Download 4-1 Test Bank Varcarolis: Essentials of Psychiatric Mental Health

Varcarolis: Essentials of Psychiatric Mental Health Nursing
Test Bank
Chapter 4: Biological Basis for Understanding Psychopharmacology
MULTIPLE CHOICE
1. A patient asks a nurse, “What are neurotransmitters? My doctor says mine are out of
balance.” The best reply would be:
a. “You must feel relieved to know that your problem has a physical basis.”
b. “It is a high-level concept to explain. You should ask the doctor to tell you more.”
c. “Neurotransmitters are substances we eat daily that influence memory and mood.”
d. “Neurotransmitters are chemicals that pass messages between brain cells.”
ANS: D
Stating that neurotransmitters are chemicals that pass messages between brain cells gives
the most accurate information. Neurotransmitters are chemical substances that function as
messengers in the central nervous system. They are released from the axon terminal,
diffuse across the synapse, and attach to specialized receptors on the postsynaptic neuron.
The first response does not answer the patient’s question. The second response does not
answer the patient’s question and is somewhat demeaning. The third response provides
untrue, misleading information.
DIF: Cognitive Level: Application
TOP: Nursing Process: Implementation
REF: Page: 53
MSC: NCLEX: Physiological Integrity
2. The parent of an adolescent with schizophrenia asks a nurse, “My child’s doctor ordered
a PET. What kind of test is that?” Select the nurse’s best reply.
a. “This test uses a magnetic field and gamma waves to identify problems areas in the
brain. Does your teenager have any metal implants?”
b. “It’s a special type of x-ray that shows structures of the brain and whether there
has ever been a brain injury.”
c. “PET means positron emission tomography. It’s a scan that involves an injection
and lying still. It shows blood flow and activity in the brain.”
d. “PET scans pass an electrical current through the brain and show brain wave
activity. PET can help diagnose seizures.”
ANS: C
The parent is seeking information about PET scans. It’s important to use terms the parent
can understand, so the nurse should identify what the initials mean. The third option is
the only option that provides factual information relevant to PET scans. The first option
describes MRI, the second describes CT scans, and the fourth describes EEG.
DIF: Cognitive Level: Application
TOP: Nursing Process: Implementation
REF: Page: 51
MSC: NCLEX: Physiological Integrity
Copyright © 2009 by Saunders, an imprint of Elsevier Inc.
Test Bank
4-2
3. A patient has dementia. The health care provider wants to make a differential diagnosis
between Alzheimer’s disease or multiple infarcts. Which diagnostic procedure should a
nurse expect to prepare the patient for first?
a. Computed tomography (CT) scan
b. Functional magnetic resonance imaging (fMRI)
c. PET scan
d. Single-photon emission computed tomography (SPECT)
ANS: A
A CT scan shows the presence or absence of structural changes, including cortical
atrophy, ventricular enlargement, and areas of infarct, information that would be helpful
to the health care provider. The other tests show brain activity rather than structure and
may be ordered later.
DIF: Cognitive Level: Analysis
Planning
MSC: NCLEX: Physiological Integrity
REF: Page: 51
TOP: Nursing Process:
4. A patient has delusions and hallucinations. Before beginning treatment with psychotropic
drugs, the health care provider wishes to rule out the presence of a brain tumor. For
which test will a nurse need to prepare the patient?
a. CT scan or MRI
b. PET or SPECT
c. Cerebral arteriogram
d. fMRI
ANS: A
CT and MRI scans visualize neoplasms and other structural abnormalities. PET, SPECT,
or fMRI scans, which give information about brain function, are not called for, and an
arteriogram would not be appropriate.
DIF: Cognitive Level: Application
Planning
MSC: NCLEX: Physiological Integrity
REF: Page: 44
TOP: Nursing Process:
5. A patient being admitted for depression should be assessed for disturbances in circadian
rhythms. Which question best implements this assessment?
a. “What are your worst and best times of day?”
b. “Do you ever see or hear things that others do not?”
c. “How would you describe your thinking?”
d. “Would you say your memory is failing?”
ANS: A
Mood changes throughout the day are related to circadian rhythms. Questions about sleep
pattern would also be relevant to circadian rhythms. The question about seeing or hearing
things is relevant to the assessment for illusions and hallucinations. The question about
thinking is relevant to the assessment of thought processes. The fourth question is
relevant to the assessment of memory.
