Brunner And Suddarth’s Medical Surgical Nursing 12th Edition by Suzanne C. Smeltzer – Test Bank


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Brunner And Suddarth’s Medical Surgical Nursing 12th Edition by Suzanne C. Smeltzer – Test Bank

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Chapter: Chapter 02: Community-Based Nursing Practice





Multiple Choice





  1. A community health nurse has scheduled a hypertension clinic. This service would be an example of which type of health care?
  2. A) Tertiary prevention
  3. B) Secondary prevention
  4. C) Primary prevention
  5. D) Disease prevention



  1. The nursing instructor is preparing her students for their home-care rotation. She discusses the patients that they are likely to care for in the home. Which of the following are the most frequent users of home care services?
  2. A) Disabled patients
  3. B) Chronically ill patients
  4. C) Terminally ill patients
  5. D) Elderly patients


  1. Patients’ lifestyles in the home may vary greatly from the nurse’s own beliefs. To work successfully with the patient, what must the nurse do?
  2. A) Ask for another assignment if there is a conflict of interest
  3. B) Ask the patient to come to the agency to receive treatment
  4. C) Convey respect for the patient’s beliefs
  5. D) Adapt the patient’s home to a hospital-like environment



  1. Infection control is important in every setting where nursing care is provided. In the home setting, how will the nurse best implement infection control?
  2. A) Cleanse the hands before and after giving direct patient care
  3. B) Remove the patient’s wound dressings from the home
  4. C) Dispose of patient’s syringes in the patient’s garbage
  5. D) Disinfect all work areas in the patient’s home





  1. Your patient is ready to be discharged from the hospital. When should your patient’s discharge planning begin?
  2. A) The day prior to discharge
  3. B) The day of estimated discharge
  4. C) The day the patient is admitted
  5. D) Once the nurse determines care needs




  1. During the initial visit to a patient’s home, what information is it important to provide to the patient and family?
  2. A) Available community resources to meet their needs
  3. B) Information on other patients in the area with similar health care needs
  4. C) The nurse’s home address and phone number
  5. D) Dates and times of all scheduled home care visits



  1. The home health nurse receives a referral from the hospital for a patient who needs a home visit. After reading the referral, what would be the first action the nurse should take?
  2. A) Identify community services to initiate for the patient
  3. B) Obtain a physician’s order for the visit
  4. C) Call the patient to obtain permission to visit
  5. D) Schedule a home health aide to visit the patient



  1. Why is it important for the nurse to inform the health care agency of her daily schedule?
  2. A) Allows the agency to keep track for payment of the nurse
  3. B) Supports suggested safety precautions for the nurse when making a home care visit
  4. C) Allows easy accessibility of the nurse for changes in assignments
  5. D) Allows the patient to cancel appointments with minimal inconvenience





  1. There are specific guidelines and regulations for documentation related to home care that the nurse must consider and follow. For those patients with Medicaid, what is most important for the nurse to document to assure reimbursement for services?
  2. A) The medical diagnosis and supplies needed to care for the patient
  3. B) Directions to the patient’s home
  4. C) Quality of nursing care needed
  5. D) The patient’s homebound status and the need for skilled professional nursing care





  1. Your patient has had a total knee replacement and will need to walk with crutches for 6 weeks. He is being discharged home with a referral for home health care. What will the home care nurse need to assess during her initial assessment?
  2. A) Assistance of neighbors
  3. B) Previous health status
  4. C) Costs of the visits
  5. D) Home environment




  1. A nurse who has an advanced degree in primary care for a pediatric population is employed in a health clinic. In what role is this nurse functioning?
  2. A) Nurse practitioner
  3. B) Case cocoordinator
  4. C) Clinical nurse specialist
  5. D) Clinic supervisor




  1. A nurse working in a large meat-packaging plant sees patients for work-related issues. What is the role of the nurse?
  2. A) Occupational health nurse
  3. B) Staff nurse
  4. C) Nurse clinician
  5. D) Nurse educator



  1. A school nurse is concerned about a fourth grade student with cystic fibrosis. The nurse is aware that children with health problems are at major risk for what?
  2. A) Sports injuries
  3. B) Attention disorders
  4. C) Experiencing school-related stress due to a desire to overachieve
  5. D) Underachieving or failing in school



  1. Which patients seek health care late in the course of their disease process and deteriorate more quickly than other patients?
  2. A) Homeless
  3. B) Immigrants
  4. C) Elderly
  5. D) Adolescents



Multiple Selection





  1. What changes in the health care system have created an increased need for nurses to practice in community-based settings? (Mark all that apply.)
  2. A) Tighter insurance regulations
  3. B) Younger population
  4. C) Increased rural population
  5. D) Changes in federal legislation
  6. E) Decreasing hospital revenues




