Foundations and Adult Health Nursing Test Bank

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A patient with suspected tuberculosis (TB) presents with cough, weight loss, night sweats, and hemoptysis. Chest X-ray reveals upper lobe infiltrates and cavitation. Which of the following diagnostic tests is most appropriate for confirming the diagnosis of pulmonary TB?

  • A. Sputum acid-fast bacilli (AFB) smear and culture
  • B. Tuberculin skin test (TST)
  • C. Interferon-gamma release assay (IGRA)
  • D. Chest CT-guided biopsy
Correct Answer: A

Rationale: In a patient with suspected pulmonary TB, the most appropriate diagnostic test for confirming the diagnosis is the sputum acid-fast bacilli (AFB) smear and culture. This test involves examining sputum samples under the microscope for the presence of acid-fast bacilli, which are characteristic of Mycobacterium tuberculosis, the bacteria that causes TB. Additionally, culturing the sputum allows for the bacteria to grow in a controlled environment, further confirming the diagnosis. In the given scenario, the patient's symptoms (cough, weight loss, night sweats, hemoptysis), along with chest X-ray findings of upper lobe infiltrates and cavitation, are highly suggestive of pulmonary TB. Therefore, performing a sputum AFB smear and culture is crucial for definitive diagnosis and initiation of appropriate treatment. The other options (Tuberculin skin test, Interferon

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What post operative teaching will the patient strictly follow?

  • A. Reinforce that fact that airplane travel is no longer permitted.
  • B. Show patient how to gently irrigate the external auditory canal.
  • C. Inform physician any dizziness that develops after she is discharged.
  • D. Stress that hair washing should be avoided immediately after surgery
Correct Answer: B

Rationale: The patient who had a left total hip replacement surgery due to osteoarthritis needs to strictly follow the postoperative teaching of being shown how to gently irrigate the external auditory canal because this instruction is unrelated to a hip replacement surgery. The other options are not relevant to the surgery and patient's condition. Option A about airplane travel, Option C about dizziness, and Option D about hair washing are not appropriate instructions for a patient who had a hip replacement. It is important for healthcare providers to give accurate and relevant postoperative instructions to help the patient recover successfully.

The nurse in the practice of her profession is guided by ________.

  • A. code of ethics
  • B. local government code
  • C. standards of care
  • D. Nursing processs
Correct Answer: A

Rationale: The nurse in the practice of her profession is guided by a code of ethics, which outlines the moral duties and professional responsibilities of nurses. The code of ethics provides a framework for ethical decision-making and sets standards for professional behavior within the nursing profession. Nurses are expected to adhere to the principles of the code of ethics in order to promote the well-being and safety of their patients, maintain professional integrity, and uphold the values of nursing practice.

A woman in active labor is receiving intravenous oxytocin for labor augmentation. What nursing intervention is essential to prevent oxytocin-induced uterine hyperstimulation?

  • A. Monitor maternal vital signs every 2 hours.
  • B. Increase the oxytocin infusion rate gradually.
  • C. Administer intravenous fluids rapidly.
  • D. Encourage the mother to ambulate regularly.
Correct Answer: B

Rationale: When a woman in active labor is receiving intravenous oxytocin for labor augmentation, it is essential to increase the oxytocin infusion rate gradually to prevent oxytocin-induced uterine hyperstimulation. Uterine hyperstimulation can lead to complications such as fetal distress, uterine rupture, and postpartum hemorrhage. By increasing the oxytocin infusion rate gradually, the uterus has more time to adapt to the medication and reduces the risk of hyperstimulation. It is crucial for the healthcare provider to carefully monitor the woman's response to oxytocin and adjust the infusion rate as needed to ensure safe and effective labor augmentation. Monitoring for signs of uterine hyperstimulation, such as persistent contractions close together or excessive uterine activity, is crucial in preventing complications and ensuring the well-being of both the mother and baby.

Which of the following nursing actions should the nurse TEACH the patient's care giver regarding tracheostomy care?

  • A. Remove the tracheostomy tube if obstruction occurs
  • B. Leave the tracheostomy ties in place until the physician change them
  • C. Remove and clean the inner cannula daily
  • D. Never put a covering over the tracheostomy stoma
Correct Answer: C

Rationale: Cleaning the inner cannula daily helps prevent the accumulation of secretions and debris, which can lead to blockages and infections. It is an essential aspect of tracheostomy care to maintain the patency of the airway and prevent complications. Caregivers should be taught how to safely remove, clean, and reinsert the inner cannula as part of routine tracheostomy care.

A patient presents with a sensation of fullness and pressure in the left ear, along with hearing loss and occasional tinnitus. Otoscopic examination reveals a retracted tympanic membrane with decreased mobility on pneumatic otoscopy. Which of the following conditions is most likely responsible for this presentation?

  • A. Acute otitis media
  • B. Otitis externa
  • C. Serous otitis media (otitis media with effusion)
  • D. Cholesteatoma
Correct Answer: C

Rationale: The presentation described with a sensation of fullness and pressure in the left ear, along with hearing loss and occasional tinnitus, and the findings of a retracted tympanic membrane with decreased mobility on pneumatic otoscopy are most consistent with serous otitis media, also known as otitis media with effusion (OME). OME is characterized by the presence of non-infected fluid in the middle ear space, leading to symptoms such as ear fullness, hearing loss, and occasionally tinnitus.

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