Advanced Medical-Surgical Nursing Test Bank
Course Introduction
Advanced Medical-Surgical Nursing delves into the complex care of adult patients with acute and chronic medical-surgical conditions. Emphasizing clinical reasoning, evidence-based practices, and advanced nursing interventions, this course covers the management of multi-system health problems, diagnostic procedures, pharmacologic therapies, and collaborative care strategies. Students develop critical decision-making skills while exploring advanced concepts in patient assessment, safety, and education, as well as ethical and legal considerations in high-acuity settings. Through case studies and simulated clinical scenarios, learners enhance their ability to provide holistic, patient-centered care in diverse and dynamic healthcare environments.
Recommended Textbook
Introduction to Critical Care Nursing 6th Edition by Mary Lou Sole
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21 Chapters
756 Verified Questions
756 Flashcards
Source URL: https://quizplus.com/study-set/2011 Page 2
Chapter 1: Overview of Critical Care Nursing
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24 Verified Questions
24 Flashcards
Source URL: https://quizplus.com/quiz/39999
Sample Questions
Q1) The most important outcome of effective communication is to:
A) demonstrate caring practices to family members.
B) ensure that patient teaching is done.
C) meet the diversity needs of patients.
D) reduce patient errors.
Answer: D
Q2) The AACN Standards for Acute and Critical Care Nursing Practice use what framework to guide critical care nursing practice?
A) Evidence-based practice
B) Healthy work environment
C) National Patient Safety Goals
D) Nursing process
Answer: D
Q3) Which of the following assists the critical care nurse in ensuring that care is appropriate and based on research?
A) Clinical practice guidelines
B) Computerized physician order entry
C) Consulting with advanced practice nurses
D) Implementing Joint Commission National Patient Safety Goals
Answer: A
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Chapter 2: Patient and Family Response to the Critical Care Experience
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28 Verified Questions
28 Flashcards
Source URL: https://quizplus.com/quiz/40000
Sample Questions
Q1) Family members have a need for information.Which interventions best assist in meeting this need?
A) Handing family members a pamphlet that explains all of the critical care equipment
B) Providing a daily update of the patient's progress and facilitating communication with the intensivist
C) Telling them that you are not permitted to give them a status report but that they can be present at 4:00 PM for family rounds with the intensivist
D) Writing down a list of all new medications and doses and giving the list to family members during visitation
Answer: B
Q2) The constant noise of a ventilator,monitor alarms,and infusion pumps predisposes the patient to:
A) anxiety.
B) pain.
C) powerlessness.
D) sensory overload.
Answer: D
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Chapter 3: Ethical and Legal Issues in Critical Care Nursing
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23 Verified Questions
23 Flashcards
Source URL: https://quizplus.com/quiz/40001
Sample Questions
Q1) A specific request made by a competent person that directs medical care related to life-prolonging procedures if the patient loses capacity to make decisions is called a:
A) do not resuscitate order.
B) healthcare proxy.
C) informed consent.
D) living will.
Answer: D
Q2) A critically ill patient has a living will in his chart.His condition has deteriorated.His wife says she wants "everything done," regardless of the patient's wishes.Which ethical principle is the wife violating?
A) Autonomy
B) Beneficence
C) Justice
D) Nonmaleficence
Answer: A
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Chapter 4: End-Of-Life Care in the Critical Care Unit
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26 Verified Questions
26 Flashcards
Source URL: https://quizplus.com/quiz/40002
Sample Questions
Q1) Which statement is consistent with societal views of dying in the United States?
A) Dying is viewed as a failure on the part of the system and providers.
B) Most Americans would prefer to die in a hospital to spare loved ones the burden of care.
C) People die of indistinct, complex illness for which a cure is always possible.
D) The purpose of the healthcare system is to prevent disease and treat symptoms.
Q2) The patient's husband is terrified by the prospect of removing life-sustaining treatments from the patient.He asks why anyone would do that.The nurse explains,
A) "It is to save you money so you won't have such a large financial burden."
B) "It will preserve limited resources for the hospital so other patients may benefit from them."
C) "It is to discontinue treatments that are not helping your wife and may be very uncomfortable for her."
D) "We have done all we can for your wife and any more treatment would be futile."
