Brunner & Suddarth’s Textbook of Medical Surgical Nursing 16TH Edition

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Sample questions from Brunner & Suddarth’s Textbook of Medical Surgical Nursing 16TH Edition

This material has 20 questions with answers and rationales. Here are the first 5.

1. 1.A client receiving treatment for pneumonia becomes confused. Blood pressure is 86/48 mm Hg, respiratory rate is 32/min, and oxygen saturation is 88%. Which action should the nurse take first?

   • A.Complete the scheduled admission history before contacting the clinician.
   • B.Activate immediate assistance and support airway and oxygenation.
   • C.Offer oral fluids to improve blood pressure.
   • D.Reassess in 30 minutes after the client rests.

   Rationale: B is correct because the client has acute respiratory and circulatory instability requiring immediate assistance and stabilization. A delays emergency care for nonurgent documentation. C risks aspiration in a confused, unstable client and does not provide controlled resuscitation. D allows potentially life-threatening deterioration to continue.

2. 2.A client with acute kidney injury has potassium 6.6 mEq/L and new peaked T waves. Which prescribed medication most directly stabilizes the cardiac membrane?

   • A.Intravenous calcium gluconate.
   • B.Intravenous regular insulin with dextrose.
   • C.An oral potassium binder.
   • D.Intravenous furosemide.

   Rationale: A is correct because intravenous calcium stabilizes the myocardium during dangerous hyperkalemia but does not lower potassium. B shifts potassium into cells and is often also necessary, but its purpose is not direct membrane stabilization. C removes potassium through the gastrointestinal tract with agent-dependent onset. D may promote renal potassium loss when kidney function and volume status permit but is not the immediate membrane-protective treatment.

3. 3.Arterial blood gas results are pH 7.29, PaCO2 54 mm Hg, and bicarbonate 25 mEq/L. Which interpretation is most appropriate?

   • A.Metabolic alkalosis.
   • B.Respiratory alkalosis.
   • C.Respiratory acidosis without significant metabolic compensation.
   • D.Metabolic acidosis with respiratory compensation.

   Rationale: C is correct because the low pH indicates acidemia and the elevated PaCO2 explains it; bicarbonate is within the usual reference range. A would require elevated bicarbonate as the primary disturbance. B would involve reduced PaCO2 and an alkaline tendency. D would require a primary decrease in bicarbonate with a compensatory decrease, not increase, in PaCO2.

4. 4.A client with chest pressure has a prescription for sublingual nitroglycerin. Which finding requires the nurse to withhold the dose and immediately clarify the treatment plan?

   • A.Pain rated 7 out of 10.
   • B.Heart rate of 88/min.
   • C.Oxygen saturation of 96% on room air.
   • D.The client took sildenafil 6 hours ago.

   Answer and rationale are in the full material.

5. 5.Which statement by a client with heart failure indicates an accurate understanding of home monitoring?

   • A.I will stop my diuretic whenever my ankles look normal.
   • B.I will weigh myself under similar conditions and follow my team's instructions for reporting increases.
   • C.I only need to report shortness of breath if I also have chest pain.
   • D.All clients with heart failure should drink exactly the same amount of fluid.

   Answer and rationale are in the full material.