Adult Health Nursing Quizlet Final

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A patient presents with abdominal pain, fever, and peripheral blood smear showing fragmented red blood cells (schistocytes). Laboratory tests reveal elevated lactate dehydrogenase (LDH), decreased haptoglobin, and increased indirect bilirubin. Which of the following conditions is most likely to cause these findings?

  • A. Hemolytic uremic syndrome (HUS)
  • B. Thrombotic thrombocytopenic purpura (TTP)
  • C. Disseminated intravascular coagulation (DIC)
  • D. Immune thrombocytopenic purpura (ITP)
Correct Answer: B

Rationale: Thrombotic thrombocytopenic purpura (TTP) is a rare blood disorder characterized by microangiopathic hemolytic anemia, thrombocytopenia, fever, neurological abnormalities, and renal dysfunction. The peripheral blood smear in TTP typically shows fragmented red blood cells (schistocytes) due to mechanical destruction within small blood vessels. Laboratory findings in TTP commonly include elevated lactate dehydrogenase (LDH), decreased haptoglobin (as it is consumed in the clearance of free hemoglobin), and increased indirect bilirubin due to increased red blood cell breakdown. This combination of clinical presentation and laboratory abnormalities is classic for TTP. Hemolytic uremic syndrome (HUS) may present similarly but is more commonly associated with renal dysfunction and is often triggered by infection with Shiga toxin-producing E. coli.

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Cultural competence is the process of

  • A. Learning about vast cultures
  • B. Acquiring specific knowledge, skills, and attitudes
  • C. Influencing treatment and care of clients
  • D. Motivation and commitment to caring
Correct Answer: B

Rationale: Cultural competence is the process of acquiring specific knowledge, skills, and attitudes to effectively work with individuals from diverse cultural backgrounds. It involves understanding and respecting the values, beliefs, languages, and practices of different cultures in order to provide appropriate care and services. Cultural competence goes beyond just learning about different cultures; it requires the development of skills and attitudes that promote effective communication, understanding, and collaboration with individuals of diverse backgrounds. This includes being aware of one's own biases, being open-minded, and adapting practices to be inclusive and respectful of cultural differences. Ultimately, cultural competence is essential in providing high-quality, respectful, and effective care to clients from various cultural backgrounds.

This condition has difficulty in progressing stimuli and new information. Alzheimer`s is the most common form of which of these?

  • A. Fatigue
  • B. Malnutrition
  • C. Psychosis
  • D. Dementia
Correct Answer: D

Rationale: Alzheimer's disease is the most common form of dementia. Dementia is a general term for a decline in mental ability that becomes severe enough to interfere with daily life. It can affect memory, thinking skills, and the ability to perform everyday tasks. Alzheimer's disease specifically is a progressive brain disorder that slowly destroys memory and thinking skills and eventually impairs the ability to carry out simple tasks. Therefore, the provided condition of having difficulty in processing stimuli and new information aligns with the symptoms commonly seen in individuals with Alzheimer's disease.

A patient with terminal illness expresses a desire to spend quality time with their family but feels guilty for being a burden. How should the palliative nurse respond?

  • A. Dismiss the patient's feelings and reassure them that they are not a burden.
  • B. Encourage the patient to focus on their own needs rather than worrying about others.
  • C. Validate the patient's feelings of guilt and offer support to address their concerns.
  • D. Suggest involving family members in caregiving tasks to alleviate the patient's guilt.
Correct Answer: C

Rationale: In this situation, the most appropriate response for the palliative nurse is to validate the patient's feelings of guilt and offer support to address their concerns. It is important to acknowledge the patient's emotions and help them navigate through their guilt in a compassionate and understanding manner. By validating their feelings, the nurse can create a safe space for the patient to express their concerns and work towards finding solutions to alleviate their guilt. This approach fosters trust and a therapeutic relationship between the patient and the nurse, ultimately promoting emotional well-being and facilitating open communication.

A patient in the ICU develops acute respiratory distress syndrome (ARDS) secondary to sepsis. What intervention should the healthcare team prioritize to manage the patient's respiratory failure?

  • A. Initiate lung-protective mechanical ventilation with low tidal volume.
  • B. Administer inhaled nitric oxide (iNO) for pulmonary vasodilation.
  • C. Perform prone positioning to improve oxygenation.
  • D. Recommend high-dose corticosteroid therapy for anti-inflammatory effects.
Correct Answer: A

Rationale: ** In a patient with ARDS, the priority intervention to manage respiratory failure is to initiate lung-protective mechanical ventilation with low tidal volume. ARDS is characterized by widespread inflammation and injury to the alveoli, leading to impaired gas exchange and severe hypoxemia. Lung-protective ventilation strategies aim to minimize ventilator-induced lung injury by using lower tidal volumes (around 6 mL/kg of predicted body weight) to reduce barotrauma and volutrauma.

A patient presents with chest pain, dyspnea, and syncope. An electrocardiogram (ECG) shows a wide QRS complex with absence of P waves. Which cardiovascular disorder is most likely responsible for these symptoms?

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

Rationale: Ventricular tachycardia (VT) is a potentially life-threatening arrhythmia characterized by wide QRS complexes and absence of P waves on electrocardiogram (ECG). Patients with VT may present with symptoms such as chest pain, dyspnea, and syncope due to reduced cardiac output and ineffective pumping of the heart. VT is a serious condition that requires prompt treatment to prevent hemodynamic compromise and potential cardiac arrest. Stable angina typically presents with chest pain that is provoked by exertion and relieved by rest or nitroglycerin. Atrial fibrillation is characterized by an irregularly irregular rhythm with absent P waves on ECG. Supraventricular tachycardia typically presents with a narrow QRS complex on ECG.

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