Copyright © 2009 by Saunders, an imprint of Elsevier Inc.
Test Bank
4-3
DIF: Cognitive Level: Application
TOP: Nursing Process: Assessment
REF: Page: 48
MSC: NCLEX: Physiological Integrity
6. A nurse administers a medication that potentiates the action of GABA. Which finding
would be expected?
a. Reduced anxiety
b. Improved memory
c. More organized thinking
d. Fewer sensory perceptual alterations
ANS: A
Increased levels of GABA reduce anxiety, thus any potentiation of GABA action should
result in anxiety reduction. Memory enhancement is associated with acetylcholine and
substance P. Thought disorganization is associated with dopamine. GABA is not
associated with sensory perceptual alterations.
DIF: Cognitive Level: Application
Evaluation
MSC: NCLEX: Physiological Integrity
REF: Page: 40
TOP: Nursing Process:
7. On the basis of current knowledge of neurotransmitter effects, a nurse could anticipate
that the treatment plan for a patient with memory difficulties might include medications
designed to:
a. inhibit GABA.
b. increase dopamine at receptor sites.
c. decrease dopamine at receptor sites.
d. prevent destruction of acetylcholine.
ANS: D
Increased acetylcholine plays a role in learning and memory. Preventing destruction of
acetylcholine by acetylcholinesterase would result in higher levels of acetylcholine, with
the potential for improved memory. GABA is known to affect anxiety level rather than
memory. Increased dopamine would cause symptoms associated with schizophrenia or
mania rather than improve memory. Decreasing dopamine at receptor sites is associated
with Parkinson’s disease rather than improving memory.
DIF: Cognitive Level: Comprehension
Planning
MSC: NCLEX: Physiological Integrity
REF: Page: 55
TOP: Nursing Process:
8. A patient has disorganized thinking associated with schizophrenia. A PET scan would
most likely show dysfunction in which part of the brain?
a. Temporal lobe
b. Cerebellum
c. Brainstem
d. Frontal lobe
ANS: D
Copyright © 2009 by Saunders, an imprint of Elsevier Inc.
Test Bank
4-4
The frontal lobe is responsible for intellectual functioning. The temporal lobe is
responsible for the sensation of hearing. The cerebellum regulates skeletal muscle
coordination and equilibrium. The brainstem regulates internal organs.
DIF: Cognitive Level: Application
TOP: Nursing Process: Assessment
REF: Page: 46
MSC: NCLEX: Physiological Integrity
9. A nurse should assess a patient taking a drug with anticholinergic properties for inhibited
function of the:
a. parasympathetic nervous system.
b. sympathetic nervous system.
c. reticular activating system.
d. medulla oblongata.
ANS: A
Acetylcholine is the neurotransmitter found in high concentration in the parasympathetic
nervous system. When acetylcholine action is inhibited by anticholinergic drugs,
parasympathetic symptoms such as blurred vision, dry mouth, constipation, and urinary
retention appear. The functions of the sympathetic nervous system, the reticular
activating system, and the medulla oblongata are not affected by anticholinergics.
DIF: Cognitive Level: Comprehension
TOP: Nursing Process: Assessment
REF: Page: 51
MSC: NCLEX: Physiological Integrity
10. The therapeutic action of monoamine oxidase inhibitors (MAOIs) blocks
neurotransmitter reuptake, causing:
a. increased concentration of neurotransmitter in the synaptic gap.
b. decreased concentration of neurotransmitter in the synaptic gap.
c. destruction of receptor sites.
d. limbic system stimulation.
ANS: A
If the reuptake of a substance is inhibited, it accumulates in the synaptic gap and its
concentration increases, permitting ease of transmission of impulses across the synaptic
gap. Normal transmission of impulses across synaptic gaps is consistent with normal
rather than depressed mood. The other options are not associated with blocking
neurotransmitter reuptake.
DIF: Cognitive Level: Comprehension
TOP: Nursing Process: Implementation
REF: Page: 61
MSC: NCLEX: Physiological Integrity
11. A patient taking medication for mental illness develops restlessness and an uncontrollable
need to be in motion. A nurse can correctly analyze that these symptoms are related to
which drug action?
a. Dopamine-blocking effects
b. Anticholinergic effects
c. Endocrine-stimulating effects
d. Ability to stimulate spinal nerves
Copyright © 2009 by Saunders, an imprint of Elsevier Inc.