Multiple Choice





  1. Nurses are now working in ambulatory health clinics, hospice settings, and homeless shelters and clinics. What has influenced this increase in practice settings for nurses?
  2. A) Population shift to more rural areas
  3. B) Shift of health care delivery into the community
  4. C) Advent of primary care clinics
  5. D) Increased use of rehabilitation hospitals



  1. What is the focus of community-based nursing?
  2. A) Community health
  3. B) Maintaining and improving the health of the community
  4. C) Promoting and maintaining the health of individuals and families
  5. D) Family health





  1. You are the community-based nurse who acts as case-manager for a small town about 60 miles from a major health care center. What is the most important factor of community-based nursing you should be knowledgeable about?
  2. A) Eligibility requirements for services
  3. B) Community resources available to patients
  4. C) Transportation costs to the medical center
  5. D) Possible charges for any services provided


  1. A new community-based nurse is looking for community resources for one of her clients. Where would be the best place to look?
  2. A) Hospital directories
  3. B) Telephone book
  4. C) Community directories
  5. D) Church directories




Multiple Selection





  1. You are a community-based care manager in a community that does not have a resource directory available. One of your goals is to compile such a directory. What would be important to include in this directory? (Mark all that apply.)
  2. A) Nearby medical facilities
  3. B) List of social service workers in the community
  4. C) Eligibility requirements for services
  5. D) Commonly used resources
  6. E) Costs of services




Multiple Choice





  1. You are assessing a new patient and his home environment. What is a responsibility that you, as a community-based nurse, have at this initial visit?
  2. A) Encourage the patient and his family to use local stores to support their community.
  3. B) Encourage the patient and his family to contact their church as a resource.
  4. C) Encourage the patient and his family to use the Internet to find local resources.
  5. D) Encourage the patient and his family to contact appropriate community resources.




  1. What type of health care is most likely to be available in both community and hospital-based settings?
  2. A) Dieticians
  3. B) Ambulatory health care
  4. C) Physical therapy
  5. D) Hospice care




  1. Every home health agency, based on the principle of due diligence, must inform its employees of what?
  2. A) At-risk working environments
  3. B) OSHA requirements
  4. C) Available training for personal safety
  5. D) Policies and procedures about clinical safety




  1. A home health nurse is making a visit to a new patient. During the visit, the patient’s husband arrives home in an intoxicated condition. He speaks to both you and the patient in an abusive and threatening manner. What should you do?
  2. A) Ignore the husband and focus on the patient
  3. B) Return to your agency and notify your supervisor
  4. C) Call the police from your cell phone
  5. D) Remove the patient from the home



  1. You have been notified by your agency of a new patient in your community. The agency tells you that this patient resides in a high-crime area. What is the most important request you should make of the agency?
  2. A) A cell phone
  3. B) Directions to the home
  4. C) Someone to accompany you on the visit
  5. D) Someone to wait in the car while you make your visit




  1. What level of care do home health nurses often focus on?
  2. A) Preventative care
  3. B) Primary prevention
  4. C) Secondary prevention
  5. D) Tertiary prevention



  1. You are admitting two new patients to your home health care service. These patients live within two blocks of each other, and both homes are in a high-crime area. What is recommended for your personal safety?
  2. A) Drive a car that is hard to break into.
  3. B) Keep your purse close to you at all times.
  4. C) Don’t leave anything in the car that might be stolen.
  5. D) Do not wear expensive jewelry.



Multiple Selection





  1. In two days you are scheduled to discharge a patient home status post left hip replacement. You have initiated a home health referral and you have met with a team of people who have been involved with this patient’s discharge planning. Who would be appropriate people to be on the discharge planning team? (Mark all that apply.)
  2. A) Home health nurse
  3. B) Physical therapist
  4. C) Patient’s pastor
  5. D) Social service worker
  6. E) Meal-on-Wheels provider





  1. Which type of agencies provides documented home health care services? (Mark all that apply.)
  2. A) Unofficial neighborhood groups
  3. B) Private businesses
  4. C) Proprietary chains
  5. D) Off-duty neighborhood nurses
  6. E) Hospital-based agencies





Multiple Choice





  1. Discharge planning begins with the patient’s admission to the hospital. What is involved in the discharge-planning process?
  2. A) Identifying the patient’s needs
  3. B) Making a social services referral
  4. C) Getting physical therapy involved
  5. D) Notifying the speech therapist of the discharge date



