Adult Health Med Surg Nursing Test Banks

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A patient with a history of coronary artery disease is scheduled for coronary artery bypass graft (CABG) surgery. Which preoperative nursing intervention is essential for preparing the patient for surgery?

  • A. Administering aspirin to prevent thrombosis
  • B. Providing education about postoperative pain management
  • C. Assisting the patient with deep breathing and coughing exercises
  • D. Obtaining informed consent for the surgical procedure
Correct Answer: C

Rationale: Preoperative nursing intervention that is essential for preparing a patient with a history of coronary artery disease for coronary artery bypass graft (CABG) surgery is assisting the patient with deep breathing and coughing exercises. These exercises are crucial to prevent postoperative complications such as atelectasis and pneumonia, which are common risks after surgery. Deep breathing exercises help to expand the lungs and improve ventilation, while coughing exercises help to clear secretions and prevent respiratory complications. By assisting the patient with these exercises preoperatively, the nurse can help optimize the patient's respiratory function and decrease the risk of complications during and after surgery. Administering aspirin, providing education about pain management, and obtaining informed consent are also important aspects of preoperative care, but assisting with deep breathing and coughing exercises is particularly essential for patients undergoing CABG surgery due to the increased risk of respiratory complications in this population.

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A patient presents with a thyroid nodule and signs of hyperthyroidism. Fine-needle aspiration biopsy reveals spindle-shaped cells and psammoma bodies. Which endocrine disorder is most likely responsible for these symptoms?

  • A. Hashimoto's thyroiditis
  • B. Graves' disease
  • C. Follicular thyroid carcinoma
  • D. Papillary thyroid carcinoma
Correct Answer: C

Rationale: The presence of spindle-shaped cells and psammoma bodies on fine-needle aspiration biopsy is characteristic of follicular thyroid carcinoma. This type of thyroid cancer can present as a thyroid nodule associated with signs of hyperthyroidism due to the release of thyroid hormones from the cancerous thyroid cells. Hashimoto's thyroiditis is an autoimmune condition that typically presents with hypothyroidism, while Graves' disease is another autoimmune disorder that results in hyperthyroidism but is not associated with the presence of spindle-shaped cells and psammoma bodies in this context. Papillary thyroid carcinoma may also present with thyroid nodules, but it is more commonly associated with papillary structures and nuclear features rather than spindle-shaped cells seen in follicular thyroid carcinoma.

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.

While preparing the surgical site, the nurse notices that the skin preparation solution has expired. What should the nurse do?

  • A. Use the expired solution as it is still effective
  • B. Document the expiration date in the patient's chart
  • C. Discard the expired solution and obtain a new one
  • D. Dilute the solution with sterile water to extend its shelf life
Correct Answer: C

Rationale: Using an expired skin preparation solution can compromise the safety and effectiveness of the surgical site cleansing. Expired solutions may have reduced efficacy or could cause adverse reactions due to chemical breakdown over time. Therefore, it is essential for the nurse to discard the expired solution and obtain a new one to ensure proper sanitation and reduce the risk of complications during the surgical procedure. It is important to adhere to proper protocols and guidelines in healthcare settings to maintain patient safety and optimal outcomes.

Choose an indicator that models personal and professional behavior and values.

  • A. Utilizes communication and social media responsibly
  • B. Attends conferences
  • C. Enrolls in school
  • D. Joins civic organization
Correct Answer: A

Rationale: Utilizing communication and social media responsibly is an indicator that models personal and professional behavior and values. Responsible use of communication and social media demonstrates a commitment to maintaining a positive online presence, interacting respectfully with others, and upholding professional standards in digital communication. This behavior reflects integrity, accountability, and respect for oneself and others, which are essential qualities in both personal and professional settings. Additionally, demonstrating responsible behavior in the digital sphere can help build trust, enhance reputation, and foster valuable relationships with colleagues, clients, and the community.

A 28-year-old woman presents with lower abdominal pain, dyspareunia, and dysmenorrhea that worsens during menstruation. On pelvic examination, tender nodules are palpated along the uterosacral ligaments. Which condition is most likely to be responsible for these findings?

  • A. Polycystic ovary syndrome (PCOS)
  • B. Endometriosis
  • C. Pelvic inflammatory disease (PID)
  • D. Uterine fibroids
Correct Answer: B

Rationale: The clinical presentation of lower abdominal pain, dyspareunia (pain during sexual intercourse), dysmenorrhea (painful periods), and tender nodules along the uterosacral ligaments is highly suggestive of endometriosis. Endometriosis is a condition where the tissue that lines the uterus (endometrium) grows outside the uterus, commonly on the pelvic organs such as the ovaries, fallopian tubes, and the peritoneum. The characteristic tender nodules along the uterosacral ligaments are known as "nodularity" and are a classic finding in endometriosis.

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