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6
Chapter 5: Comfort and Sedation
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33 Verified Questions
33 Flashcards
Source URL: https://quizplus.com/quiz/40003
Sample Questions
Q1) The nurse is caring for a patient with hyperactive delirium.The nurse focuses interventions toward keeping the patient:
A) comfortable
B) nourished
C) safe
D) sedated
Q2) The nurse wishes to assess the quality of a patient's pain.Which of the following questions is appropriate to obtain this assessment if the patient is able to give a verbal response?
A) "Is the pain constant or intermittent?"
B) "Is the pain sharp, dull, or crushing?"
C) "What makes the pain better? Worse?"
D) "When did the pain start?"
Q3) The nurse recognizes that which patient is likely to benefit most from patient-controlled analgesia?
A) 21-year-old with a C4 fracture and quadriplegia
B) 45-year-old with femur fracture and closed head injury
C) 59-year-old postoperative elective bariatric surgery
D) 70-year-old postoperative cardiac surgery; mild dementia
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Page 7
Chapter 6: Nutritional Support
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30 Verified Questions
30 Flashcards
Source URL: https://quizplus.com/quiz/40004
Sample Questions
Q1) Calorie-dense feedings: (Select all that apply.)
A) are most useful in heart failure and liver disease.
B) are most useful in malabsorption syndromes.
C) contain 2 kcal/mL and 70 g protein/L.
D) include increased fiber.
Q2) In trauma patients,enteral nutrition via nasogastric tube feedings into the small bowel is best initiated within what time frame following the injury?
A) 24 hours
B) 48 hours
C) 7 days
D) 72 hours
Q3) A patient with a history of emphysema,diabetes,and hyperlipidemia is in the critical care unit on a ventilator.The nutrition assessment notes that the patient has a protein and vitamin deficiency and is underweight.Which formula for nutritional assessment is most appropriate?
A) Elemental protein formula
B) Fiber-added formula
C) High medium-chain triglyceride formula
D) Lactose-free formula
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Page 8
Chapter 7: Dysrhythmia Interpretation and Management
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59 Verified Questions
59 Flashcards
Source URL: https://quizplus.com/quiz/40005
Sample Questions
Q1) The patient has an irregular heart rhythm.To determine an accurate heart rate,the nurse first:
A) identifies the markers on the ECG paper that indicate a 6-second strip.
B) counts the number of large boxes between two consecutive P waves.
C) counts the number of small boxes between two consecutive QRS complexes.
D) divides the number of complexes in a 6-second strip by 10.
Q2) The nurse is caring for a patient who has atrial fibrillation.Sequelae that place the patient at greater risk for mortality/morbidity include which of the following? (Select all that apply.)
A) Stroke
B) Ashman beats
C) Pulmonary emboli
D) Prolonged PR interval
E) Decreased cardiac output
Q3) The patient is having premature ventricular contractions (PVCs).The nurse's greatest concern should be:
A) the proximity of the R wave of the PVC to the T wave of a normal beat.
B) the fact that PVCs are occurring, because they are so rare.
C) if the number of PVCs are decreasing.
D) if the PVCs are wider than 0.12 seconds.
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Chapter 8: Hemodynamic Monitoring
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35 Verified Questions
35 Flashcards
Source URL: https://quizplus.com/quiz/40006
Sample Questions
Q1) The charge nurse is supervising care for a group of patients monitored with a variety of invasive hemodynamic devices.Which patient should the charge nurse evaluate first?
A) A patient with a central venous pressure (RAP/CVP) of 6 mm Hg and 40 mL of urine output in the past hour
B) A patient with a left radial arterial line with a BP of 110/60 mm Hg and slightly dampened arterial waveform
C) A patient with a pulmonary artery occlusion pressure of 25 mm Hg and an oxygen saturation of 89% on 3 L of oxygen via nasal cannula
D) A patient with a pulmonary artery pressure of 25/10 mm Hg and an oxygen saturation of 94% on 2 L of oxygen via nasal cannula
Q2) Which of the following situations may result in a low cardiac output and low cardiac index? (Select all that apply.)
A) Exercise
B) Hypovolemia
C) Myocardial infarction
D) Shock
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Chapter 9: Ventilatory Assistance
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36 Verified Questions
36 Flashcards
Source URL: https://quizplus.com/quiz/40007
Sample Questions
Q1) The nurse is assessing the exhaled tidal volume (EVT)in a mechanically ventilated patient.The rationale for this assessment is to:
A) assess for tension pneumothorax.
B) assess the level of positive end-expiratory pressure.
C) compare the tidal volume delivered with the tidal volume prescribed.