  1. Within the public health system there has been an increased demand for medical, nursing, and social services. What is the basis for this increased demand?
  2. A) A shift from hospital to community-based health care
  3. B) The growing number of older adults in the United States
  4. C) The rise in poverty in the United States
  5. D) The decreasing revenues in health care



  1. Nursing care, no matter where it is delivered, has many consistencies. One of these consistencies is the need for what?
  2. A) Advanced education
  3. B) Certification in a specialty
  4. C) Cultural competence
  5. D) Independent practice




  1. Medicare finances many home health care expenses. What does this allow nurses to do?
  2. A) Provide care without the oversight of a physician
  3. B) Write necessary medication orders for the patient
  4. C) Order physical, occupational, and speech therapy if needed
  5. D) Manage and evaluate patient care for seriously ill patients




  1. You are a school nurse who is concerned about an incoming kindergartner with muscular dystrophy. Why would you make a home visit before school starts?
  2. A) To provide anticipatory guidance to the family
  3. B) To measure the child’s wheelchair to make sure it fits through the school doors
  4. C) To set up home teachers for the child
  5. D) To provide follow-up care after the child’s clinic visit



Chapter: Chapter 04: Health Education and Health Promotion





Multiple Choice





  1. Nurses in all venues have an obligation to provide health education to patients. Who is ultimately responsible for maintaining and promoting health?
  2. A) Classroom teachers
  3. B) Parents
  4. C) Physicians
  5. D) Patients



  1. The elderly patient has come to the clinic for a follow-up appointment. The nurse learns from the patient’s daughter that the patient is not following the instructions she received upon discharge from the hospital last month. What could be a factor in a patient not adhering to her therapeutic regimen?
  2. A) Ethnic background of health care provider
  3. B) Costs of prescribed regimen
  4. C) Wellness state
  5. D) Personality of the physician




  1. Elderly people often do not adhere to a therapeutic regimen. This is a significant problem. What strategy is the best to assist the elderly in adhering to a therapeutic regimen?
  2. A) Demonstrate a dressing change and allow the patient to practice.
  3. B) Provide a pamphlet on a dressing change.
  4. C) Verbally instruct the patient how to change a dressing.
  5. D) Have a family member change the dressing.



  1. A patient newly diagnosed with type 1 diabetes needs to learn how to give himself insulin. A nurse preparing to teach this patient how to administer an insulin injection must remember that one of the major variables that influences a patient’s readiness to learn is what?
  2. A) Lifespan
  3. B) Gender
  4. C) Occupation
  5. D) Culture


  1. The nurse is planning to teach a 75-year-old patient about administering her medication. How can the nurse enhance the patient’s ability to learn?
  2. A) Provide links to websites that contain information related to the medication
  3. B) Exclude family members from the session
  4. C) Use color-coded materials
  5. D) Make the information relevant to the patient’s condition




  1. All nursing diagnoses imply that teaching must be done. For which of the following nursing diagnoses would education of the patient be the highest priority?
  2. A) Risk for impaired mobility related to joint pain
  3. B) Incontinence related to surgical repair of bladder
  4. C) Altered range of movement related to contractures
  5. D) Risk for ineffective management of therapeutic regimen


  1. The nursing instructor has given an assignment to a group of nurse practitioner students. They are to break into groups of four and complete a health-promotion teaching project and present a report back to their fellow students. What project is the best example of health-promotion teaching?
  2. A) Demonstrating an injection technique to a patient for anticoagulant therapy
  3. B) Explaining the side effects of a medication to an adult patient
  4. C) Discussing the importance of preventing sexually transmitted disease to a group of 12th-grade students
  5. D) Instructing an adolescent patient about safe food preparation




  1. Health promotion ranks high on the list of health-related concerns of the American public. Based on current knowledge, what factor is the most significant in health, longevity, and weight control?
  2. A) Good nutrition
  3. B) Stress reduction
  4. C) Use of vitamins
  5. D) Screening for health risks


  1. The nursing profession and nurses as individuals have a responsibility to promote activities that foster well-being. What has most influenced the nurse to play this vital role?
  2. A) Nurses are seen as nurturing.
  3. B) Nurses have post-secondary education.
  4. C) Nurses have a desire to help others.
  5. D) Nurses have long-established credibility with consumers.




  1. The nurse is teaching a local community group about the importance of disease prevention. Why is disease prevention necessary in health promotion?
  2. A) Prevention is emphasized as the link between personal behavior and health.
  3. B) The majority of deaths of Americans under age 60 aren’t related to preventable causes.
  4. C) Health maintenance organizations now emphasize prevention as the main criterion of health care.
  5. D) The external environment affects the outcome of most disease processes.




