Adult Health Nursing First Chapter Quizlet

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A patient admitted to the ICU develops severe sepsis with refractory hypotension despite adequate fluid resuscitation. What intervention should the healthcare team prioritize to manage the patient's septic shock?

  • A. Administer vasopressor medications to restore vascular tone.
  • B. Perform blood cultures to identify the causative pathogen.
  • C. Initiate broad-spectrum antibiotics targeting likely pathogens.
  • D. Recommend prophylactic anticoagulation to prevent thrombosis.
Correct Answer: A

Rationale: In the scenario described, the patient is experiencing refractory hypotension despite adequate fluid resuscitation, indicating the presence of septic shock. In septic shock, systemic vasodilation and vascular hyporesponsiveness contribute to hypotension. Therefore, the primary management approach is to restore vascular tone and blood pressure to maintain organ perfusion. Administering vasopressor medications (Choice A) is the crucial intervention to achieve this goal. Vasopressors, such as norepinephrine or vasopressin, constrict blood vessels and increase blood pressure, helping to stabilize the patient in septic shock. While options B and C (performing blood cultures and initiating broad-spectrum antibiotics) are important for identifying the causative pathogen and treating the infection, they are secondary to the immediate need for hemodynamic support in septic shock. Prophylactic anticoagulation (Choice D) is not the primary intervention for

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A patient with terminal illness expresses fear and anxiety about dying alone. What intervention should the palliative nurse prioritize to address the patient's concerns?

  • A. Arrange for family members or loved ones to be present at the patient's bedside.
  • B. Offer reassurance that dying alone is a common experience in palliative care.
  • C. Recommend distracting activities to divert the patient's attention from their fears.
  • D. Administer sedative medications to alleviate anxiety and promote relaxation.
Correct Answer: A

Rationale: The most appropriate intervention for the palliative nurse to prioritize in this situation is to arrange for family members or loved ones to be present at the patient's bedside. Having loved ones nearby can provide emotional support, comfort, and reassurance to the patient during their final moments. This can help alleviate the fear and anxiety the patient is experiencing about dying alone. Additionally, it can contribute to a sense of connectedness and peace for both the patient and their loved ones during this challenging time. Offering practical solutions to address the patient's emotional needs is key in providing holistic palliative care.

A patient is prescribed an antipsychotic medication for the management of schizophrenia. Which adverse effect should the nurse monitor closely in the patient?

  • A. Hypertension
  • B. Hypoglycemia
  • C. Extrapyramidal symptoms
  • D. Hypercalcemia
Correct Answer: C

Rationale: Antipsychotic medications, especially first-generation antipsychotics, can cause extrapyramidal symptoms (EPS) as an adverse effect. EPS include symptoms such as muscle rigidity, tremors, akathisia (restlessness), and tardive dyskinesia (involuntary movements of the face and body). These symptoms are due to the medications' effects on the dopamine system in the brain. It is crucial for the nurse to monitor the patient closely for EPS because they can be uncomfortable, distressing, and may impact the patient's quality of life and medication adherence. Early recognition and management of EPS are essential to prevent further complications and improve the patient's overall well-being.

A patient with a history of multiple myeloma presents with weakness, bone pain, and recurrent infections. Laboratory tests reveal anemia, hypercalcemia, renal insufficiency, and monoclonal spike on serum protein electrophoresis. Which of the following conditions is most likely to cause these findings?

  • A. Waldenstrom macroglobulinemia
  • B. Hodgkin lymphoma
  • C. Chronic lymphocytic leukemia (CLL)
  • D. Multiple myeloma
Correct Answer: D

Rationale: Multiple myeloma is a plasma cell neoplasm characterized by the presence of abnormal monoclonal plasma cells in the bone marrow, which produce a monoclonal spike on serum protein electrophoresis. The clinical presentation of weakness, bone pain, and recurrent infections is typical of multiple myeloma. Anemia can result from bone marrow infiltration by the abnormal plasma cells, hypercalcemia is due to bone destruction and release of calcium, renal insufficiency can result from hypercalcemia and protein deposition in the kidneys, and the monoclonal spike in serum protein electrophoresis indicates the presence of a monoclonal protein. Waldenström macroglobulinemia, Hodgkin lymphoma, and chronic lymphocytic leukemia do not typically present with the classic tetrad of findings seen in multiple myeloma.

A patient with a history of deep vein thrombosis (DVT) is prescribed warfarin therapy. Which laboratory test is used to monitor the therapeutic effect of warfarin?

  • A. Activated partial thromboplastin time (aPTT)
  • B. International normalized ratio (INR)
  • C. Platelet count
  • D. D-dimer
Correct Answer: B

Rationale: The laboratory test used to monitor the therapeutic effect of warfarin therapy is the International Normalized Ratio (INR). Warfarin is a commonly prescribed anticoagulant medication that works by inhibiting the action of vitamin K-dependent clotting factors. Maintaining the INR within the target range specific to the indication for anticoagulation (e.g., DVT prevention or treatment) is essential to balance the risk of bleeding and clotting.

Non verbal communication is the behavior that accompanies verbal communication, which of the following is NOT an indicator of this

  • A. Eye contact
  • B. Grunts and groans
  • C. Words representing an object
  • D. Bochy language
Correct Answer: C

Rationale: Nonverbal communication consists of gestures, facial expressions, body language, posture, tone of voice, touch, and eye contact, among other behaviors. Option C, words representing an object, refers to verbal communication rather than nonverbal communication. Nonverbal communication is the behavior that accompanies verbal communication, providing additional layers of meaning and adding context to the spoken words. Therefore, words representing an object are not indicators of nonverbal communication.

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