Adult Health Nursing Test Bank

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A 20-year-old woman presents with sudden onset of severe lower abdominal pain and missed menstrual periods for the past two months. She has a positive urine pregnancy test. On transvaginal ultrasound, an empty uterus is visualized, and there is fluid in the cul-de-sac. Which condition is most likely to be responsible for these findings?

  • A. Ovarian cyst rupture
  • B. Ectopic pregnancy
  • C. Septic abortion
  • D. Ovarian torsion
Correct Answer: B

Rationale: The correct answer is B: Ectopic pregnancy. In this scenario, the combination of missed periods, positive pregnancy test, and empty uterus on ultrasound with fluid in the cul-de-sac is highly suggestive of an ectopic pregnancy. Ectopic pregnancy occurs when the fertilized egg implants outside the uterus, commonly in the fallopian tube. The presence of fluid in the cul-de-sac indicates possible blood from a ruptured ectopic pregnancy, causing the severe lower abdominal pain. Ovarian cyst rupture (A) typically presents with less severe pain. Septic abortion (C) would present with signs of infection and products of conception in the uterus. Ovarian torsion (D) would present with acute onset of unilateral lower abdominal pain and a palpable adnexal mass, not fluid in the cul-de-sac.

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A patient with a suspected autoimmune disorder exhibits antibodies directed against self-antigens, leading to tissue damage and inflammation. Which of the following mechanisms is primarily responsible for the development of autoimmune diseases?

  • A. Loss of self-tolerance
  • B. Failure of innate immunity
  • C. Defective T cell activation
  • D. Impaired phagocytosis
Correct Answer: A

Rationale: The correct answer is A: Loss of self-tolerance. This is because autoimmune diseases result from a breakdown in the immune system's ability to distinguish between self and non-self antigens, leading to the production of antibodies against self-antigens. When self-tolerance is lost, immune cells mistakenly target the body's own tissues, causing tissue damage and inflammation.

Choice B (Failure of innate immunity) is incorrect because autoimmune diseases are primarily driven by adaptive immunity rather than innate immunity. Choice C (Defective T cell activation) is incorrect as T cells play a critical role in the immune response to self-antigens in autoimmune diseases. Choice D (Impaired phagocytosis) is incorrect as phagocytosis is a mechanism primarily involved in the removal of pathogens, not in the development of autoimmune diseases.

A patient presents with sudden-onset severe headache, vomiting, and altered mental status. Imaging reveals a noncontrast-enhancing hemorrhagic lesion within the subarachnoid space. Which of the following neurological conditions is most likely responsible for these symptoms?

  • A. Ischemic stroke
  • B. Subdural hematoma
  • C. Intracerebral hemorrhage
  • D. Subarachnoid hemorrhage
Correct Answer: D

Rationale: The correct answer is D: Subarachnoid hemorrhage. This condition presents with sudden-onset severe headache, vomiting, and altered mental status due to bleeding in the subarachnoid space. This type of hemorrhage is typically noncontrast-enhancing on imaging.

A: Ischemic stroke does not typically present with sudden-onset severe headache and vomiting.
B: Subdural hematoma usually presents with a slower onset of symptoms and often develops after head trauma.
C: Intracerebral hemorrhage presents with focal neurological deficits rather than altered mental status and vomiting.

In summary, based on the sudden onset of symptoms, imaging findings, and clinical presentation, subarachnoid hemorrhage is the most likely diagnosis in this case.

A patient presents with sudden-onset, painless vision loss in the right eye. Fundoscopic examination reveals a cherry-red spot at the macula and attenuated retinal vessels. Which of the following conditions is most likely responsible for this presentation?

  • A. Central retinal artery occlusion
  • B. Central retinal vein occlusion
  • C. Retinal detachment
  • D. Acute angle-closure glaucoma
Correct Answer: A

Rationale: The correct answer is A: Central retinal artery occlusion. This condition presents with sudden-onset, painless vision loss, cherry-red spot at the macula due to lack of blood flow, and attenuated retinal vessels. The cherry-red spot is due to the transparency of the fovea when there is ischemia in the surrounding retina. Central retinal vein occlusion (B) presents with sudden vision loss accompanied by retinal hemorrhages and dilated tortuous veins. Retinal detachment (C) typically presents with sudden flashes, floaters, and a curtain-like visual field defect. Acute angle-closure glaucoma (D) presents with severe eye pain, blurred vision, halos around lights, and a fixed mid-dilated pupil.

Before admitting the client, you should FIRST make sure that:

  • A. The consent for admission is signed by the client
  • B. The consent for admission is signed by the wife and witnessed by the daughter
  • C. The client can pay his hospital bills.
  • D. The consent form is signed by the social worker.
Correct Answer: A

Rationale: The correct answer is A because obtaining the client's own consent is the first step in ensuring the client's autonomy and right to make decisions about their own care. This is in line with ethical principles of informed consent. Choices B, C, and D are incorrect because consent should come directly from the client, not from a spouse, family member, or social worker. Choice B violates the principle of individual autonomy, choice C is not the priority before admission, and choice D is not the appropriate person to provide consent.

Which of the following clinical manifestations is most indicative of acute respiratory distress syndrome (ARDS)?

  • A. Hypocapnia with respiratory alkalosis
  • B. Bradypnea with metabolic acidosis
  • C. Tachypnea with hypoxemia refractory to supplemental oxygen
  • D. Hypercapnia with hyperkalemia
Correct Answer: C

Rationale: Rationale:
- ARDS is characterized by severe hypoxemia and respiratory distress.
- Tachypnea is a hallmark sign of ARDS due to the body's compensatory mechanism to increase oxygenation.
- Hypoxemia refractory to supplemental oxygen signifies the inability to improve oxygen levels despite intervention.
- Choices A, B, and D do not align with typical manifestations of ARDS, as they do not directly reflect severe hypoxemia or respiratory distress.

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