Foundations and Adult Health Nursing Test Bank

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A patient presents with gradual, painless visual field loss in both eyes, particularly in the peripheral vision. Tonometry reveals elevated intraocular pressure (IOP). Which of the following conditions is most likely responsible for this presentation?

  • A. Open-angle glaucoma
  • B. Closed-angle glaucoma
  • C. Age-related macular degeneration
  • D. Diabetic retinopathy
Correct Answer: A

Rationale: The patient presents with gradual, painless visual field loss in both eyes, particularly in the peripheral vision, which is characteristic of glaucoma. The elevated intraocular pressure (IOP) on tonometry further supports a diagnosis of glaucoma. Open-angle glaucoma is the most common type of glaucoma and typically presents insidiously with a slow progression of vision loss. In open-angle glaucoma, the drainage angle of the eye remains open but becomes less efficient over time, leading to increased intraocular pressure and optic nerve damage. This results in peripheral visual field loss. Closed-angle glaucoma, on the other hand, presents more acutely with sudden eye pain, redness, and blurred vision due to a sudden increase in intraocular pressure from a blocked drainage angle. Age-related macular degeneration and diabetic retinopathy typically do not present with elevated IOP or peripheral visual field loss.

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A patient is brought to the emergency department experiencing a possible stroke. What initial diagnostic test for a stroke , usually performed in the emergency department would the nurse prepare the patient for?

  • A. 12-lead electrocardiogram
  • B. Carotid ultrasound study
  • C. Noncontrast computed tomography
  • D. Transcranial Doppler flow study
Correct Answer: C

Rationale: In the emergency department setting, the initial diagnostic test typically performed for a patient suspected of having a stroke is a noncontrast computed tomography (CT) scan of the head. This imaging study is crucial in evaluating and diagnosing stroke because it can quickly identify whether the person is having a hemorrhagic stroke (bleeding in the brain) or an ischemic stroke (blood clot blocking a blood vessel). The results of the CT scan help guide immediate treatment decisions, such as administering clot-busting medications for ischemic strokes or preparing for surgical interventions for hemorrhagic strokes. Carotid ultrasound studies and transcranial Doppler flow studies may be performed after the initial CT scan to further assess the extent of damage and the underlying cause of the stroke. The 12-lead electrocardiogram is useful in assessing the heart's electrical activity but is not the primary test for diagnosing stroke.

Based on the Right to Privacy and Confidentiality under the Patient's Bill of Rights, the patient has the right to demand on the following, but NOT _______ pertaining to his care as confidential.

  • A. Information
  • B. Records
  • C. Communication
  • D. Financial status
Correct Answer: D

Rationale: The patient has the right to demand that information, records, and communications pertaining to their care be kept confidential under the Right to Privacy and Confidentiality as outlined in the Patient's Bill of Rights. However, financial status is generally not considered part of the confidential medical information and may not fall under the same level of protection as personal health information. Therefore, the patient cannot demand that their financial status be treated as confidential under this particular right.

He plans to use a Likert Scale to determine:

  • A. compliance to expected standards
  • B. level of satisfaction
  • C. degree of agreement and disagreement
  • D. degree of acceptance
Correct Answer: C

Rationale: A Likert Scale is typically used to measure the degree of agreement or disagreement with a set of statements or questions. Respondents are asked to indicate their level of agreement or disagreement using a scale that ranges from, for example, "strongly agree" to "strongly disagree". This makes it a suitable tool for assessing the degree of agreement and disagreement among individuals on various topics or statements. While a Likert Scale can potentially measure other constructs such as satisfaction or acceptance, its primary purpose and most common application involve determining the degree of agreement and disagreement.

Nurse Rica is in charge of the animal bite program of the health center, which of the following is the causative agent of rabies?

  • A. Parasite
  • B. Bacteria
  • C. Virus
  • D. Fungi
Correct Answer: C

Rationale: Rabies is a viral disease that affects the central nervous system. It is primarily transmitted through the bite of an infected animal, such as dogs, bats, raccoons, and foxes. The causative agent of rabies is the rabies virus, specifically from the genus Lyssavirus. Once the virus enters the body, it spreads through the nervous system to the brain, leading to severe neurological symptoms and, if left untreated, is almost always fatal. This is why prompt medical attention and vaccination following an animal bite are crucial in preventing the development of rabies in humans.

A patient with a history of Hodgkin lymphoma presents with fever, chills, and generalized malaise. Laboratory tests reveal pancytopenia, circulating Reed-Sternberg cells, and bone marrow involvement. Which of the following conditions is most likely to cause these findings?

  • A. Autoimmune hemolytic anemia (AIHA)
  • B. Myelodysplastic syndrome (MDS)
  • C. Aplastic anemia
  • D. Paraneoplastic syndrome
Correct Answer: D

Rationale: The patient is presenting with symptoms and laboratory findings consistent with a paraneoplastic syndrome related to Hodgkin lymphoma. In this case, the fever, chills, generalized malaise, pancytopenia, circulating Reed-Sternberg cells, and bone marrow involvement are all indicative of a paraneoplastic syndrome associated with Hodgkin lymphoma. Paraneoplastic syndromes are a group of disorders that are triggered by an abnormal immune response to a neoplasm, such as Hodgkin lymphoma, leading to various systemic manifestations.

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