Foundations and Adult Health Nursing Test Bank

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A patient receiving palliative care for end-stage renal disease expresses distress over changes in body image due to edema and weight gain. What intervention should the palliative nurse prioritize to address the patient's concerns?

  • A. Encourage the patient to focus on accepting their body changes as part of the illness.
  • B. Provide education on dietary modifications to manage fluid retention and edema.
  • C. Offer emotional support and validate the patient's feelings about body image changes.
  • D. Prescribe diuretic medications to reduce fluid retention and alleviate edema.
Correct Answer: C

Rationale: The most appropriate intervention for the palliative nurse to prioritize in this situation is to offer emotional support and validate the patient's feelings about body image changes. End-stage renal disease can lead to significant physical changes such as edema and weight gain, which can impact a patient's body image and self-esteem. By providing emotional support and validating the patient's feelings, the nurse can help address the patient's distress and concerns, improving their overall psychological well-being. While providing education on dietary modifications (choice B) and prescribing diuretic medications (choice D) may be important aspects of managing fluid retention and edema, addressing the patient's emotional distress and body image concerns should be the initial priority in a palliative care setting. Encouraging the patient to accept their body changes (choice A) may overlook the emotional impact these changes have on the patient, making choice C the most appropriate intervention.

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A nurse is caring for a patient who refuses to comply with a prescribed treatment regimen. What ethical principle should guide the nurse's approach to addressing the patient's refusal?

  • A. Beneficence
  • B. Autonomy
  • C. Nonmaleficence
  • D. Justice
Correct Answer: B

Rationale: The ethical principle of autonomy emphasizes respecting the patient's right to make their own decisions regarding their treatment. In this scenario, the patient has the right to refuse treatment, and the nurse should respect that decision while also providing information and guidance to help the patient make informed choices. By upholding the principle of autonomy, the nurse can support the patient's decision-making process and work collaboratively with them to address any concerns or barriers to compliance with the treatment regimen. This approach honors the patient's right to self-determination and promotes a trusting relationship between the nurse and the patient.

While positioning the patient for surgery, the nurse notices that the patient's arms are not adequately padded. What should the nurse do?

  • A. Proceed with the positioning as planned
  • B. Document the observation in the patient's chart
  • C. Apply soft padding to the patient's arms to prevent pressure injuries
  • D. Inform the surgeon about the inadequate padding
Correct Answer: C

Rationale: If the nurse notices that the patient's arms are not adequately padded while positioning for surgery, the nurse should immediately take action to prevent pressure injuries. Applying soft padding to the patient's arms will help distribute the pressure more evenly, reducing the risk of skin breakdown and potential harm to the patient during the surgical procedure. It is essential to prioritize the patient's safety and comfort in such situations. Simply proceeding with the positioning as planned could lead to complications, so addressing the inadequate padding promptly is the appropriate course of action.

Which communication technique should Nurse Cris employ in order to successfully capture the details of the meeting?

  • A. Summarizing
  • B. Restating
  • C. Reassuring
  • D. Validating
Correct Answer: A

Rationale: Nurse Cris should employ the communication technique of summarizing to successfully capture the details of the meeting. Summarizing involves condensing the information provided into a concise and organized form, which would help Nurse Cris remember and retain the key points discussed during the meeting. By summarizing the details, Nurse Cris can ensure that no important information is missed and can also confirm understanding by reflecting back the main points discussed. This technique promotes effective communication by enhancing clarity and reinforcing comprehension.

A client with congestive heart failure has been receiving digoxin (lanoxin). Which finding indicates that the medication is having a desired effect?

  • A. Increased weight
  • B. Increased urinary output
  • C. Improved appetite
  • D. Increased pedal edema
Correct Answer: B

Rationale: Digoxin is a medication commonly used in the treatment of congestive heart failure because it helps to improve cardiac output and reduce heart failure symptoms. One of the desired effects of digoxin is an increase in urinary output. This is because digoxin helps to improve cardiac function, which can lead to better circulation and increased kidney perfusion. As a result, the kidneys are better able to filter and excrete excess fluid, leading to increased urine output. Therefore, an increase in urinary output indicates that the digoxin is having a positive effect in managing the client's congestive heart failure. The other options, such as increased weight, improved appetite, and increased pedal edema, are not indicative of a desired effect of digoxin therapy.

A patient presents with acute onset of severe headache, visual disturbances, and vomiting. Imaging reveals a tumor compressing the optic chiasm. Which of the following neurological conditions is most likely responsible for these symptoms?

  • A. Meningioma
  • B. Glioblastoma multiforme
  • C. Pituitary adenoma
  • D. Medulloblastoma
Correct Answer: C

Rationale: A pituitary adenoma is a type of benign tumor that arises from the pituitary gland, which is located at the base of the brain. When a pituitary adenoma grows large enough, it can compress surrounding structures, including the optic chiasm – the point at which the optic nerves cross over in the brain. Compression of the optic chiasm can lead to symptoms such as vision problems (e.g., visual disturbances), headaches, and nausea/vomiting, which are consistent with the presentation described in the question. Meningiomas, glioblastoma multiforme, and medulloblastomas are less likely to compress the optic chiasm and present with different characteristic symptoms based on their locations and growth patterns.

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