Adult Health Nursing Test Bank

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A patient presents with acute onset of shoulder pain and limited range of motion after a fall onto an outstretched hand. Physical examination reveals tenderness over the greater tuberosity of the humerus and pain with passive abduction and external rotation of the shoulder. Which of the following conditions is most likely?

  • A. Rotator cuff tear
  • B. Glenohumeral dislocation
  • C. Acromioclavicular joint separation
  • D. Proximal humerus fracture
Correct Answer: A

Rationale: The correct answer is A: Rotator cuff tear. The presentation of acute shoulder pain and limited range of motion after a fall onto an outstretched hand, along with tenderness over the greater tuberosity and pain with passive abduction and external rotation, is classic for a rotator cuff tear. The mechanism of injury and physical exam findings are consistent with this condition.

B: Glenohumeral dislocation typically presents with a visibly deformed shoulder and loss of normal shoulder contour.

C: Acromioclavicular joint separation would present with tenderness over the AC joint rather than the greater tuberosity, and typically involves a history of direct trauma to the shoulder.

D: Proximal humerus fracture would present with more diffuse shoulder pain and swelling, and not specific tenderness over the greater tuberosity.

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A patient with a history of stroke is prescribed clopidogrel (Plavix) for secondary prevention of thrombotic events. Which laboratory test should the nurse monitor closely during clopidogrel therapy?

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

Rationale: The correct answer is C: Platelet count. Platelet count should be monitored closely during clopidogrel therapy because it works by inhibiting platelet aggregation, reducing the risk of clot formation. Monitoring platelet count helps assess the drug's effectiveness and prevent potential complications like bleeding or clotting events. Prothrombin time (A), activated partial thromboplastin time (B), and international normalized ratio (D) are tests that primarily assess the coagulation factors and are not directly affected by clopidogrel therapy, making them less relevant for monitoring this specific medication.

A patient with a history of asthma is prescribed an inhaled corticosteroid. Which adverse effect is associated with long-term use of inhaled corticosteroids?

  • A. Oral thrush
  • B. Hypertension
  • C. Hyperglycemia
  • D. Osteoporosis
Correct Answer: D

Rationale: The correct answer is D: Osteoporosis. Long-term use of inhaled corticosteroids can lead to decreased bone density and an increased risk of osteoporosis. Corticosteroids can interfere with calcium absorption and bone formation, resulting in bone weakening. Oral thrush (Choice A) is a common side effect of inhaled corticosteroids, but it is not associated with long-term use. Hypertension (Choice B) and hyperglycemia (Choice C) are more commonly seen with systemic corticosteroid use rather than inhaled corticosteroids.

A patient is prescribed a statin medication for lipid-lowering therapy. Which adverse effect should the nurse monitor closely in the patient?

  • A. Muscle pain or weakness
  • B. Dry cough
  • C. Hypertension
  • D. Hyperkalemia
Correct Answer: A

Rationale: The correct answer is A: Muscle pain or weakness. Statins can cause muscle-related side effects, including rhabdomyolysis, a severe condition that can lead to muscle pain and weakness. Monitoring for these symptoms is crucial to prevent serious complications.
B: Dry cough is not a common side effect of statins.
C: Hypertension is not directly associated with statin use.
D: Hyperkalemia is not a typical adverse effect of statins.

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.

The PRIORITY nursing objective when caring a patient with a tracheostomy is _________.

  • A. To increase tissue oxygenation
  • B. To provide patent airway
  • C. To decrease tissue oxygenation
  • D. To improve ventilation
Correct Answer: B

Rationale: The correct answer is B: To provide a patent airway. When caring for a patient with a tracheostomy, ensuring a clear and unobstructed airway is the top priority to maintain adequate oxygenation and ventilation. This involves suctioning, maintaining proper tube placement, and monitoring for any signs of respiratory distress. Choices A, C, and D are incorrect as they do not address the immediate need for airway management, which is crucial for the patient's safety and well-being.

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