  1. The nurse is preparing discharge teaching for a patient diagnosed with urinary retention secondary to multiple sclerosis. The nurse will teach the patient to self-catheterize at home upon discharge. What teaching method is most effective for this patient?
  2. A) A list of instructions written at a sixth-grade level
  3. B) A short videotape providing useful information and demonstrations
  4. C) An audio taped version of discharge instructions
  5. D) A discussion and demonstration between the nurse and the patient




  1. You are the nurse planning to teach tracheostomy care to one of your patients. What is the most important variable in patient teaching that you need to utilized?
  2. A) Providing the most up-to-date information available
  3. B) Alleviating the patient’s guilt associated with not knowing appropriate self-care
  4. C) Determining the patient’s readiness to learn new information
  5. D) Building on previous information




  1. A public health nurse is preparing to hold a series of health-promotion classes on a variety of topics. Which site could be best used to hold a health-promotion education series for a group of middle-aged adults?
  2. A) Physician’s office
  3. B) The workplace
  4. C) The hospital
  5. D) The nurse’s clinic




  1. Research has associated stress levels with infectious diseases. Which fact best supports the rationale for this statement?
  2. A) Stress impairs sleep patterns.
  3. B) Stress decreases the immune response.
  4. C) Stress increases weight.
  5. D) Stress decreases concentration.




  1. Health promotion should continue across the lifespan. Therefore, it is important for the nurse to understand when to initiate health promotion. When in the lifespan should health promotion begin?
  2. A) Adolescence
  3. B) School age
  4. C) Preschool
  5. D) Before birth




  1. A nurse has taught a patient with asthma how to administer his daily inhaler. How would the nurse evaluate the teaching-learning process?
  2. A) Using teaching aides
  3. B) Identifying teaching strategies
  4. C) Directly observing the patient using his inhaler
  5. D) Documenting the teaching session in the patient’s record




  1. The nurse practitioner is discussing health promotion with a group of senior nursing students. What would be the best example of health promotion?
  2. A) Blood pressure clinic
  3. B) Family planning clinic
  4. C) Immunization clinic
  5. D) Workplace health and safety seminar





  1. You are the oncoming nurse, and you have just taken report on your patients for the shift. One of your patients is a patient who is newly diagnosed with diabetes. Which behavior shows this patient’s willingness to learn?
  2. A) The patient requests a visit from the diabetic educator.
  3. B) The patient declines a slice of pie at lunch.
  4. C) The patient has a family member meet with the dietician to discuss meals.
  5. D) The patient allows the nurse to take daily blood sugar.





  1. A nurse is providing an educational event to a local group of citizens who are disabled. What would be important for the nurse to be aware of when planning this event?
  2. A) The health-promotion needs of the group the nurse is speaking to
  3. B) What each person’s disability is
  4. C) Wellness needs of each individual
  5. D) What the families want you to talk about




  1. What is the definition of wellness?
  2. A) Being without disease
  3. B) A conscious and deliberate attempt to maximize one’s health
  4. C) A desire to be without disease
  5. D) Maximizing the state in which you live




  1. A nursing instructor is working with a class of first-semester nursing students. The instructor explains the interrelatedness of health and wellness. What would be the best definition the nursing instructor could give of health?
  2. A) Health is maximizing wellness.
  3. B) Health is a lack of disease.
  4. C) Health is a dynamic, ever-changing condition that enables people to function at an optimal potential at any given time.
  5. D) Health is a reflection of wellness that involves a conscious and deliberate attempt to maximize one’s lack of disease state.




Multiple Selection





  1. Research has shown that there is a relationship between health and physical fitness. What has research shown a regular exercise program can do? (Mark all that apply.)
  2. A) Decrease cholesterol and low-density lipoprotein levels
  3. B) Delay degenerative changes
  4. C) Improve the senses
  5. D) Improve overall muscle strength
  6. E) Decrease endurance levels




Multiple Choice





  1. A nursing instructor is talking about health promotion with a group of senior nursing students. What would the instructor tell the students is the key to successful health promotion?
  2. A) Desire to learn
  3. B) Self-awareness
  4. C) Consciously practicing stress reduction
  5. D) Taking responsibility for oneself



  1. Nutritional awareness is one component of health promotion. What does nutritional awareness involve?
  2. A) An understanding of the importance of a healthy diet
  3. B) Being aware of the importance of vitamin supplements
  4. C) Knowing what minerals are necessary to eat daily
  5. D) Understanding what constitutes the recommended daily nutrients





