Foundations and Adult Health Nursing Test Bank

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.

Correct Answer: B

Rationale: Obtaining informed consent is primarily the responsibility of the physician. Informed consent is a crucial ethical and legal concept in healthcare that requires the healthcare provider, usually the physician, to ensure that the patient understands the proposed treatment, including the risks, benefits, alternatives, and potential outcomes, before agreeing to proceed with the treatment. While other healthcare professionals, such as nurses, nurse managers, anesthesiologists, and midwives, may also play a role in the informed consent process by providing information and clarifying details, it is ultimately the physician who must obtain the patient's informed consent before any treatment or procedure is performed.

Correct Answer: B

Rationale: During the acute phase response, C-reactive protein (CRP) primarily serves to activate the complement system. CRP binds to phosphocholine on the surface of pathogens, allowing for the activation of the classical pathway of the complement system. This leads to the recruitment of immune cells, opsonization of pathogens, and enhancement of phagocytosis. The activation of the complement system by CRP plays a crucial role in the host defense against infections, aiding in the elimination of pathogens and the resolution of inflammation.

Correct Answer: B

Rationale: Type I IgE-mediated immediate hypersensitivity reactions, such as anaphylaxis, are promptly managed with epinephrine. Epinephrine is the first-line treatment for anaphylaxis as it helps counteract the severe symptoms by relaxing the muscles in the airways, constricting blood vessels, and decreasing swelling. It acts quickly to reverse the potentially life-threatening effects of the allergic reaction and is crucial in managing anaphylaxis effectively. Other medications like antihistamines (e.g., diphenhydramine) and corticosteroids may be used as adjuncts, but epinephrine remains the primary treatment for immediate hypersensitivity reactions.

Correct Answer: B

Rationale: Digoxin is a medication commonly used in the treatment of congestive heart failure because it helps to improve cardiac output and reduce heart failure symptoms. One of the desired effects of digoxin is an increase in urinary output. This is because digoxin helps to improve cardiac function, which can lead to better circulation and increased kidney perfusion. As a result, the kidneys are better able to filter and excrete excess fluid, leading to increased urine output. Therefore, an increase in urinary output indicates that the digoxin is having a positive effect in managing the client's congestive heart failure. The other options, such as increased weight, improved appetite, and increased pedal edema, are not indicative of a desired effect of digoxin therapy.