Adult Health Nursing Test Bank

Adult Health Nursing Test Bank Related

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A patient with chronic kidney disease presents with fatigue, dyspnea on exertion, peripheral edema, and hypertension. Laboratory findings reveal elevated serum creatinine and urea levels, metabolic acidosis, and hyperkalemia. What is the most appropriate initial management for this patient?

  • A. Initiation of angiotensin-converting enzyme (ACE) inhibitor therapy
  • B. Hemodialysis
  • C. Intravenous administration of calcium gluconate
  • D. Sodium bicarbonate administration
Correct Answer: B

Rationale: The most appropriate initial management for the patient described is hemodialysis. Hemodialysis is essential for managing chronic kidney disease with severe symptoms and electrolyte imbalances like hyperkalemia and metabolic acidosis. Hemodialysis helps to remove urea and creatinine from the blood, correct electrolyte abnormalities, and improve symptoms such as fatigue, dyspnea, and peripheral edema. Initiation of ACE inhibitor therapy (Choice A) is contraindicated in severe kidney disease due to the risk of worsening renal function. Intravenous administration of calcium gluconate (Choice C) is used for acute hyperkalemia with cardiac toxicity, not for initial management. Sodium bicarbonate administration (Choice D) may help correct metabolic acidosis, but it does not address the underlying cause or the need for urgent renal replacement therapy.

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In providing tracheostomy care which of the following is the nurse's PRIORITY nursing action? The nurse ________.

  • A. Cuts the dressing using sterile scissors
  • B. Clean the incisions with iodine-based antiseptic
  • C. Secures clean ties before removing soiled ones
  • D. Uses clean technique
Correct Answer: C

Rationale: The correct answer is C: Secures clean ties before removing soiled ones. This is the priority action because securing clean ties prevents accidental dislodgement of the tracheostomy tube, ensuring the patient's airway remains patent. Cutting the dressing (A) or cleaning the incisions (B) can be important but not as critical as securing the tube. Using clean technique (D) is essential but not the priority in this situation.

A biphasic anti-ovulatory medication of combined progestin and estrogen is prescribed for a female patient. What should the nurse include when teaching about this oral contraceptive?

  • A. Restrict sexual activity temporarily.
  • B. Report any irregular vaginal bleeding.
  • C. Increase the intake of calcium.
  • D. Have bi-monthly Pap smears.
Correct Answer: B

Rationale: The correct answer is B: Report any irregular vaginal bleeding. This is important because irregular vaginal bleeding can indicate potential issues such as breakthrough bleeding or hormonal imbalances, which may require adjustments to the contraceptive regimen. Other choices are incorrect because: A) Restricting sexual activity is not necessary with this medication, C) Increasing calcium intake is not directly related to taking biphasic anti-ovulatory medication, and D) Bi-monthly Pap smears are not specifically required due to this type of contraception.

A postpartum client complains of persistent, heavy vaginal bleeding beyond the expected timeframe. Which nursing action is most appropriate?

  • A. Encouraging the client to increase fluid intake
  • B. Applying a cold compress to the perineum
  • C. Assessing vital signs and uterine tone
  • D. Administering pain medication as ordered
Correct Answer: C

Rationale: In a postpartum client complaining of persistent, heavy vaginal bleeding, the most appropriate nursing action is to assess vital signs and uterine tone. This is important to determine if the bleeding is within normal limits or if there is a potential postpartum hemorrhage (PPH) occurring. Monitoring vital signs can help identify signs of shock, while assessing uterine tone can help determine if the uterus is contracting effectively to control bleeding. Prompt assessment and early detection of PPH are crucial for effective management and prevention of complications. Encouraging increased fluid intake, applying a cold compress, and administering pain medication may be appropriate interventions in some situations, but assessing vital signs and uterine tone take priority in this scenario.

To assist them enhance their performance at work, the nurse manager should review regularly pertaining to the staff's

  • A. Number of submitted incident report
  • B. Academic performance in college
  • C. Job description
  • D. Family dynamics
Correct Answer: C

Rationale: Step 1: Job description is crucial for clarifying roles and responsibilities, ensuring staff understand their duties.
Step 2: Regular review of job descriptions helps align staff performance with organizational goals and expectations.
Step 3: It allows for identifying areas of improvement and providing necessary support and resources.
Step 4: Academic performance in college, family dynamics, and number of incident reports are not directly related to work performance.
Summary: Regularly reviewing staff job descriptions is essential for enhancing performance by clarifying roles, aligning expectations, and identifying areas for improvement. Other choices lack direct relevance to work performance.

The nurse is aware that which occurrence in the patient 's health history suggests the diagnosis of GBS?

  • A. viral illness few weeks before
  • B. encephalitis
  • C. severe bacterial infection
  • D. meningitis
Correct Answer: A

Rationale: The correct answer is A because a viral illness few weeks before can trigger Guillain-Barre Syndrome (GBS) due to the body's immune response attacking the peripheral nerves. Encephalitis (B), severe bacterial infection (C), and meningitis (D) are not directly linked to GBS pathophysiology. Viral infections are known to precede GBS development, making choice A the most appropriate option.

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