D) determine the patient's work of breathing.
Q2) The nurse is caring for a patient who is mechanically ventilated.As part of the nursing care,the nurse understands that:
A) communication with intubated patients is often difficult.
B) controlled ventilation is the preferred mode for most patients.
C) patients with chronic obstructive pulmonary disease wean easily from mechanical ventilation.
D) wrist restraints are applied to all patients to avoid self-extubation.
Q3) The amount of effort needed to maintain a given level of ventilation is termed: A) compliance.
B) resistance.
C) tidal volume.
D) work of breathing.
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Chapter 10: Rapid Response Teams and Code Management
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31 Verified Questions
31 Flashcards
Source URL: https://quizplus.com/quiz/40008
Sample Questions
Q1) The patient is diagnosed with abrupt onset of supraventricular tachycardia (SVT).The nurse prepares which medication that has a short half-life and is recommended to treat symptomatic SVT?
A) Adenosine
B) Amiodarone
C) Diltiazem
D) Procainamide
Q2) Which of the following statements about defibrillation are correct? (Select all that apply.)
A) Early defibrillation ( if warranted ) is recommended before other actions.
B) It is not necessary to ensure that personnel are clear of the patient if hands-off defibrillation is used.
C) It is not necessary to synchronize the defibrillation shocks.
D) Paddles/patches can be placed anteriorly and posteriorly on the chest.
Q3) Post-resuscitation goals include which of the following? (Select all that apply.)
A) Control dysrhythmias
B) Maintain airway
C) Maintain blood pressure
D) Wean off oxygen
Page 12
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Chapter 11: Shock, sepsis, and Multiple Organ Dysfunction Syndrome
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34 Verified Questions
34 Flashcards
Source URL: https://quizplus.com/quiz/40009
Sample Questions
Q1) The nurse is caring for a patient with severe sepsis who was resuscitated with 3000 mL of lactated Ringer solution over the past 4 hours.Morning laboratory results show a hemoglobin of 8 g/dL and hematocrit of 28%.What is the best interpretation of these findings by the nurse?
A) Blood transfusion with packed red blood cells is required.
B) Hemoglobin and hematocrit results indicate hemodilution.
C) Fluid resuscitation has resulted in fluid volume overload.
D) Fluid resuscitation has resulted in third spacing of fluid.
Q2) The nurse is administering both crystalloid and colloid intravenous fluids as part of fluid resuscitation in a patient admitted in severe sepsis.What findings assessed by the nurse indicate an appropriate response to therapy?
A) Normal body temperature
B) Balanced intake and output
C) Adequate pain management
D) Urine output of 0.5 mL/kg/hr
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Page 13
Chapter 12: Cardiovascular Alterations
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37 Verified Questions
37 Flashcards
Source URL: https://quizplus.com/quiz/40010
Sample Questions
Q1) Which of the following cardiac diagnostic tests would include monitoring the gag reflex before giving the patient anything to eat or drink?
A) Barium swallow
B) Transesophageal echocardiogram
C) MUGA scan
D) Stress test
Q2) An essential aspect of teaching that may prevent recurrence of heart failure is:
A) notifying the physician if a 2-lb weight gain occurs in 24 hours.
B) compliance with diuretic therapy.
C) taking nitroglycerin if chest pain occurs.
D) assessment of an apical pulse.
Q3) The patient presents to the ED with severe chest discomfort.He is taken for cardiac catheterization and angiography that shows 80% occlusion of the left main coronary artery.Which procedure will be most likely followed?
A) Coronary artery bypass graft surgery
B) Intracoronary stent placement
C) Percutaneous transluminal coronary angioplasty ( PTCA )
D) Transmyocardial revascularization
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Chapter 13: Nervous System Alterations
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35 Verified Questions
35 Flashcards
Source URL: https://quizplus.com/quiz/40011
Sample Questions
Q1) The nurse admits a patient to the critical care unit following a motorcycle crash.Assessment findings by the nurse include blood pressure 100/50 mm Hg,heart rate 58 beats/min,respiratory rate 30 breaths/min,and temperature of 100.5°.The patient is lethargic,responds to voice but falls asleep readily when not stimulated.Which nursing action is most important to include in this patient's plan of care?
