Adult Health Nursing Answer Key

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A pregnant woman presents with sudden onset of severe abdominal pain and dark red vaginal bleeding at 28 weeks gestation. On examination, the uterus is tender, and the fundus feels firm. Which of the following conditions is the most likely cause of these symptoms?

  • A. Ectopic pregnancy
  • B. Threatened abortion
  • C. Placenta previa
  • D. Abruptio placentae
Correct Answer: D

Rationale: The most likely cause of the sudden onset of severe abdominal pain and dark red vaginal bleeding with a tender, firm uterus at 28 weeks gestation is abruptio placentae. Abruptio placentae, also known as placental abruption, is the premature separation of the placenta from the uterine wall before delivery. This condition can be life-threatening to both the mother and the fetus, as it can lead to severe bleeding and compromise the oxygen and nutrients supply to the fetus. The presentation typically includes severe abdominal pain, dark red or maroon vaginal bleeding, uterine tenderness, and a firm uterus due to the blood accumulation behind the placenta. Prompt recognition and intervention are crucial to prevent adverse maternal and fetal outcomes.

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The nurse instructs the patient that the BEST time for an incontinent patient to take his diuretics is

  • A. Any time of the day
  • B. In the morning
  • C. After 4:00 PM
  • D. At bedtime
Correct Answer: D

Rationale: The best time for an incontinent patient to take diuretics is at bedtime. This timing allows for increased urine production during the night, consequently reducing the need for frequent toileting during the day. By taking the diuretic at bedtime, the patient can manage their incontinence more effectively and have better rest without disruptions from frequent urination during the day.

What is the appropriate initial management for a conscious patient experiencing a syncopal episode (fainting)?

  • A. Elevating the legs above the level of the heart.
  • B. Administering intravenous fluids rapidly.
  • C. Providing reassurance and assisting the patient to a lying position.
  • D. Administering oxygen via nasal cannula.
Correct Answer: C

Rationale: The appropriate initial management for a conscious patient experiencing a syncopal episode (fainting) is to provide reassurance and assist the patient to a lying position. This is important to ensure adequate blood flow to the brain and to prevent further injury in case the patient faints again. Elevating the legs above the level of the heart is not recommended as a routine intervention for syncope. Administering intravenous fluids rapidly is not usually needed in the initial management of syncope without signs of dehydration or significant bleeding. Administering oxygen via nasal cannula is not necessary for most cases of syncope unless there are specific indications such as signs of respiratory distress.

Patient Sonia, who bas hypothyroidism is given which ONE of the following drug therapies?

  • A. Propranolol
  • B. Iron pills
  • C. Iodine
  • D. Levothyroxine
Correct Answer: D

Rationale: Patient Sonia, who has hypothyroidism, would benefit from treatment with levothyroxine. Levothyroxine is a synthetic form of the thyroid hormone thyroxine (T4) and is commonly prescribed to replace the deficient thyroid hormone in patients with hypothyroidism. It helps restore the thyroid hormone levels in the body, relieving symptoms such as fatigue, weight gain, and cold intolerance that are characteristic of hypothyroidism. Propranolol is a beta-blocker used for conditions like hypertension, anxiety, and migraines; iron pills are used to treat iron deficiency anemia; and iodine supplementation is not typically used in the treatment of hypothyroidism unless it is due to iodine deficiency.

During a shift handover, the nurse receives information about a patient's condition from the outgoing nurse. What action by the nurse demonstrates effective communication during the handover process?

  • A. Interrupting the outgoing nurse to ask questions
  • B. Writing down the information without asking for clarification
  • C. Summarizing key points and asking clarifying questions as needed
  • D. Disregarding the information and relying on personal assessment later
Correct Answer: C

Rationale: Option C, summarizing key points and asking clarifying questions as needed, demonstrates effective communication during the handover process. This action ensures that the nurse fully understands the information being provided and helps to prevent misunderstandings or missing critical details. By summarizing key points, the nurse confirms their understanding and can ask for clarification on any areas that are unclear. Effective communication during handovers is essential for maintaining patient safety and continuity of care.

A woman in active labor is experiencing umbilical cord prolapse. What is the priority nursing action?

  • A. Elevating the mother's hips to relieve pressure on the cord
  • B. Preparing for immediate cesarean section
  • C. Administering intravenous fluids rapidly
  • D. Applying external fetal monitoring to assess fetal heart rate
Correct Answer: B

Rationale: In the case of umbilical cord prolapse, the priority nursing action is to prepare for an immediate cesarean section. Umbilical cord prolapse is a serious obstetric emergency where the umbilical cord slips through the cervix ahead of the presenting part of the fetus. This can lead to compression of the cord, compromising fetal blood flow and oxygenation. Immediate delivery via cesarean section is necessary in order to prevent fetal hypoxia and avoid potential complications such as brain damage or death. Elevating the mother's hips or administering intravenous fluids rapidly may be interventions done in conjunction with preparing for a cesarean section, but the priority remains expedited delivery of the baby. Applying external fetal monitoring is not the most appropriate action in this emergency situation.

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