Adult Health Nursing Answer Key

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A patient with a tibial shaft fracture undergoes surgical fixation with an intramedullary nail. What postoperative complication should the healthcare team monitor for in the immediate postoperative period?

  • A. Wound infection
  • B. Nonunion
  • C. Fat embolism syndrome
  • D. Compartment syndrome
Correct Answer: C

Rationale: Following surgical fixation of a tibial shaft fracture with an intramedullary nail, healthcare providers should monitor for the development of fat embolism syndrome (FES) in the immediate postoperative period. FES is a serious complication that occurs when fat droplets from the bone marrow enter the bloodstream and cause respiratory and neurological symptoms. Clinical manifestations of FES may include dyspnea, tachypnea, petechial rash, altered mental status, and hypoxemia. Prompt recognition and treatment are essential in managing fat embolism syndrome to prevent serious complications such as respiratory failure and neurological deficits. Monitoring for signs and symptoms of FES is crucial in the postoperative care of patients undergoing surgical fixation of long bone fractures.

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What is the recommended position for a conscious patient experiencing an acute asthma exacerbation?

  • A. High-Fowler's position
  • B. Supine position with legs elevated
  • C. Left lateral recumbent position
  • D. Semi-Fowler's position
Correct Answer: A

Rationale: The recommended position for a conscious patient experiencing an acute asthma exacerbation is the High-Fowler's position. This position involves the patient sitting upright or almost upright at about a 90-degree angle. The High-Fowler's position helps improve ventilation by expanding the lungs and maximizing airflow in and out of the airways. It also reduces the work of breathing in patients with asthma by allowing gravity to assist in moving air in and out of the lungs more easily. Additionally, this position can help alleviate shortness of breath and improve oxygenation in patients experiencing an asthma exacerbation.

Which of the following definition MOST accurately describes meningomyelocele? It is _______.

  • A. Spinal cord tumor containing nerve roots.
  • B. Complete exposure of the spinal cord and meninges.
  • C. Herniation of spinal cord, cerebro-spinal fluid and meninges into a sac.
  • D. Sac formation containing meninges and spinal fluid.
Correct Answer: C

Rationale: Meningomyelocele is a type of neural tube defect where there is a protrusion of the spinal cord, cerebrospinal fluid, and meninges through a defect in the vertebrae, forming a sac on the surface of the back. This condition occurs during fetal development when the neural tube fails to close completely, leading to the exposure of the spinal cord and its coverings. This herniation can result in a range of neurological deficits and complications, requiring surgical repair shortly after birth to prevent further damage and infections.

Which of the following immunoglobulin classes is primarily involved in providing passive immunity to newborn infants through breast milk?

  • A. IgA
  • B. IgG
  • C. IgE
  • D. IgM
Correct Answer: A

Rationale: IgA is the primary immunoglobulin class involved in providing passive immunity to newborn infants through breast milk. IgA antibodies are highly concentrated in colostrum and breast milk, offering important protection to newborns against infections. IgG antibodies can also be passed from the mother to the fetus through the placenta, providing passive immunity during pregnancy, but IgA is the main immunoglobulin class transferred through breast milk for protecting the infant's gastrointestinal and respiratory tracts. IgE is mainly involved in allergies and hypersensitivity reactions, while IgM is an early responder in the immune response to infections.

After several days in the hospital, the physician ordered the patient to be discharged. Which of the following is a PRIORITY restriction that you should emphasize when he goes home?

  • A. Stool softener to induce bowel elimination.
  • B. Driving if not using narcotic drug.
  • C. Take shower even if ´still with surgical drain.
  • D. Lifting of objects not more than 10 lbs.
Correct Answer: D

Rationale: The priority restriction that should be emphasized when the patient is discharged from the hospital is the lifting of objects not more than 10 lbs. This is important to prevent any strain on the body, especially if the patient is still recovering or weak from their hospitalization. Lifting heavy objects can lead to complications, injuries, or setbacks in the recovery process. It is essential for the patient to follow this restriction to promote healing and avoid any further health issues.

Disclosure of client information beyond the interdisciplinary team without consent of the client is a breach of ______.

  • A. confidentiality
  • B. duty
  • C. beneficence
  • D. veracity
Correct Answer: A

Rationale: Confidentiality is the ethical principle that requires healthcare providers to keep client information private and not disclose it without the client's consent. When client information is shared beyond the interdisciplinary team without the client's consent, it breaches the trust and privacy expected in the nurse-client relationship. This breach not only violates the ethical principle of confidentiality but also undermines the client's autonomy and right to control their own personal information. Maintaining confidentiality is crucial for building trust and ensuring the well-being of the client.

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