A) Frequent neurological assessments
B) Side to side position changes
C) Range of motion to extremities
D) Frequent oropharyngeal suctioning
Q2) The nurse is caring for a patient admitted to the ED following a fall from a 10-foot ladder.Upon admission,the nurse assesses the patient to be awake,alert,and moving all four extremities.The nurse also notes bruising behind the left ear and straw-colored drainage from the left nare.What is the most appropriate nursing action?
A) Insert bilateral ear plugs.
B) Monitor airway patency.
C) Maintain neutral head position.
D) Apply a small nasal drip pad.
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Chapter 14: Acute Respiratory Failure
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36 Verified Questions
36 Flashcards
Source URL: https://quizplus.com/quiz/40012
Sample Questions
Q1) The nurse is discharging a patient with asthma.As part of the discharge instruction,the nurse instructs the patient to prevent exacerbation by:
A) obtaining an appointment for follow-up pulmonary function studies 1 week after discharge.
B) limiting activity until patient is able to climb two flights of stairs.
C) taking all asthma medications as prescribed.
D) taking medications on a "prn" basis according to symptoms.
Q2) An acute exacerbation of asthma is treated with which of the following?
A) Corticosteroids and theophylline by mouth
B) Inhaled bronchodilators and intravenous corticosteroids
C) Prone positioning or continuous lateral rotation
D) Sedation and inhaled bronchodilators
Q3) The nurse is concerned that a patient is at increased risk of developing a pulmonary embolus and develops a plan of care for prevention to include which of the following?
A) Antiseptic oral care
B) Bed rest with head of bed elevated
C) Coughing and deep breathing
D) Mobility
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16
Chapter 15: Acute Kidney Injury
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50 Verified Questions
50 Flashcards
Source URL: https://quizplus.com/quiz/40013
Sample Questions
Q1) Peritoneal dialysis is different from hemodialysis in that peritoneal dialysis:
A) is more frequently used for acute kidney injury.
B) uses the patient's own semipermeable membrane (peritoneal membrane).
C) is not useful in cases of drug overdose or electrolyte imbalance.
D) is not indicated in cases of water intoxication.
Q2) The patient has just returned from having an arteriovenous fistula placed.The patient asks,"When will they be able to use this and take this other catheter out?" The nurse should reply,
A) "It can be used immediately so the catheter can come out anytime."
B) "It will take 2 to 4 weeks to heal before it can be used."
C) "The fistula will be usable in about 4 to 6 weeks."
D) "The fistula was made using graft material so it depends on the manufacturer."
Q3) The patient is on intake and output (I&O)as well as daily weights.The nurse notes that output is considerably less than intake over the last shift,and daily weight is 1 kg more than yesterday.The nurse should:
A) draw a trough level after the next dose of antibiotic.
B) obtain an order to place the patient on fluid restriction.
C) assess the patient's lungs.
D) insert an indwelling catheter.
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Page 17
Chapter 16: Hematological and Immune Disorders
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55 Verified Questions
55 Flashcards
Source URL: https://quizplus.com/quiz/40014
Sample Questions
Q1) The nurse is caring for an elderly patient who is being admitted for anemia of unknown cause.The patient has been on multiple medications at home for various ailments.In assessing the patient's medication list,the nurse notes medications that may alter hemostasis,including: (Select all that apply.)
A) aminoglycosides.
B) antiplatelet agents.
C) cephalosporins.
D) vasoconstrictors.
E) sulfonamides.
Q2) The patient comes to the hospital complaining of headache,fever,and sore throat for the past 2 weeks and is concerned that he might have acquired immune deficiency syndrome (AIDS).The patient's blood work shows the presence of HIV antibodies.The nurse should explain that:
A) HIV symptoms will continue throughout the patient's life.
B) HIV is an acute disease with a short prognosis.
C) AIDS is considered a chronic disease.
D) very few people with HIV develop AIDS.
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Chapter 17: Gastrointestinal Alterations
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52 Verified Questions
52 Flashcards
Source URL: https://quizplus.com/quiz/40015
Sample Questions
Q1) When assessing bowel sounds,the nurse:
A) uses the "bell" part of the stethoscope.
B) listens at least 15 minutes.
C) expects bowel sounds to be regular in rhythm.
D) listens for 5 minutes before noting "absent bowel sounds."
Q2) The nurse is caring for a patient with liver disease.When assessing the patient's laboratory values,the nurse should:
A) disregard the level of conjugated bilirubin.
B) assess the indirect serum bilirubin.
C) call the provider immediately if the direct bilirubin is elevated.
D) be aware that unconjugated bilirubin is harmless.