Test Bank
4-5
ANS: A
Medication that blocks dopamine often produces disturbances of movement such as
akathisia because dopamine affects neurons involved in both thought processes and
movement regulation. Anticholinergic effects include dry mouth, blurred vision, urinary
retention, and constipation. Akathisia is not caused by endocrine stimulation or spinal
nerve stimulation.
DIF: Cognitive Level: Application
TOP: Nursing Process: Assessment
REF: Page: 56
MSC: NCLEX: Physiological Integrity
12. A nurse assesses that a patient demonstrates anxiety, increased heart rate, and fear. The
nurse would suspect the presence of a high concentration of which neurotransmitter?
a. GABA
b. Histamine
c. Acetylcholine
d. Norepinephrine
ANS: D
Norepinephrine is the neurotransmitter associated with sympathetic nervous system
stimulation, preparing the individual for “fight or flight.” GABA is a mediator of anxiety
level. A high concentration of histamine is associated with an inflammatory response. A
high concentration of acetylcholine is associated with parasympathetic nervous system
stimulation.
DIF: Cognitive Level: Application
TOP: Nursing Process: Assessment
REF: Pages: 55-57
MSC: NCLEX: Physiological Integrity
13. A patient has symptoms of acute anxiety related to the death of a parent in an automobile
accident 2 hours ago. The patient will need teaching about a drug from which group?
a. Tricyclic antidepressants
b. Antimanic drugs
c. Benzodiazepines
d. Antipsychotic drugs
ANS: C
Benzodiazepines provide anxiety relief. Tricyclic antidepressants are used to treat
symptoms of depression. Antimanic drugs are used to treat bipolar disorder.
Antipsychotic drugs are used to treat psychosis.
DIF: Cognitive Level: Application
Planning
MSC: NCLEX: Physiological Integrity
REF: Page: 63
TOP: Nursing Process:
14. A patient is hospitalized for severe depression. Of the medications listed below, a nurse
can expect to provide the patient with teaching about:
a. clozapine (Clozaril).
b. chlordiazepoxide (Librium).
c. tacrine (Cognex).
d. fluoxetine (Prozac).
Copyright © 2009 by Saunders, an imprint of Elsevier Inc.
Test Bank
4-6
ANS: D
Fluoxetine is an SSRI. It is an antidepressant that blocks the reuptake of serotonin with
few anticholinergic and sedating side effects. Clozapine is an antipsychotic.
Chlordiazepoxide is an anxiolytic. Tacrine is used to treat Alzheimer’s disease.
DIF: Cognitive Level: Application
Planning
MSC: NCLEX: Physiological Integrity
REF: Page: 55
TOP: Nursing Process:
15. A patient hospitalized with a mood disorder has an elevated unstable mood,
aggressiveness, agitation, talkativeness, and irritability. A nurse begins care planning
based on the expectation that the health care provider is most likely to prescribe a
medication classified as a(n):
a. anticholinergic.
b. mood stabilizer.
c. psychostimulant.
d. antidepressant.
ANS: B
The symptoms describe a manic attack. Mania is effectively treated by the antimanic drug
lithium and selected anticonvulsants such as carbamazepine, valproic acid, and
lamotrigine. No drugs from the other classifications listed are effective in the treatment of
mania.
DIF: Cognitive Level: Application
Planning
MSC: NCLEX: Physiological Integrity
REF: Page: 60
TOP: Nursing Process:
16. A drug causes muscarinic receptor blockade. A nurse will assess the patient for:
a. gynecomastia.
b. pseudoparkinsonism.
c. orthostatic hypotension.
d. dry mouth.
ANS: D
Muscarinic receptor blockade includes atropine-like side effects such as dry mouth,
blurred vision, and constipation. Gynecomastia is associated with decreased prolactin
levels. Movement defects are associated with dopamine blockade. Orthostatic
hypotension is associated with alpha1 antagonism.
DIF: Cognitive Level: Application
TOP: Nursing Process: Assessment
REF: Pages: 57-58
MSC: NCLEX: Physiological Integrity
17. A patient begins therapy with a phenothiazine medication. What teaching should a nurse
provide related to the drug’s strong dopaminergic effect?
a. Chew sugarless gum.
b. Increase fiber in the diet.
c. Arise slowly from bed.
