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

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

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.A client with acute left-sided heart failure develops severe dyspnea, crackles, and pink frothy sputum. Which action should the nurse take first?

   • A.Place the client upright with legs dependent, if tolerated
   • B.Encourage oral fluids to thin secretions
   • C.Place the client flat and elevate the legs
   • D.Obtain a daily weight before intervening

   Rationale: Upright positioning reduces venous return and improves lung expansion, helping relieve acute pulmonary congestion. Oral fluids can worsen fluid overload, and a flat position with elevated legs increases venous return. Daily weights are important for ongoing management but do not address this immediate respiratory emergency.

2. 2.A client taking digoxin reports nausea and yellow-green halos around lights. The apical pulse is 54/min. What should the nurse do?

   • A.Administer the medication with food
   • B.Withhold digoxin and notify the health care provider
   • C.Give the next dose and recheck the pulse in 1 hour
   • D.Encourage foods high in calcium

   Rationale: Nausea, visual disturbances, and bradycardia suggest digoxin toxicity, so the dose should be withheld and the prescriber notified. Food does not treat toxicity, and administering another dose could worsen it. Calcium intake is not the relevant intervention; potassium and renal function are important considerations in digoxin safety.

3. 3.A client with atrial fibrillation takes warfarin. Which laboratory result is most important for evaluating the medication's therapeutic effect?

   • A.Activated partial thromboplastin time
   • B.International normalized ratio
   • C.Serum platelet count
   • D.Bleeding time

   Rationale: The international normalized ratio (INR) is used to monitor warfarin anticoagulation. The activated partial thromboplastin time is generally used to monitor unfractionated heparin, while platelet count assesses thrombocytopenia rather than warfarin effect. Bleeding time is not the routine test used to titrate warfarin.

4. 4.A client with suspected acute myocardial infarction reports chest pressure that began 30 minutes ago. Which prescribed medication should the nurse administer first if there is no contraindication?

   • A.Sublingual nitroglycerin
   • B.Oral simvastatin
   • C.Oral metoprolol in all cases
   • D.Intramuscular morphine

   Answer and rationale are in the full material.

5. 5.A client with chronic obstructive pulmonary disease is receiving oxygen for acute hypoxemia. Which nursing approach is appropriate?

   • A.Withhold oxygen because it can suppress respiratory drive
   • B.Titrate oxygen to the prescribed target and reassess oxygenation
   • C.Use the highest available oxygen flow without reassessment
   • D.Discontinue oxygen once the client reports less dyspnea

   Answer and rationale are in the full material.