Adult Health Nursing Test Banks

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A patient presents with a history of recurrent nosebleeds, easy bruising, and gum bleeding. Laboratory tests reveal prolonged bleeding time and normal platelet count, PT, and aPTT. Which of the following conditions is most likely to cause these findings?

  • A. Von Willebrand disease
  • B. Hemophilia A
  • C. Thrombocytopenia
  • D. Factor V Leiden mutation
Correct Answer: A

Rationale: Von Willebrand disease is a hereditary bleeding disorder that results from a deficiency or dysfunction of von Willebrand factor (vWF), a protein that plays a key role in platelet adhesion and the initiation of primary hemostasis. The clinical manifestations of von Willebrand disease include recurrent mucocutaneous bleeding, such as nosebleeds, easy bruising, and gum bleeding. Laboratory findings typically show a prolonged bleeding time due to impaired platelet function, while platelet count, PT (prothrombin time), and aPTT (activated partial thromboplastin time) are usually normal. This distinguishes von Willebrand disease from other bleeding disorders such as hemophilia A (Factor VIII deficiency), which would show abnormal PT and aPTT due to deficiencies in specific clotting factors. Thrombocytopenia, on the other hand, would be characterized by a low platelet count

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A patient with a history of chronic kidney disease is prescribed a low-phosphorus diet. Which dietary choice indicates understanding of the prescribed diet?

  • A. Grilled chicken breast
  • B. Cheese omelet
  • C. Whole wheat toast with peanut butter
  • D. Spinach salad with almonds
Correct Answer: A

Rationale: Grilled chicken breast is a suitable choice for a low-phosphorus diet because poultry is typically lower in phosphorus compared to dairy products (like cheese), nuts (like almonds), and whole grains (like wheat toast). This option indicates an understanding of the need to restrict phosphorus intake, which is important for individuals with chronic kidney disease to prevent complications.

A patient with a history of chronic kidney disease is prescribed a low-protein diet. Which dietary choice indicates understanding of the prescribed diet?

  • A. Grilled salmon
  • B. Lentil soup
  • C. Beef stew
  • D. Chicken Caesar salad
Correct Answer: D

Rationale: A patient with chronic kidney disease prescribed a low-protein diet should avoid high-protein foods like grilled salmon, lentil soup, and beef stew. Chicken Caesar salad, on the other hand, typically contains a smaller amount of protein compared to the other options. This choice indicates an understanding of the need to limit protein intake while still enjoying a balanced meal. However, it is important to note that the quantity and portion sizes of high-protein ingredients in the salad should also be moderate to comply with a low-protein diet.

The physician orders cromolyn sodium (nasal crom) for the client. The nurse instructs the client that the most effective administration schedule is ________.

  • A. When manifestations peak only, with two or three doses per day
  • B. At the start of the allergy season, with a dose of once-a-day
  • C. One week before the allergy season begins, with four to six doses per day
  • D. Just after manifestations begin, with a dose of twice-a-day
Correct Answer: D

Rationale: Cromolyn sodium (nasal crom) is a mast cell stabilizer that is commonly used to prevent symptoms of allergic rhinitis, such as sneezing, itching, and congestion. It works best when used before exposure to allergens. The most effective administration schedule for nasal crom is to start using it just after allergy symptoms begin, with a dose of twice-a-day. This helps to prevent the release of histamine and other inflammatory substances from mast cells, thereby reducing allergic symptoms. Using nasal crom in this way can help provide relief and improve the overall management of allergic rhinitis.

After a throurough assessment by the physician-specialist, an order for an immediate sonogram was made specific for the medical condition?

  • A. Operation Room
  • B. Intervention
  • C. Laboratory
  • D. CT Scan
Correct Answer: B

Rationale: In this scenario, the physician-specialist assessed the patient and determined that an immediate sonogram is needed for the medical condition. An intervention is a specific action taken in response to a medical need or condition. Ordering an immediate sonogram falls under the category of an intervention because it involves a timely and targeted diagnostic procedure to address the medical situation identified by the physician. The other options (A. Operation Room, C. Laboratory, D. CT scan) do not accurately represent the specific action of ordering a sonogram in response to the medical condition assessed by the physician.

A patient presents with a painless thyroid nodule and hoarseness of voice. Fine-needle aspiration biopsy reveals papillary thyroid carcinoma. Which endocrine disorder is most likely responsible for these symptoms?

  • A. Hashimoto's thyroiditis
  • B. Graves' disease
  • C. Diabetes mellitus
  • D. Thyroid cancer
Correct Answer: D

Rationale: In this scenario, the patient's presentation of a painless thyroid nodule and hoarseness of voice is consistent with papillary thyroid carcinoma, a type of thyroid cancer. While Hashimoto's thyroiditis and Graves' disease are autoimmune thyroid conditions that can lead to thyroid nodules, they typically do not present with hoarseness of voice. Diabetes mellitus does not directly cause these symptoms. Thyroid cancer, particularly papillary thyroid carcinoma, is the most likely cause based on the patient's clinical presentation and the biopsy results.

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