Copyright © 2009 by Saunders, an imprint of Elsevier Inc.
Test Bank
4-7
d. Report muscle stiffness.
ANS: D
Phenothiazines block dopamine receptors in both the limbic system and basal ganglia.
The movement disorder dystonia is likely to occur early in the course of treatment and is
often heralded by sensations of muscle stiffness. Early intervention with antiparkinsonian
medication can increase the patient’s comfort and prevent dystonic reactions.
DIF: Cognitive Level: Application
TOP: Nursing Process: Implementation
REF: Page: 58
MSC: NCLEX: Physiological Integrity
18. A patient tells a nurse, “My doctor prescribed Paxil [paroxetine] for my depression. I
suppose I’ll have side effects like I had when I was taking Tofranil [imipramine].” The
nurse’s reply should be based on the knowledge that paroxetine is a(n):
a. tricyclic antidepressant.
b. MAOI.
c. selective serotonin reuptake inhibitor.
d. selective norepinephrine reuptake inhibitor.
ANS: C
Paroxetine is a selective serotonin reuptake inhibitor and will not produce the same side
effects as imipramine, a tricyclic antidepressant. The patient will probably not experience
dry mouth, constipation, or orthostatic hypotension.
DIF: Cognitive Level: Comprehension
TOP: Nursing Process: Implementation
REF: Pages: 62-63
MSC: NCLEX: Physiological Integrity
19. A nurse can anticipate anticholinergic side effects are likely when a patient is taking:
a. lithium (Lithobid).
b. risperidone (Risperdal).
c. buspirone (BuSpar).
d. fluphenazine (Prolixin).
ANS: D
Fluphenazine, a first-generation antipsychotic, exerts muscarinic blockade, resulting in
dry mouth, blurred vision, constipation, and urinary retention. Lithium therapy is more
often associated with fluid balance problems, including polydipsia, polyuria, and edema.
Risperidone therapy is more often associated with movement disorders, orthostatic
hypotension, and sedation. Buspirone is associated with anxiety reduction without major
side effects.
DIF: Cognitive Level: Application
Planning
MSC: NCLEX: Physiological Integrity
REF: Page: 58
TOP: Nursing Process:
20. Priority teaching for a patient taking clozapine (Clozaril) should include which
instructions?
a. Report sore throat and fever immediately.
b. Avoid foods high in polyunsaturated fat.
Copyright © 2009 by Saunders, an imprint of Elsevier Inc.
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4-8
c. Use over-the-counter preparations for rashes.
d. Avoid unprotected sex.
ANS: A
Clozapine therapy may produce agranulocytosis; therefore, signs of infection should be
immediately reported to the health care provider. In addition, the patient should have
white blood cell levels measured weekly. The other options are not relevant to clozapine
administration.
DIF: Cognitive Level: Application
Planning
MSC: NCLEX: Physiological Integrity
REF: Page: 59
TOP: Nursing Process:
21. A nurse cares for patients taking various medications, including buspirone (BuSpar),
haloperidol (Haldol), carbamazepine (Tegretol), trazodone (Desyrel), and phenelzine
(Nardil). The nurse must ensure that a special diet is ordered for the patient taking:
a. buspirone.
b. haloperidol.
c. carbamazepine.
d. trazodone.
e. phenelzine.
ANS: E
Patients taking phenelzine, an MAOI, must be on a tyramine-free diet to prevent
hypertensive crisis.
DIF: Cognitive Level: Application
Planning
MSC: NCLEX: Physiological Integrity
REF: Page: 62
TOP: Nursing Process:
22. A nurse instructs a patient taking a drug that inhibits monoamine oxidase (MAO) to avoid
certain foods and drugs because of the risk of:
a. hypotensive shock.
b. hypertensive crisis.
c. cardiac dysrhythmia.
d. cardiogenic shock.
ANS: B
Patients taking MAO-inhibiting drugs must be on a tyramine-free diet to prevent
hypertensive crisis. In the presence of MAOIs, tyramine is not destroyed by the liver and
in high levels produces intense vasoconstriction, resulting in elevated blood pressure.
DIF: Cognitive Level: Comprehension
Planning
MSC: NCLEX: Physiological Integrity
REF: Page: 62
TOP: Nursing Process:
23. A nurse caring for a patient taking an SSRI will develop outcome criteria related to:
a. mood improvement.
b. logical thought processes.
