Foundations and Adult Health Nursing Test Bank

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A patient with suspected tuberculosis (TB) presents with cough, weight loss, night sweats, and hemoptysis. Chest X-ray reveals upper lobe infiltrates and cavitation. Which of the following diagnostic tests is most appropriate for confirming the diagnosis of pulmonary TB?

  • A. Sputum acid-fast bacilli (AFB) smear and culture
  • B. Tuberculin skin test (TST)
  • C. Interferon-gamma release assay (IGRA)
  • D. Chest CT-guided biopsy
Correct Answer: A

Rationale: In a patient with suspected pulmonary TB, the most appropriate diagnostic test for confirming the diagnosis is the sputum acid-fast bacilli (AFB) smear and culture. This test involves examining sputum samples under the microscope for the presence of acid-fast bacilli, which are characteristic of Mycobacterium tuberculosis, the bacteria that causes TB. Additionally, culturing the sputum allows for the bacteria to grow in a controlled environment, further confirming the diagnosis. In the given scenario, the patient's symptoms (cough, weight loss, night sweats, hemoptysis), along with chest X-ray findings of upper lobe infiltrates and cavitation, are highly suggestive of pulmonary TB. Therefore, performing a sputum AFB smear and culture is crucial for definitive diagnosis and initiation of appropriate treatment. The other options (Tuberculin skin test, Interferon

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Nurse Rica is in charge of the animal bite program of the health center, which of the following is the causative agent of rabies?

  • A. Parasite
  • B. Bacteria
  • C. Virus
  • D. Fungi
Correct Answer: C

Rationale: Rabies is a viral disease that affects the central nervous system. It is primarily transmitted through the bite of an infected animal, such as dogs, bats, raccoons, and foxes. The causative agent of rabies is the rabies virus, specifically from the genus Lyssavirus. Once the virus enters the body, it spreads through the nervous system to the brain, leading to severe neurological symptoms and, if left untreated, is almost always fatal. This is why prompt medical attention and vaccination following an animal bite are crucial in preventing the development of rabies in humans.

Which of the following is the MOST common emotional response among women during the First trimester of pregnancy?

  • A. Ambivalence
  • B. Acceptance
  • C. Depression
  • D. Jealousy
Correct Answer: A

Rationale: Ambivalence is the most common emotional response among women during the first trimester of pregnancy. This is because the news of being pregnant might evoke a mix of emotions, including joy and apprehension. Women may feel uncertain about their readiness for the responsibility of motherhood, have concerns about changes in their body, or worry about the impact on their career or relationships. Ambivalence is a natural response to a significant life change, and many women experience conflicting feelings before fully accepting and embracing their pregnancy.

To ensure quality nursing care to a patient in skin traction, what is the PRIORTTY intervention that a nurse has to assess frequently?

  • A. Signs of infection around the pin site.
  • B. Signs of skin breakdown
  • C. Urinary incontinence
  • D. Presence' of bowel sounds
Correct Answer: B

Rationale: When a patient is in skin traction, the constant pressure and rubbing against the skin from the traction device can lead to skin breakdown. Therefore, assessing for signs of skin breakdown, such as redness, irritation, or pressure injuries, is crucial to prevent complications and ensure the patient's comfort and safety. Prompt identification and intervention for any skin issues can prevent further damage and promote healing, making this the priority intervention for quality nursing care in skin traction. While monitoring for signs of infection, urinary incontinence, and bowel sounds are important, skin breakdown poses a more immediate threat to the patient's well-being in this scenario.

Which of the following nursing actions should the nurse TEACH the patient's care giver regarding tracheostomy care?

  • A. Remove the tracheostomy tube if obstruction occurs
  • B. Leave the tracheostomy ties in place until the physician change them
  • C. Remove and clean the inner cannula daily
  • D. Never put a covering over the tracheostomy stoma
Correct Answer: C

Rationale: Cleaning the inner cannula daily helps prevent the accumulation of secretions and debris, which can lead to blockages and infections. It is an essential aspect of tracheostomy care to maintain the patency of the airway and prevent complications. Caregivers should be taught how to safely remove, clean, and reinsert the inner cannula as part of routine tracheostomy care.

A patient in the ICU develops acute myocardial infarction (MI) with cardiogenic shock. What intervention should the healthcare team prioritize to manage the patient's shock?

  • A. Perform emergent percutaneous coronary intervention (PCI).
  • B. Administer inotropic medications to improve cardiac contractility.
  • C. Initiate therapeutic hypothermia to reduce myocardial oxygen demand.
  • D. Recommend anticoagulant therapy to prevent thromboembolism.
Correct Answer: A

Rationale: In a patient with acute myocardial infarction (MI) complicated by cardiogenic shock, the primary intervention to manage shock is emergent percutaneous coronary intervention (PCI). PCI is a procedure performed to restore blood flow in an occluded coronary artery that is causing the MI. By opening up the blocked artery and restoring blood flow to the heart muscle, PCI can help reduce myocardial damage, improve cardiac function, and stabilize the patient's condition. Prompt reperfusion via PCI is crucial in the setting of cardiogenic shock to improve survival outcomes and reduce the risk of further complications. Administering inotropic medications, initiating therapeutic hypothermia, or recommending anticoagulant therapy may be components of management in specific cases but are not the primary intervention for managing shock in a patient with acute MI and cardiogenic shock.

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