Adult Health Med Surg Nursing Test Banks

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A nurse is preparing to perform a colposcopy procedure for a patient with abnormal cervical cytology results. What action should the nurse prioritize to enhance patient comfort during colposcopy?

  • A. Administering intravenous sedation to the patient before the procedure
  • B. Explaining the procedure steps and providing emotional support to the patient
  • C. Applying a topical anesthetic cream to the cervix before colposcopy
  • D. Allowing the patient to have a support person present during the procedure
Correct Answer: B

Rationale: The best action the nurse should prioritize to enhance patient comfort during a colposcopy procedure is to explain the procedure steps and provide emotional support to the patient. Colposcopy is a procedure that involves examining the cervix, vagina, and vulva closely. Patients may feel anxious or uncomfortable during the procedure due to the sensitive nature of the area being examined and the potential concerns related to abnormal cervical cytology results. By explaining the procedure steps in detail before starting and providing emotional support, the nurse can help alleviate the patient's fears and anxieties, thereby enhancing their comfort and promoting a more positive experience overall. Additionally, establishing good communication and trust with the patient can also improve their cooperation during the procedure. Administering sedation, applying a topical anesthetic cream, and allowing a support person to be present are all important factors in providing holistic care as well, but the initial priority should be on communication and emotional support.

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A postpartum client exhibits signs of postpartum psychosis, including hallucinations, delusions, and disorganized behavior. Which nursing intervention is most appropriate?

  • A. Administering antipsychotic medication as ordered
  • B. Encouraging the client to participate in group therapy sessions
  • C. Providing education on coping skills and stress management
  • D. Notifying the healthcare provider immediately
Correct Answer: D

Rationale: When a postpartum client exhibits signs of postpartum psychosis such as hallucinations, delusions, and disorganized behavior, it is crucial to involve the healthcare provider immediately. Postpartum psychosis is a psychiatric emergency that requires prompt assessment and intervention by mental health professionals. The healthcare provider can determine the appropriate course of action, which may include hospitalization, medication management, and specialized psychiatric care. Delaying notification can lead to serious consequences for both the client and her infant, so timely intervention is essential in managing postpartum psychosis.

A patient admitted to the ICU develops acute intracerebral hemorrhage (ICH) with elevated intracranial pressure (ICP). What intervention should the healthcare team prioritize to manage the patient's ICP?

  • A. Initiate hypertonic saline therapy for osmotic diuresis.
  • B. Perform emergent craniotomy for hematoma evacuation.
  • C. Implement head-of-bed elevation to promote cerebral venous drainage.
  • D. Recommend sedative medications to reduce agitation and anxiety.
Correct Answer: B

Rationale: In cases of acute intracerebral hemorrhage (ICH) with elevated intracranial pressure (ICP), a significant factor contributing to the elevated ICP is often the mass effect caused by the hematoma within the brain. Performing an emergent craniotomy for hematoma evacuation is a critical intervention to relieve the pressure within the intracranial space, thereby mitigating the risk of herniation and further neurological damage. While other interventions such as hypertonic saline therapy, head-of-bed elevation, and sedative medications may have supporting roles in managing ICP, none address the primary cause of elevated ICP in cases of acute intracerebral hemorrhage as effectively as hematoma evacuation through craniotomy.

The MOST significant contributory factor to the development of lung cancer is ________.

  • A. being a cigarette smoker
  • B. belonging to the male sex
  • C. Being extremely obese
  • D. age over 4 0years
Correct Answer: A

Rationale: The most significant contributory factor to the development of lung cancer is being a cigarette smoker. Cigarette smoking is directly linked to approximately 85% of lung cancer cases. The harmful substances in tobacco smoke, such as carcinogens, damage the cells in the lungs, leading to the development of cancer over time. Smokers are at a significantly higher risk of developing lung cancer compared to non-smokers. Therefore, being a cigarette smoker is the primary and most influential risk factor for developing lung cancer.

After formulating and delimiting the research problem, which following will be a PRIORITY action of Gloria?

  • A. Develop the theoretical framework of the study
  • B. Formulate the hypothesis
  • C. Plan the research design of the study
  • D. Conduct a 1iterature search on the topic
Correct Answer: C

Rationale: After formulating and delimiting the research problem, the priority action would be to plan the research design of the study. This is crucial because the research design will outline the specific methods and procedures that Gloria will use to investigate the research problem and answer the research questions. Planning the research design involves determining the overall structure of the study, selecting the appropriate research methods, and outlining how data will be collected and analyzed. This step is essential for ensuring that the study is well-organized, rigorous, and will yield reliable results. Developing a solid research design early on will set a strong foundation for the rest of the research process.

A woman in active labor is diagnosed with a prolapsed umbilical cord. What is the priority nursing action?

  • A. Elevate the mother's hips to relieve pressure on the cord.
  • B. Prepare for immediate cesarean section.
  • C. Administer intravenous fluids rapidly.
  • D. Perform a vaginal examination to assess cervical dilation.
Correct Answer: B

Rationale: A prolapsed umbilical cord is a medical emergency during labor because it can cause compression of the umbilical cord, leading to decreased oxygen supply to the fetus. The priority nursing action in this situation is to prepare for an immediate cesarean section. This is necessary to quickly deliver the baby and relieve pressure on the cord, preventing potential fetal distress or death. Elevating the mother's hips may help reduce pressure on the cord temporarily, but it is not the definitive treatment for a prolapsed cord. Administering intravenous fluids rapidly may be necessary, but it is not the priority intervention when the fetus is at risk due to a prolapsed cord. Performing a vaginal examination to assess cervical dilation is contraindicated in the presence of a prolapsed umbilical cord as it can further compress the cord and worsen the situation.

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