Q3) The nurse is caring for a patient who has had a portacaval shunt placed surgically.The nurse is aware that this procedure:
A) improves survival in patients with varices.
B) decreases the risk of encephalopathy.
C) decreases the incidence of ascites.
D) decreases rebleeding.
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Chapter 18: Endocrine Alterations
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35 Verified Questions
35 Flashcards
Source URL: https://quizplus.com/quiz/40016
Sample Questions
Q1) The nurse is caring for a 27-year-old patient with a diagnosis of head trauma.The nurse notes that the patient's urine output has increased tremendously over the past 18 hours.The nurse suspects that the patient may be developing:
A) diabetes insipidus.
B) diabetic ketoacidosis.
C) hyperosmolar hyperglycemic syndrome.
D) syndrome of inappropriate secretion of antidiuretic hormone.
Q2) Which of the following patients is at the highest risk for hyperosmolar hyperglycemic syndrome?
A) An 18-year-old college student with type 1 diabetes who exercises excessively
B) A 45-year-old woman with type 1 diabetes who forgets to take her insulin in the morning
C) A 75-year-old man with type 2 diabetes and coronary artery disease who has recently started on insulin injections
D) An 83-year-old, long-term care resident with type 2 diabetes and advanced Alzheimer's disease who recently developed influenza
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Chapter 19: Trauma and Surgical Management
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31 Verified Questions
31 Flashcards
Source URL: https://quizplus.com/quiz/40017
Sample Questions
Q1) The need for fluid resuscitation can be assessed best in the trauma patient by monitoring and trending which of the following tests?
A) Arterial oxygen saturation
B) Hourly urine output
C) Mean arterial pressure
D) Serum lactate levels
Q2) When providing information on trauma prevention,it is important to realize that individuals age 35 to 54 years are most likely to experience which type of trauma incident?
A) High-speed motor vehicle crashes
B) Poisonings from prescription or illegal drugs
C) Violent or domestic traumatic altercations
D) Work-related falls
Q3) Which of the following patients would require greater amounts of fluid resuscitation to prevent acute kidney injury associated with rhabdomyolysis? (Select all that apply.)
A) Crush injury to right arm
B) Gunshot wound to the abdomen
C) Lightning strike of the left arm and chest
D) Pulmonary contusion and rib fracture
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Chapter 20: Burns
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31 Verified Questions
31 Flashcards
Source URL: https://quizplus.com/quiz/40018
Sample Questions
Q1) An elderly individual from an assisted living facility presents with severe scald burns to the buttocks and back of the thighs.The caregiver from the ALF accompanies the patient to the emergency department and states that the bath water was "too hot" and that the "patient sat in the water too long." What should the nurse do?
A) Ask the caregiver at what temperature the water heater is set in the home.
B) Ask the caregiver to step out while examining the patient's burn injury.
C) Immediately contact the police to report the suspected elder abuse.
D) Ask the caregiver to describe exactly how the injury occurred.
Q2) A patient with a 60% burn in the acute phase of treatment develops a tense abdomen,decreasing urine output,hypercapnia,and hypoxemia.Based on this assessment,the nurse anticipates interventions to evaluate and treat the patient for:
A) acute kidney injury.
B) acute respiratory distress syndrome.
C) intraabdominal hypertension.
D) disseminated intravascular coagulation disorder.
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22
Chapter 21: Solid Organ Transplantation
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35 Verified Questions
35 Flashcards
Source URL: https://quizplus.com/quiz/40019
Sample Questions
Q1) The nurse is providing postoperative education to a transplant patient's family.When asked about detecting rejection,which answer by the nurse is most appropriate?
A) "Endomyocardial biopsies will be performed weekly for the first six weeks after surgery."
B) "Increased shortness of breath most likely indicates immediate, acute rejection of the heart."
C) "Biopsies of the heart are done every 6 months after the day of the transplant surgery."
D) "As time passes, the more biopsies that are performed, the more reliable the results become."
Q2) The nurse is caring for a patient following a bilateral lung transplant.When planning postoperative care of the patient,priority is placed on pulmonary hygiene.Which statement provides the best explanation for this priority?
A) Immunosuppressant medications reduce the body's ability to fight infections.
B) During the early postoperative period, atelectasis decreases oxygenation.
C) Pulmonary hygiene reduces the risk of early primary graft dysfunction.
D) Loss of cough reflex results in decreased ability to remove secretions effectively.
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Page 23