  1. Like the nursing process, what must be incorporated into the teaching-learning interaction for it to be successful?
  2. A) Evaluation
  3. B) Social and cultural patterns
  4. C) Patient awareness
  5. D) Measurable interventions




  1. Positive patient outcomes are the goal of nurse-patient interactions. What is an influential factor directly related to positive patient-care outcomes?
  2. A) Patient’s age
  3. B) Ethnic heritage
  4. C) Health education
  5. D) Outcome evaluation






  1. Part of health promotion in the adolescent population is health screening. What is the goal of health screening in this population?
  2. A) To teach teenagers about health risks
  3. B) To screen for potential health problems
  4. C) To identify chronic health problems and their risks
  5. D) To detect health problems at an early age so they can be treated at this time



  1. Each generation has specific interests in health promotion. What type of health promotion programs do young adults actively seek?
  2. A) Family planning
  3. B) Risky behaviors
  4. C) Physical fitness
  5. D) Marriage classes



Multiple Selection





  1. Middle-aged adults are part of an age group that is interested in health and health promotion. What suggestions do they respond to with enthusiasm? (Mark all that apply.)
  2. A) How lifestyle practices can improve health
  3. B) How to eat healthier
  4. C) How exercise can improve your life
  5. D) How to eat fast food and survive
  6. E) Exercise for the aging





Multiple Choice





  1. Despite chronic illnesses and disabilities, the elderly benefit most from what kind of activities?
  2. A) Those that help them eat well
  3. B) Those that help them maintain independence
  4. C) Those that preserve their social interactions
  5. D) Those that accomplish financial stability




  1. Health promotion is as much a function of nursing as wound care is. As a health care professional, what is a responsibility of a nurse?
  2. A) To promote activities that enhance the community
  3. B) To encourage self-awareness
  4. C) To promote activities that foster personal fulfillment
  5. D) To influence social interactions




  1. Health promotion is an integral part of health care. What is the purpose of health promotion?
  2. A) To teach people how to act
  3. B) To teach people how to grow
  4. C) To change the environment in ways that enhance cultural expectations
  5. D) To change the environment in ways that reduce risks




  1. Health care professionals are involved in the promotion of health as much as in the treatment of disease. Health promotion has evolved as a part of health care for many reasons. Which of the following is one of them?
  2. A) A changing definition of health
  3. B) An awareness that wellness exists
  4. C) An expanded definition of chronic illness
  5. D) A belief that disease is preventable




  1. What is one of the most important goals of patient education?
  2. A) To encourage patients to exercise
  3. B) To encourage patients to adhere to their therapeutic regimen
  4. C) To teach nutritional awareness
  5. D) To encourage a disease-free state




  1. Research has shown that patient adherence to prescribed regimens is generally low, especially when the patient will have to follow the regimen for a long period of time. What is one diagnosis where adherence rates are low?
  2. A) MRSA
  3. B) SARS
  4. C) Multiple sclerosis
  5. D) Beta hemolytic strep infection



Multiple Selection





  1. You are the clinic nurse doing patient education with a teenager who was diagnosed 6 months ago with type 1 diabetes mellitus. This patient has been noncompliant with her treatment regimen. As the nurse, what variables do you need to assess to help this patient adhere to their treatment regimen? (Mark all that apply.)
  2. A) Variables that affect the patients’ ability to obtain resources
  3. B) Variables that affect the patients’ ability to stay in school
  4. C) Variables that affect the patients’ ability to maintain healthy relationships
  5. D) Variables that affect the patients’ ability to maintain a healthy social environment
  6. E) Variables that affect the patients’ ability to adopt specific behaviors





Multiple Choice





  1. Nurses doing patient education often use motivators for learning with patients who are struggling with behavioral changes necessary to adhere to a treatment regimen. What is one motivator the nurse might use with a young adult?
  2. A) A learning contract
  3. B) A star chart
  4. C) A point system
  5. D) A food-reward system


  1. As the nurse working in a gerontology clinic, you know that some elderly people are noncompliant with therapeutic regimens because of chronic illnesses that require long-term treatment by several health care providers. What is the most important consideration when dealing with this segment of the elderly population?
  2. A) Health care professionals must know all the medications the patient is taking.
  3. B) Health care professionals must work together to provide coordinated care.
  4. C) Health care professionals may negate the efforts of another health care provider.
  5. D) Health care professionals must have documentation of their interactions with the patient.




  1. The nursing process is an active process that requires a positive nurse-patient relationship. How is this most like the teaching–learning process?
  2. A) Both processes involve people other than the nurse and the patient.
  3. B) Both processes are static processes.
  4. C) Both processes require the involvement of both parties to reach the desired outcome.
  5. D) Both processes are based on current research.



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