Copyright © 2009 by Saunders, an imprint of Elsevier Inc.
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4-9
c. reduced levels of motor activity.
d. decreased extrapyramidal symptoms.
ANS: A
SSRIs affect mood, relieving depression in many cases. SSRIs do not act to reduce
thought disorders. SSRIs reduce depression but have little effect on motor hyperactivity.
SSRIs do not produce extrapyramidal symptoms.
DIF: Cognitive Level: Application
Planning
MSC: NCLEX: Physiological Integrity
REF: Page: 62
TOP: Nursing Process:
24. A patient’s spouse, who is a chemist, asks a nurse the action by which SSRIs lift
depression. The nurse should explain that SSRIs:
a. make more serotonin available at the synaptic gap.
b. destroy increased amounts of neurotransmitter.
c. increase production of acetylcholine and dopamine.
d. block muscarinic and alpha1 norepinephrine receptors.
ANS: A
Depression is thought to be related to lowered availability of the neurotransmitter
serotonin. SSRIs act by blocking reuptake of serotonin, leaving a higher concentration
available at the synaptic cleft; actually prevent destruction of serotonin; have no effect on
acetylcholine and dopamine production; and do not produce muscarinic or alpha1
norepinephrine blockade.
DIF: Cognitive Level: Comprehension
TOP: Nursing Process: Implementation
REF: Page: 62
MSC: NCLEX: Physiological Integrity
25. A patient has taken many conventional antipsychotic drugs over years. The health care
provider, concerned about early signs of tardive dyskinesia, prescribes risperidone
(Risperdal). A nurse planning care for this patient understands that atypical
antipsychotics:
a. are less costly.
b. have higher potency.
c. are more readily available.
d. produce fewer motor side effects.
ANS: D
Atypical antipsychotic drugs often exert their action on the limbic system rather than the
basal ganglia. The limbic system is not involved in motor disturbances. Atypical
antipsychotics are not more readily available. They are not considered to be of higher
potency; rather, they have different modes of action. Atypical antipsychotic drugs tend to
be more expensive.
DIF: Cognitive Level: Comprehension
Planning
MSC: NCLEX: Physiological Integrity
REF: Page: 59
TOP: Nursing Process:
Copyright © 2009 by Saunders, an imprint of Elsevier Inc.
Test Bank
4-10
26. The laboratory report for a patient taking clozapine (Clozaril) shows a white blood cell
count of 3000 mm3 and a granulocyte count of 1500 mm3. The nurse should:
a. report the laboratory results to the health care provider.
b. give the next dose as prescribed.
c. repeat the laboratory tests.
d. give aspirin and force fluids.
ANS: A
These laboratory values indicate the possibility of agranulocytosis, a serious side effect of
clozapine therapy. These results must be immediately reported to the health care
provider. The drug should be withheld because the health care provider will discontinue
it. The health care provider may repeat the laboratory test, but in the meantime the drug
should be withheld. Giving aspirin and forcing fluids are measures that are less important
than stopping administration of the drug.
DIF: Cognitive Level: Analysis
TOP: Nursing Process: Implementation
REF: Page: 59
MSC: NCLEX: Physiological Integrity
27. A nurse administering psychotropic medications should be prepared to intervene when
giving a drug that blocks the attachment of norepinephrine to alpha1 receptors because
the patient may experience:
a. increased psychotic symptoms.
b. a hypertensive crisis.
c. orthostatic hypotension.
d. severe appetite disturbance.
ANS: C
Sympathetic mediated vasoconstriction is essential for maintaining normal blood pressure
in the upright position. Blockage of alpha1 receptors leads to vasodilation and orthostatic
hypotension. Orthostatic hypotension may cause fainting and falls. Patients should be
taught ways of minimizing this phenomenon.
DIF: Cognitive Level: Application
TOP: Nursing Process: Implementation
REF: Page: 58
MSC: NCLEX: Physiological Integrity
28. A nurse cares for four patients who are receiving clozapine, lithium, fluoxetine, and
venlafaxine, respectively. For which patient should the nurse be most alert for alterations
in cardiac or cerebral electrical conductivity as well as fluid and electrolyte imbalance?
The patient receiving:
a. lithium (Lithobid)
b. clozapine (Clozaril)
c. fluoxetine (Prozac)
d. venlafaxine (Effexor)
ANS: A
Copyright © 2009 by Saunders, an imprint of Elsevier Inc.
