Adult Health Nursing First Chapter Quizlet

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A patient with a history of multiple myeloma presents with weakness, bone pain, and recurrent infections. Laboratory tests reveal anemia, hypercalcemia, renal insufficiency, and monoclonal spike on serum protein electrophoresis. Which of the following conditions is most likely to cause these findings?

  • A. Waldenstrom macroglobulinemia
  • B. Hodgkin lymphoma
  • C. Chronic lymphocytic leukemia (CLL)
  • D. Multiple myeloma
Correct Answer: D

Rationale: Multiple myeloma is a plasma cell neoplasm characterized by the presence of abnormal monoclonal plasma cells in the bone marrow, which produce a monoclonal spike on serum protein electrophoresis. The clinical presentation of weakness, bone pain, and recurrent infections is typical of multiple myeloma. Anemia can result from bone marrow infiltration by the abnormal plasma cells, hypercalcemia is due to bone destruction and release of calcium, renal insufficiency can result from hypercalcemia and protein deposition in the kidneys, and the monoclonal spike in serum protein electrophoresis indicates the presence of a monoclonal protein. Waldenström macroglobulinemia, Hodgkin lymphoma, and chronic lymphocytic leukemia do not typically present with the classic tetrad of findings seen in multiple myeloma.

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Ella's feeling of joining lory in heaven is a manifestation of:

  • A. Suicidal intent
  • B. Paranoia
  • C. Suicidal threat
  • D. Suicidal ideation
Correct Answer: D

Rationale: Ella's feeling of joining Lory in heaven is best categorized as suicidal ideation. Suicidal ideation refers to thoughts or fantasies about dying, including thoughts of one's own death or thoughts of wanting to harm oneself. In this scenario, Ella is not explicitly expressing any immediate intent to harm herself or others, nor is she exhibiting paranoia or making a direct threat. Instead, her mention of joining Lory in heaven suggests that she is contemplating the idea of death, which falls under the category of suicidal ideation. It is essential to take such thoughts seriously and seek appropriate help and support for the individual experiencing them.

Nurse Gay is assigned in the Medical Unit. She is guided that in documentation, she should use abbreviation that is ______.

  • A. used automatically to save precious time.
  • B. reduced to the minimum in all units.
  • C. approved standard list by the hospital.
  • D. not used at all because it can be misinterpreted.
Correct Answer: C

Rationale: Nurse Gay should use abbreviations that are part of an approved standard list by the hospital. Using standardized abbreviations ensures clarity, accuracy, and consistency in documentation. It helps in preventing misinterpretation, errors, and ambiguity in patient records. By following an approved list of abbreviations, healthcare professionals can communicate effectively and efficiently while maintaining patient safety and quality of care.

Which type of plan should the nurse employ to assess the strengths and weaknesses of the organization?

  • A. Nursing care
  • B. Strategic
  • C. Operational
  • D. Program
Correct Answer: B

Rationale: To assess the strengths and weaknesses of the organization, the nurse should employ a strategic plan. A strategic plan involves setting overall goals, objectives, and strategies for the organization. It provides a comprehensive framework for evaluating the current state of the organization, identifying areas of improvement, and aligning resources to achieve long-term success. By using a strategic plan, the nurse can conduct a thorough analysis of the organization's internal and external factors, including its strengths and weaknesses, to determine the most effective course of action for the future.

A patient presents with petechiae, purpura, and mucosal bleeding. Laboratory tests reveal thrombocytopenia, elevated serum creatinine, and schistocytes on peripheral blood smear. Which of the following conditions is most likely to cause these findings?

  • A. Thrombotic thrombocytopenic purpura (TTP)
  • B. Idiopathic thrombocytopenic purpura (ITP)
  • C. Hemolytic uremic syndrome (HUS)
  • D. Disseminated intravascular coagulation (DIC)
Correct Answer: A

Rationale: Thrombotic thrombocytopenic purpura (TTP) is a rare but serious condition characterized by microangiopathic hemolytic anemia, thrombocytopenia, neurological abnormalities, fever, and renal dysfunction. The classic pentad of symptoms includes fever, neurologic changes, renal impairment, thrombocytopenia, and microangiopathic hemolytic anemia. The presence of petechiae, purpura, and mucosal bleeding along with thrombocytopenia, elevated serum creatinine, and schistocytes on peripheral blood smear are consistent with TTP. In TTP, there is usually a deficiency of ADAMTS13 (a von Willebrand factor-cleaving protease) leading to excessive platelet adhesion, aggregation, and microthrombi formation within small blood vessels. Treatment typically

Take home medications given to Patient Lily includes digitalis therapy which was given to patient since she was pregnant. Which of the following would the nurse anticipate with patient's drug therapy?

  • A. Switching to a more potent drug.
  • B. Continuation of the same dosage.
  • C. Need for change in medication.
  • D. Addition of diuretic to the regimen.
Correct Answer: B

Rationale: Digitalis therapy, commonly prescribed for heart conditions, is known for its narrow therapeutic range and potential for toxicity. In the case of Patient Lily, who has been on digitalis therapy since she was pregnant, the nurse would anticipate the continuation of the same dosage to maintain the therapeutic effects and reduce the risks of toxicity. It is essential to monitor the patient's digitalis levels regularly and adjust the dosage if necessary based on the patient's response and any changes in their clinical status. Switching to a more potent drug, changing the medication, or adding a diuretic would not be appropriate without further assessment and consultation with the healthcare provider managing Lily's digitalis therapy.

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