Adult Health Med Surg Nursing Test Banks

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A patient with a history of chronic liver disease presents with bruising, petechiae, and mucosal bleeding. Laboratory tests reveal prolonged prothrombin time (PT) and activated partial thromboplastin time (aPTT) with decreased platelet count. Which of the following conditions is most likely to cause these findings?

  • A. Immune thrombocytopenic purpura (ITP)
  • B. Disseminated intravascular coagulation (DIC)
  • C. Hemophilia A
  • D. Von Willebrand disease
Correct Answer: B

Rationale: Disseminated intravascular coagulation (DIC) is a condition characterized by widespread activation of coagulation leading to both thrombosis and hemorrhage. In patients with chronic liver disease, especially in the setting of advanced cirrhosis, DIC can develop due to factors such as decreased synthesis of coagulation factors and impaired clearance of activated clotting factors. The patient in this scenario presents with signs of both abnormal bleeding (bruising, petechiae, mucosal bleeding) and laboratory findings consistent with DIC, including prolonged prothrombin time (PT) and activated partial thromboplastin time (aPTT) along with decreased platelet count.

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After tracheostomy procedure, the nurse documents important observation made during the procedure such us _________.

  • A. Response of the patient's after procedure
  • B. Vital signs of the patient's during the procedure
  • C. Amount, color and consistency of sputum and appearance of the incision
  • D. Behavior of the patient during the procedure
Correct Answer: C

Rationale: It is essential for the nurse to document important observations made during a tracheostomy procedure, and this includes the amount, color, and consistency of sputum as well as the appearance of the incision. Monitoring these factors helps assess the patient's respiratory status, risk of infection, and wound healing progress. Ensuring detailed documentation in this area allows for timely intervention if there are any concerning changes observed post-procedure. Observations such as the response of the patient, vital signs during the procedure, and patient behavior are also important but may be documented separately from the specific details related to sputum, incision appearance, and wound care.

Nurse Emma advised the patient to quit smoking because nicotine wil1 contribute to _______.

  • A. low birth weight infant
  • B. ectopic tubal, pregnancy
  • C. congenital anomalies
  • D. large for gestation age infants
Correct Answer: A

Rationale: Nicotine, a substance found in cigarettes, is known to have harmful effects on pregnancy. Smoking during pregnancy can lead to numerous complications, one of which is the increased risk of delivering a low birth weight infant. Low birth weight infants are born weighing less than 5.5 pounds (2.5 kilograms) and are at a higher risk of various health issues, developmental delays, and even mortality. Therefore, Nurse Emma advised the patient to quit smoking to reduce the risk of having a low birth weight infant.

A patient is prescribed a benzodiazepine for the management of insomnia. Which adverse effect should the nurse monitor closely in the patient?

  • A. Hypotension
  • B. Hyperglycemia
  • C. Daytime drowsiness
  • D. Bradycardia
Correct Answer: C

Rationale: Benzodiazepines are commonly prescribed for the management of insomnia due to their sedative effects. One of the most common adverse effects of benzodiazepines is daytime drowsiness, which can impair the patient's ability to function normally during the day. Monitoring the patient closely for daytime drowsiness is important to ensure their safety and well-being, as it can affect their daily activities and increase the risk of accidents or falls. It is essential for the nurse to educate the patient on the potential for daytime drowsiness and advise them to avoid activities that require full alertness, such as driving or operating heavy machinery, until they know how the medication affects them. If the patient experiences severe or persistent daytime drowsiness, the healthcare provider may need to adjust the dosage or consider alternative treatment options.

Which is the MOST important criterion in budgeting?

  • A. Flexibility
  • B. Consistency
  • C. Standardized
  • D. Cost of effectiveness
Correct Answer: A

Rationale: Flexibility is the most important criterion in budgeting because it allows for adjustments to be made as circumstances change. Budgeting is a dynamic process, and having a flexible budget enables organizations or individuals to adapt to unexpected changes in income or expenses. This helps in ensuring that resources are allocated efficiently and effectively to meet the overall financial goals. Consistency, standardization, and cost-effectiveness are also important considerations in budgeting, but flexibility is key to successfully managing financial resources in a changing environment.

Pulmonary Rehabilitation for COPD has a duration of at least 4 to 12 weeks. Which of the following should be avoided while patient is having this program?

  • A. Pursed lip breathing
  • B. Smoking cessation
  • C. Aerobic, upper and lower body conditioning
  • D. Peripheral muscle wasting
Correct Answer: B

Rationale: During pulmonary rehabilitation for COPD, smoking cessation should not be avoided but instead strongly encouraged. Smoking cessation is a crucial component in managing COPD and improving lung function. Continued smoking can exacerbate COPD symptoms and hinder the progress made through rehabilitation efforts. Therefore, it is essential for patients to quit smoking while undergoing pulmonary rehabilitation to maximize the benefits of the program and improve their overall lung health.

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