Test Bank
4-11
Lithium is known to alter electrical conductivity, producing cardiac dysrhythmias,
tremor, convulsions, polyuria, edema, and other symptoms of fluid and electrolyte
imbalance. Patients receiving clozapine should be monitored for agranulocytosis. Patients
receiving fluoxetine should be monitored for acetylcholine block. Patients receiving
venlafaxine should be monitored for heightened feelings of anxiety.
DIF: Cognitive Level: Application
TOP: Nursing Process: Assessment
REF: Page: 60
MSC: NCLEX: Physiological Integrity
29. During a care planning meeting for an obese patient with schizophrenia, the nurse
suggests to the health care provider that it would be appropriate to select a medication
that does not block the receptors for:
a. H1.
b. GABA.
c. Acetylcholine.
d. 5 HT2.
ANS: A
H1 receptor blockade results in weight gain, which is undesirable for an obese patient.
Blocking of the other receptors would have little or no effect on the patient’s weight.
DIF: Cognitive Level: Application
Planning
MSC: NCLEX: Physiological Integrity
REF: Page: 58
TOP: Nursing Process:
30. Which patient is most likely to have the best therapeutic effect from citalopram (Celexa)?
a. An African American patient
b. A Korean American patient
c. A white patient
d. Ethnicity is unrelated to medication effects.
ANS: C
Many white individuals have a genetic variation that favors a positive therapeutic
response to citalopram. This genetic variation is not likely to be present in African
Americans or Korean Americans.
DIF: Cognitive Level: Application
Planning
MSC: NCLEX: Physiological Integrity
REF: Page: 65
TOP: Nursing Process:
MULTIPLE RESPONSE
1. A nurse prepares to administer antipsychotic medication to a patient with schizophrenia.
Additional monitoring of the medication’s effects and side effects will be most important
if the patient is also diagnosed with which health problem? (More than one answer is
correct.)
a. Diabetes
b. Parkinson’s disease
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Test Bank
4-12
c. Osteoarthritis
d. Graves’ disease
e. Epilepsy
ANS: A, B, E
Antipsychotic medications may produce weight gain, which would complicate care of a
patient with diabetes and/or lower the seizure threshold, which would complicate care of
a patient with epilepsy. Parkinson’s disease involves changes in transmission of
dopamine and acetylcholine, so these drugs would also complicate care of a patient with
the disorder. Osteoarthritis and Graves’ disease should have no synergistic effect with
this medication.
DIF: Cognitive Level: Analysis
Planning
MSC: NCLEX: Physiological Integrity
REF: Page: 58
TOP: Nursing Process:
2. The spouse of a patient with schizophrenia asks, “Which neurotransmitters are more
active when a person has schizophrenia?” The nurse should state, “The current thinking is
that the thought disturbances are related to increased activity of: (More than one answer
is correct.)
a. dopamine.”
b. substance P.”
c. histamine.”
d. increased GABA.”
e. norepinephrine.”
ANS: A, E
Dopamine plays a role in integration of thoughts and emotions, and excess dopamine is
implicated in the thought disturbances of schizophrenia. Increased activity of
norepinephrine also occurs. Substance P is most related to the pain experience. Histamine
decrease is associated with depression. Increased GABA is associated with anxiety
reduction.
DIF: Cognitive Level: Application
TOP: Nursing Process: Implementation
REF: Page: 55
MSC: NCLEX: Physiological Integrity
3. An individual is experiencing problems associated with memory. Which cerebral
structures are most likely to be involved in this deficit? (More than one answer is
correct.)
a. Frontal lobe
b. Parietal lobe
c. Occipital lobe
d. Temporal lobe
e. Basal ganglia
ANS: A, B, D
Copyright © 2009 by Saunders, an imprint of Elsevier Inc.
Test Bank
4-13
The frontal, parietal, and temporal lobes of the cerebrum play a key role in the storage
and processing of memories. The occipital lobe is predominantly involved with vision.
The basal ganglia influence integration of physical movement, as well as some thoughts
and emotions.
DIF: Cognitive Level: Comprehension
TOP: Nursing Process: Assessment
REF: Pages: 46-48
MSC: NCLEX: Physiological Integrity
Copyright © 2009 by Saunders, an imprint of Elsevier Inc.