Adult Health Nursing Test Banks

Correct Answer: B

Rationale: Vestibular neuritis is a condition characterized by the acute onset of severe vertigo, nausea, vomiting, and nystagmus. These symptoms are typically worsened by head movement. Vestibular neuritis is caused by inflammation of the vestibular nerve, which plays a key role in balance and spatial orientation. The classic presentation of these symptoms, along with the absence of hearing loss (which is seen in labyrinthitis), points towards vestibular neuritis as the most likely cause in this scenario. Meniere's disease presents with recurrent episodes of vertigo, hearing loss, tinnitus, and sensation of fullness in the ear. Benign paroxysmal positional vertigo (BPPV) is characterized by brief episodes of vertigo triggered by changes in head position.

Correct Answer: A

Rationale: The presentation of sudden-onset, painless vision loss in the right eye with a cherry-red spot at the macula and attenuated retinal vessels is classic for central retinal artery occlusion (CRAO). In this condition, the blockage of the central retinal artery results in severe ischemia of the retina, leading to rapid and profound vision loss. The cherry-red spot at the macula is a result of preserved choroidal circulation contrasting with the pale, ischemic retina. Attenuated retinal vessels are also commonly observed due to decreased blood flow. Prompt evaluation and management are critical in CRAO to potentially restore some vision and prevent further ischemic damage to the retina.

Correct Answer: B

Rationale: Religious Affiliation is not typically included in the history taking process for diagnosing medical conditions. While a patient's religious beliefs may sometimes be relevant in certain situations, it is not a standard component of medical history. History taking usually includes aspects such as the history of present illness, social and family history, and past medical history as these can provide important information related to the patient's health condition.

Correct Answer: D

Rationale: Cromolyn sodium (nasal crom) is a mast cell stabilizer that is commonly used to prevent symptoms of allergic rhinitis, such as sneezing, itching, and congestion. It works best when used before exposure to allergens. The most effective administration schedule for nasal crom is to start using it just after allergy symptoms begin, with a dose of twice-a-day. This helps to prevent the release of histamine and other inflammatory substances from mast cells, thereby reducing allergic symptoms. Using nasal crom in this way can help provide relief and improve the overall management of allergic rhinitis.

Correct Answer: B

Rationale: The clinical scenario described is consistent with a diagnosis of anterior epistaxis due to a prominent vascular lesion located in Little's area, which is an important site for nosebleeds. Silver nitrate cautery is the most appropriate intervention for managing this condition. Silver nitrate cautery is a commonly used method to chemically cauterize and eliminate the friable blood vessels responsible for recurrent epistaxis. It is a cost-effective and minimally invasive technique that can be easily performed in an outpatient setting. Nasal packing with anterior nasal tampons might be considered in cases of severe or refractory epistaxis, but in this scenario, where the source of bleeding is localized and identifiable, silver nitrate cautery is the treatment of choice. Endoscopic cauterization of the sphenopalatine artery and surgical excision of a nasal polyp are unnecessary and overly invasive for the described scenario.