extremities. A weight gain of 6 lb is also noted in the past 24 hours. For therapeutic diuresis to occur, what would the medical management likely include? 3. Mr. D. puts his call light on to request assistance to ambulate. The nurse notes subclavicular retractions and cyanosis of his nail beds. What would be the most appropriate nursing actions? Chapter 48: Care of the Patient with a Respiratory Disorder Nursing Care Plan 48-1: The Patient with Emphysema 1. Mr. O. turns on his call light and states that he is “unable to get my air.” The nurse notes subclavicular retractions and a respiratory rate of 36 breaths per minute. His oxygen is flowing at 1 L/min via nasal cannula. What nursing interventions would decrease his dyspnea? 2. While the nurse is performing an assessment on Mr. O., he states, “I’m so tired of fighting to breathe that I wish I could just go to sleep and never wake up.” What is an appropriate response? 3. When performing the assessment, the nurse notes the following: temperature is 102° F (38.8° C), pulse rate is 110 bpm, and the respiratory rate is 44 breaths per minute. What risk factors are increased as a result of Mr. O.’s COPD? Chapter 49: Care of the Patient with a Urinary Disorder Nursing Care Plan 49-1: The Patient with End-Stage Renal Disease 1. Mr. J. complains of loss of appetite and limited food choices. What would be some helpful suggestions to improve his nutritional status? 2. Mr. J. established a therapeutic nurse-patient relationship with the nurse and he confided that he is having marital problems partly due to his inability to have a satisfactory sexual relationship with his wife. What would be an appropriate response? 3. The nurse notes Mr. J.’s lack of interest in his therapeutic regimen of diet, medications, and fluid restrictions. He states, “What’s the use? I will never be well again.” What would be some therapeutic interventions? Chapter 50: Care of the Patient with an Endocrine Disorder Nursing Care Plan 50-1: The Patient with Diabetes Mellitus 1. Ms. T. received Humalog 75/25, 25 units subQ at 7:30 AM. After, she ate breakfast. She had lunch at 12:30 PM. At 3:00 PM she complains of being hungry and nervous. The nurse notes Ms. T. is shaky. What are the immediate nursing interventions? 2. Ms. T. reports she feels she would be better able to manage her condition if she lost weight. What would be some helpful suggestions from the nurse? 3. In discharge planning, the nurse notes that Ms. T. has poorly fitting shoes. What would be some important discharge patient teaching for foot care? Chapter 51: Care of the Patient with a Reproductive Disorder Nursing Care Plan 51-1: The Patient Undergoing Modified Radical Mastectomy 1. Ms. C. confides in her nurse that she feels ugly and unattractive, and she refuses to look at her incision. Review approaches by the nurse that may assist Ms. C. 2. When assessing Ms. C., the nurse notes her holding her left arm guardedly in an adducted position. She does not use it for activities of daily living. What should effective patient teaching include? 3. What should be included in discharge teaching for Ms. C. to prevent trauma and infection of her left arm? Chapter 52: Care of the Patient with a Sensory Disorder Nursing Care Plan 52-1: The Patient with Cataracts 1. Ms. J. puts her call light on and tells the nurse that she has severe pain and pressure in her right eye. What should be the initial response by the nurse? 2. What should be included in Ms. J.’s discharge planning to minimize the risk of injury to her operative eye? 3. In visiting with Ms. J., the nurse finds that she enjoys embroidery and knitting. Ms. J. states that she is looking forward to resuming her handiwork. What should be included as appropriate patient teaching? Nursing Care Plan 52-2: The Patient with Ménière Disease 1. Ms. L. states that she would prefer going to the bathroom without the assistance of a nurse. What is an appropriate response by the nurse? 2. Ms. L. tells the nurse that she is very depressed because of her very unpleasant symptoms and wonders of she will ever feel well again. What would be a therapeutic reply? 3. The nurse notes an unpleasant odor from Ms. L.; her hair is unkempt, and she has poor oral hygiene. The nurse is preparing to give her a warm, therapeutic bed bath. Ms. L. states, “I feel too dizzy to take a bath.” What nursing interventions would help promote personal hygiene and patient compliance? Chapter 53: Care of the Patient with a Neurologic Disorder Nursing Care Plan 53-1: The Patient with Alzheimer Disease 1. Ms. A. continually wanders about the long-term care facility. She is unable to sit at the table for an entire meal. She has lost approximately 20 lb in the past 3 months. What are some helpful measures to improve her nutritional status? 2. What are some helpful interventions to assist Ms. A. to obtain a better sleep pattern? 3. Ms. A. has difficulty in maintaining good personal hygiene. What are some methods for assisting Ms. A. to maintain personal hygiene? Chapter 55: Care of the Patient with HIV/AIDS Nursing Care Plan 55-1: The Patient Who Is HIV-Positive 1. Ms. J is very tearful and asks the nurse if there is any treatment to prevent her baby from becoming HIV-positive. What should be included in the nurse’s information to Ms. J? 2. Ms. J asks the nurse if she can legally require her boyfriend to be tested for HIV. What is the most appropriate response? 3. Ms. J asks the nurse when she will develop AIDS now that she is HIV-positive. What is the correct answer? [Show More]

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