Adult Health Nursing Test Banks

Adult Health Nursing Test Banks Related

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A patient presents with recurrent episodes of joint pain, swelling, and limited range of motion in multiple joints. Laboratory tests reveal elevated erythrocyte sedimentation rate (ESR), positive rheumatoid factor (RF), and presence of anti-cyclic citrullinated peptide (anti-CCP) antibodies. Which of the following conditions is most likely to cause these findings?

  • A. Rheumatoid arthritis (RA)
  • B. Systemic lupus erythematosus (SLE)
  • C. Ankylosing spondylitis (AS)
  • D. Psoriatic arthritis (PsA)
Correct Answer: A

Rationale: The combination of recurrent joint pain, swelling, and limited range of motion in multiple joints along with elevated ESR, positive RF, and presence of anti-CCP antibodies is classic for rheumatoid arthritis (RA). Elevated ESR indicates inflammation, positive rheumatoid factor (RF) is an autoantibody commonly found in the serum of patients with RA, and the presence of anti-cyclic citrullinated peptide (anti-CCP) antibodies further supports the diagnosis of RA. These laboratory findings along with the clinical presentation are highly suggestive of rheumatoid arthritis. Systemic lupus erythematosus (SLE), ankylosing spondylitis (AS), and psoriatic arthritis (PsA) can have overlapping symptoms with RA, but the specific combination of elevated ESR, positive RF, and anti-CCP antibodies points more towards RA in this scenario.

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In order to determine the patient's ability to concentrate and focus, which would be the PRIORITY nursing action?

  • A. Asked for the academic performance
  • B. Conduct paper and pencil test
  • C. Assess the mental status of the patient
  • D. Refer the patient to the psychiatrist
Correct Answer: C

Rationale: Assessing the mental status of the patient is the PRIORITY nursing action to determine the patient's ability to concentrate and focus. This assessment includes evaluating the patient's level of alertness, orientation, memory, thought processes, and mood. By observing the patient's mental status, the nurse can gain valuable information about the patient's cognitive function, attention span, and ability to concentrate. This assessment will help guide further interventions and care planning for the patient. Asking for academic performance or conducting paper and pencil tests may be useful tools to assess concentration and focus, but they should come after a comprehensive evaluation of the patient's mental status. Referring the patient to a psychiatrist may be necessary based on the assessment findings, but it should not be the first step in determining the patient's ability to concentrate and focus.

Nurse Nilda immediately responds to any cry from her pediatric patients because it is, which of the following reasons?

  • A. to attend to her patients who cannot communicate verbally
  • B. to check if the child is hungry or wet
  • C. to lessen the noise overload in the Unit
  • D. a powerful influence over that individual's interactions with others for the remainder of his/her 1ife
Correct Answer: A

Rationale: Nurse Nilda immediately responds to any cry from her pediatric patients to attend to her patients who cannot communicate verbally. Crying is one of the few ways infants and young children communicate their needs and discomforts. By responding promptly to their cries, Nurse Nilda can assess and address potential issues such as hunger, pain, discomfort, or other needs that the child may have. This enhances the quality of care provided and helps in comforting and soothing the child, ultimately promoting their well-being and building trust between the nurse and the patient.

Which of the following manifestation should the nurse APPROPRIATELY observe during generalized seizures?

  • A. Loss of Consciousness, dilated pupils, and muscular stiffening
  • B. Jerking movements of al1 extremities.
  • C. Facial grimace with patting and smacking.
  • D. Vacant stare with a brief Loss of consciousness
Correct Answer: A

Rationale: Generalized seizures involve both hemispheres of the brain and can present with various manifestations. The typical features of generalized seizures include loss of consciousness, dilated pupils, and muscular stiffening. These seizures may also involve other symptoms such as tonic-clonic movements, convulsions, and postictal confusion. Jerking movements of all extremities (option B) are more characteristic of tonic-clonic seizures, a subtype of generalized seizures. Facial grimace with patting and smacking (option C) may be seen in focal seizures originating from a certain area of the brain. A vacant stare with a brief loss of consciousness (option D) is more typical of absence seizures rather than generalized seizures.

A patient with a history of chronic liver disease presents with easy bruising and prolonged bleeding from minor cuts. Laboratory tests reveal prolonged PT and aPTT, and mixing studies show correction of coagulation times with normal plasma. Which of the following conditions is most likely to cause these findings?

  • A. Disseminated intravascular coagulation (DIC)
  • B. Vitamin K deficiency
  • C. Liver cirrhosis
  • D. Hemophilia A
Correct Answer: B

Rationale: Vitamin K is essential for the production of several clotting factors in the liver, including factors II, VII, IX, and X. In a patient with chronic liver disease, impaired liver function can lead to decreased synthesis of these clotting factors. As a result, there is an underlying deficiency of these clotting factors, leading to prolonged PT (prothrombin time) and aPTT (activated partial thromboplastin time). The mixing studies showing correction with normal plasma further support the diagnosis of a factor deficiency rather than an inhibitor, which helps in ruling out conditions like DIC or hemophilia.

Nurse Nora observes that the Ellie's uterine contractions are irregular in frequency and short in duration. Ellie screams in pain during contractions. Which of the following actions is considered BEST for the nurse to perform?

  • A. Try to divert attention from pain.
  • B. Administer pain reliever as ordered.
  • C. Stay with the patient and offer her a back rub
  • D. Document and report frequency and duration of contractions..
Correct Answer: B

Rationale: Administering pain relief medication as ordered is the best action for the nurse to take in this situation where the patient is experiencing intense pain during irregular and short uterine contractions. Pain relief medications can help alleviate the discomfort and distress that Ellie is experiencing, providing her with much-needed relief and improving her overall comfort during labor. It is important for the nurse to follow the prescribed orders for pain relief medication to ensure safe and effective pain management for the patient.

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