Adult Health Nursing Test Bank

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Lillian complains of unbearable pain. Which of the following characteristics axe EMPHASIZED in a culturally sensitive nursing Care? (Select all that apply) I The expression of pain is affected by learned behavior II. Physiologically, all individuals experience pain in a similar manner, III.. Some Asian people has high response to pain medications IV. Patients should be assessed for pain regardless of overt symptomatology.

  • A. III and IV
  • B. I and II I
  • C. I and II
  • D. II and III
Correct Answer: C

Rationale: Step-by-step rationale for the correct answer (C: I and II):
1. Choice I (The expression of pain is affected by learned behavior) is correct because cultural beliefs and upbringing influence how individuals express and perceive pain.
2. Choice II (Physiologically, all individuals experience pain in a similar manner) is correct because pain perception is largely influenced by biological factors that are universal.
3. Choice III (Some Asian people have a high response to pain medications) is incorrect as it focuses on a specific cultural group, which is not a general characteristic emphasized in culturally sensitive care.
4. Choice IV (Patients should be assessed for pain regardless of overt symptomatology) is incorrect as it is not specifically related to cultural sensitivity in pain management.

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A pregnant woman presents with fever, chills, and abdominal pain localized to the right upper quadrant. On examination, she has tenderness in the right upper abdomen and a positive Murphy's sign. Which of the following conditions is the most likely cause of these symptoms?

  • A. Ectopic pregnancy
  • B. Pelvic inflammatory disease
  • C. Acute cholecystitis
  • D. Ovarian torsion
Correct Answer: C

Rationale: The scenario described in the question is consistent with acute cholecystitis, which is inflammation of the gallbladder usually caused by an impacted gallstone in the cystic duct. The key clinical features of acute cholecystitis include fever, chills, right upper quadrant abdominal pain (which can be localized to the right upper quadrant), tenderness in the right upper abdomen, and a positive Murphy's sign (pain and inspiratory arrest upon palpation of the right upper quadrant). This condition is more common in pregnant women due to hormonal changes that can lead to gallstone formation and subsequent inflammation of the gallbladder. Ectopic pregnancy, pelvic inflammatory disease, and ovarian torsion typically present with different clinical features compared to those described in acute cholecystitis.

A patient with advanced cancer develops malignant bowel obstruction, resulting in abdominal pain and distension. What intervention should the palliative nurse prioritize to manage the patient's symptoms?

  • A. Initiate bowel rest and maintain the patient in a semi-Fowler's position.
  • B. Administer opioid analgesics to alleviate abdominal pain and discomfort.
  • C. Refer the patient to a surgeon for consideration of surgical intervention.
  • D. Prescribe antiemetic medications to prevent nausea and vomiting.
Correct Answer: B

Rationale: The correct answer is B: Administer opioid analgesics to alleviate abdominal pain and discomfort. Opioid analgesics are effective in managing severe pain associated with malignant bowel obstruction. By providing adequate pain relief, the patient's comfort and quality of life can be significantly improved.

Choice A is incorrect because initiating bowel rest and maintaining the patient in a semi-Fowler's position may not effectively address the severe pain and discomfort experienced by the patient.

Choice C is incorrect as surgical intervention in this scenario may not be appropriate or feasible due to the advanced stage of cancer and the presence of malignant bowel obstruction.

Choice D is incorrect as antiemetic medications primarily target nausea and vomiting, which may not be the primary symptoms of concern in this case. Focusing on pain management should be the priority.

A patient with a history of stroke is prescribed aspirin and clopidogrel for dual antiplatelet therapy. Which nursing intervention is essential for preventing bleeding complications in this patient?

  • A. Administering proton pump inhibitors (PPIs) concomitantly
  • B. Encouraging increased fluid intake
  • C. Monitoring for signs of thrombocytopenia
  • D. Providing education on fall prevention measures
Correct Answer: A

Rationale: The correct answer is A: Administering proton pump inhibitors (PPIs) concomitantly. Aspirin and clopidogrel can increase the risk of gastrointestinal bleeding. PPIs help reduce this risk by decreasing gastric acid production. Therefore, administering PPIs with dual antiplatelet therapy is essential for preventing bleeding complications. Encouraging increased fluid intake (B) may not directly address the risk of bleeding. Monitoring for signs of thrombocytopenia (C) is important but may not directly prevent bleeding in this case. Providing education on fall prevention measures (D) is important for overall safety but does not directly address bleeding risks associated with dual antiplatelet therapy.

Which of the following interventions is recommended for managing a patient with suspected pelvic inflammatory disease (PID)?

  • A. Empiric antibiotic therapy directed against common pathogens.
  • B. Surgical exploration and drainage of pelvic abscesses.
  • C. Hormonal therapy to suppress ovarian function.
  • D. Symptomatic treatment with nonsteroidal anti-inflammatory drugs (NSAIDs).
Correct Answer: A

Rationale: The correct answer is A: Empiric antibiotic therapy directed against common pathogens. This is recommended for managing PID because it helps treat the infection and prevent complications. Antibiotics target the underlying bacterial infection causing PID. Surgical exploration (B) is not the initial treatment for PID. Hormonal therapy (C) is not indicated for PID management. Symptomatic treatment with NSAIDs (D) can help with pain but does not address the infection itself.

A surgeon accidentally cuts his patient's bladder while attempting to remove his appendix. The surgeon could be guilty of _________

  • A. Battery
  • B. Negligence
  • C. Malpractice
  • D. Tort
Correct Answer: C

Rationale: The correct answer is C: Malpractice. Malpractice refers to professional negligence or failure to perform duties according to accepted standards of practice. In this scenario, the surgeon's act of cutting the patient's bladder during an appendectomy could be considered a breach of duty and failure to provide the expected standard of care, which falls under malpractice. Battery (A) involves intentional harmful or offensive contact without consent. Negligence (B) is the failure to exercise reasonable care, but in this case, it was more than just a lack of care. Tort (D) refers to a civil wrong that causes harm, but malpractice is a specific type of tort related to professional negligence.

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