Adult Health Med Surg Nursing Test Banks

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A patient with acute respiratory distress syndrome (ARDS) develops refractory hypoxemia despite maximal ventilatory support and prone positioning. Which of the following adjunctive therapies is most likely to improve oxygenation and reduce mortality in this patient?

  • A. High-frequency oscillatory ventilation (HFOV)
  • B. Continuous renal replacement therapy (CRRT)
  • C. Extracorporeal membrane oxygenation (ECMO)
  • D. Inhaled nitric oxide (iNO)
Correct Answer: C

Rationale: In a patient with ARDS who is experiencing refractory hypoxemia despite maximal ventilatory support and prone positioning, the use of extracorporeal membrane oxygenation (ECMO) is a potentially life-saving adjunctive therapy. ECMO works by providing temporary support for gas exchange outside the body, allowing the lungs to rest and heal while providing adequate oxygenation and carbon dioxide removal. The use of ECMO has been associated with improved oxygenation and reduced mortality in severe cases of ARDS, especially in patients who fail conventional therapies. High-frequency oscillatory ventilation (HFOV) has not consistently shown mortality benefit in ARDS, continuous renal replacement therapy (CRRT) is not directly indicated for hypoxemia in ARDS, and inhaled nitric oxide (iNO) has shown limited benefit in improving oxygenation in ARDS without a clear impact on mortality.

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Nurse Cris received information from some community residents who suspect that a neighbor ls abusing his young child. Which should be the PRIORITY nursing action ?

  • A. Report the police authorities.
  • B. Notify the social worker.
  • C. Ignore the information
  • D. Validate the information
Correct Answer: A

Rationale: The PRIORITY nursing action when receiving information about suspected child abuse is to report to the police authorities. Child abuse is a serious issue that requires immediate intervention to ensure the safety and well-being of the child. The police are trained to investigate these types of situations and can take the necessary steps to protect the child from harm. It is essential to act swiftly and report any suspicions of child abuse to the proper authorities to prevent further harm and ensure the child's safety.

After formulating and delimiting the research problem, which following will be a PRIORITY action of Gloria?

  • A. Develop the theoretical framework of the study
  • B. Formulate the hypothesis
  • C. Plan the research design of the study
  • D. Conduct a 1iterature search on the topic
Correct Answer: C

Rationale: After formulating and delimiting the research problem, the priority action would be to plan the research design of the study. This is crucial because the research design will outline the specific methods and procedures that Gloria will use to investigate the research problem and answer the research questions. Planning the research design involves determining the overall structure of the study, selecting the appropriate research methods, and outlining how data will be collected and analyzed. This step is essential for ensuring that the study is well-organized, rigorous, and will yield reliable results. Developing a solid research design early on will set a strong foundation for the rest of the research process.

In the ethical principle of beneficence, which is the BASIS of every nursing action in all work settings?

  • A. Treating all patients selectively.
  • B. Informing patients of hospital bills.
  • C. Respecting refusal of treatment.
  • D. Doing good at all times.
Correct Answer: D

Rationale: The ethical principle of beneficence, which is the basis of every nursing action in all work settings, emphasizes the importance of doing good at all times for the benefit of the patient. Nurses are expected to act in the best interest of their patients and strive to promote their well-being and welfare. This principle guides nurses to provide care that is compassionate, effective, and in line with the patient's needs and preferences. By prioritizing the good of the patient in all actions and decisions, nurses uphold the principle of beneficence and demonstrate their commitment to promoting positive outcomes for those under their care.

A patient presents with redness, pain, and photophobia in the left eye. Slit-lamp examination reveals ciliary injection, corneal edema, and a mid-dilated pupil with fixed reaction to light. Which of the following conditions is most likely responsible for this presentation?

  • A. Anterior uveitis
  • B. Acute angle-closure glaucoma
  • C. Endophthalmitis
  • D. Corneal abrasion
Correct Answer: A

Rationale: The presentation described is consistent with anterior uveitis. Anterior uveitis involves inflammation of the iris and ciliary body. Patients typically present with symptoms such as redness, pain, photophobia, and blurred vision. The slit-lamp examination findings of ciliary injection (redness and dilation of blood vessels in the iris and ciliary body), corneal edema, and a mid-dilated pupil with a fixed reaction to light (due to ciliary muscle spasm causing decreased accommodation) are characteristic of anterior uveitis. This condition is often idiopathic but can be associated with various systemic diseases like ankylosing spondylitis, inflammatory bowel disease, and other autoimmune disorders. Treatment involves addressing the inflammation with topical corticosteroids and, in some cases, cycloplegic agents to reduce pain and inflammation.

The nurse researcher is planning a research study that will use human subjects and their choice to participate in a specific treatment. The ethical principle that describes a prospective subject's freedom to choose whether or not to participate in the research study is what?

  • A. Justice
  • B. Confidentiality
  • C. Beneficence
  • D. Respect for persons
Correct Answer: D

Rationale: Respect for persons is an ethical principle that emphasizes the autonomy and freedom of individuals to make their own decisions regarding participation in research studies. In the context of human subjects research, this principle requires that individuals have the right to choose whether or not to participate in a study, without any coercion or manipulation. The principle of respect for persons also includes the concept of informed consent, where individuals must be provided with all necessary information about the study in order to make an informed decision about participation. Overall, respecting the autonomy and choices of individuals is a fundamental aspect of ethical research conduct.

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