Adult Health Nursing Test Bank

Adult Health Nursing Test Bank Related

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The nurse is working in a clinic that is designed to provide health education and immunization. As such, the clinic aims to provide_______________

  • A. diagnosis and treatment
  • B. Secondary prevention
  • C. Primary prevention
  • D. Tertiary prevention
Correct Answer: C

Rationale: The correct answer is C: Primary prevention. In this scenario, the clinic focuses on preventing disease before it occurs through health education and immunization. Primary prevention aims to promote general health and prevent the onset of diseases. It targets the entire population to reduce the risk of disease occurrence.

Incorrect Choices:
A: Diagnosis and treatment - This choice involves identifying and treating existing health conditions, which is not the primary focus of a clinic designed for health education and immunization.
B: Secondary prevention - This choice involves early detection and treatment of diseases to prevent complications, which is more focused on individuals who already have risk factors or symptoms, not on the general population.
D: Tertiary prevention - This choice involves managing and treating complications of diseases to prevent further deterioration, which is not the primary goal of a clinic focused on health education and immunization.

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The nurse specialist explains that chemotherapyis extremely toxic to the bone marrow and the patient may develop thrombocytopenia. What is the priority goal of the nurse? To take precautions to control _______.

  • A. Bleeding
  • B. Infection
  • C. Hypotension
  • D. diarrhea
Correct Answer: A

Rationale: The correct answer is A: Bleeding. Chemotherapy can lead to low platelet counts (thrombocytopenia), increasing the risk of bleeding. The priority goal of the nurse is to prevent bleeding by taking precautions such as avoiding invasive procedures, using soft toothbrushes, and monitoring for signs of bleeding. Infection (B) is important but not the priority as bleeding can be life-threatening. Hypotension (C) is not directly related to thrombocytopenia. Diarrhea (D) is a potential side effect of chemotherapy but is not the priority when considering thrombocytopenia.

A patient presents with severe headache, photophobia, and neck stiffness. On examination, there is nuchal rigidity and positive Kernig and Brudzinski signs. Which of the following neurological conditions is most likely responsible for these symptoms?

  • A. Migraine headache
  • B. Cluster headache
  • C. Meningitis
  • D. Subarachnoid hemorrhage
Correct Answer: C

Rationale: The correct answer is C: Meningitis. The patient's symptoms of severe headache, photophobia, neck stiffness, nuchal rigidity, and positive Kernig and Brudzinski signs are classic signs of meningitis. Meningitis is an inflammation of the meninges surrounding the brain and spinal cord, leading to these specific neurological symptoms. Migraine headache (A) typically presents with a throbbing headache, nausea, and sensitivity to light and sound, but does not typically cause neck stiffness or positive meningeal signs. Cluster headache (B) is characterized by severe unilateral headache with autonomic symptoms like tearing or nasal congestion, but does not typically cause neck stiffness or positive meningeal signs. Subarachnoid hemorrhage (D) presents with sudden severe headache often described as "the worst headache of my life," and may cause neck stiffness, but typically does not present with photophobia or positive meningeal signs like Kernig and Brudzinski signs.

Nurse Erika tap all the newly hired nurses to be members of her new project. she is observing the ethical principle of ________.

  • A. Justice
  • B. Nonmaleficence
  • C. Autonomy
  • D. Respect
Correct Answer: A

Rationale: The correct answer is A: Justice. Nurse Erika is ensuring fairness by including all newly hired nurses in her project without discrimination. Justice in healthcare promotes equity and equal opportunities. Nonmaleficence (B) refers to the duty to do no harm, not relevant here. Autonomy (C) relates to respecting individuals' right to make decisions for themselves, not evident in the scenario. Respect (D) is important but not the primary ethical principle demonstrated here.

During the active phase of labor, a woman's cervical dilation is progressing slowly despite regular contractions. What maternal condition should the nurse assess for that may contribute to abnormal labor progression?

  • A. Maternal exhaustion
  • B. Pelvic outlet obstruction
  • C. Fetal macrosomia
  • D. Uterine hyperstimulation
Correct Answer: B

Rationale: One potential maternal condition that may contribute to abnormal labor progression with slow cervical dilation despite regular contractions is pelvic outlet obstruction. This can occur if the maternal pelvis is too small, misshapen, or has an obstruction such as a fibroid tumor. The inadequate space in the pelvis can prevent the fetus from descending properly and can result in a prolonged or difficult labor. If suspected, interventions such as a cesarean delivery may be necessary to prevent complications for both the mother and baby. It is essential for the nurse to assess for signs of pelvic outlet obstruction and work with the healthcare team to address any issues promptly to ensure a safe delivery.

A patient presents with palpitations, dizziness, and syncope. An electrocardiogram (ECG) shows ventricular tachycardia. Which cardiovascular disorder is most likely responsible for these symptoms?

  • A. Stable angina
  • B. Unstable angina
  • C. Atrial fibrillation
  • D. Ventricular tachycardia
Correct Answer: D

Rationale: The correct answer is D: Ventricular tachycardia. Ventricular tachycardia is a serious arrhythmia that can lead to palpitations, dizziness, and syncope due to the rapid and abnormal heart rhythm originating in the ventricles. This arrhythmia can be life-threatening if not promptly treated.

A: Stable angina is characterized by chest discomfort or pain due to reduced blood flow to the heart muscle, usually during physical exertion or stress. It does not typically present with palpitations, dizziness, or syncope.

B: Unstable angina is a more severe form of angina where symptoms occur even at rest. While it can lead to serious complications like heart attack, it does not commonly present with palpitations, dizziness, or syncope.

C: Atrial fibrillation is a common arrhythmia originating in the atria, leading to an irregular and often rapid heartbeat. While it can cause palpitations and dizziness,

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