Adult Health Med Surg Nursing Test Banks

Correct Answer: A

Rationale: The clinical presentation of recurrent episodes of epistaxis, gum bleeding, and easy bruising, along with laboratory findings of prolonged bleeding time, normal platelet count, and normal coagulation studies (PT and aPTT) are highly suggestive of Von Willebrand disease. Von Willebrand disease is the most common inherited bleeding disorder and is characterized by a deficiency or dysfunction of von Willebrand factor (vWF), which plays a key role in platelet adhesion and aggregation. The prolonged bleeding time is due to impaired platelet adhesion to the damaged vessel wall in the absence of functional vWF. Normal platelet count and normal PT/aPTT help differentiate Von Willebrand disease from other bleeding disorders such as hemophilia and platelet function disorders like Glanzmann thrombasthenia and Bernard-Soulier syndrome.

Correct Answer: C

Rationale: The primary collaborative goal for the treatment of Ms. C should be to restore normal nutrition and weight. This is essential in addressing the potential health issues associated with anorexia nervosa, which is characterized by significantly low body weight and malnutrition. By focusing on restoring normal nutrition and weight, Ms. C can improve her physical health and overall well-being. Resolving possible dysfunctional family roles as an adolescent, increasing the desire to eat, and assisting her to increase feelings of control over eating are important aspects of treatment as well, but the most immediate goal should be to address the physical consequences of anorexia nervosa through restoring normal nutrition and weight.

Correct Answer: C

Rationale: Medico-legal charts are typically stored for a minimum of 10 years after the case is closed to ensure compliance with legal requirements and to provide a comprehensive record of the medical care provided. This duration allows for potential future reference, follow-up treatment, or legal purposes that may arise within the specified timeframe. It is important to maintain these records for an extended period to protect both the patient's rights and the healthcare provider's accountability. Additionally, storing medico-legal charts for 10 years aligns with standard retention practices in the healthcare industry.

Correct Answer: A

Rationale: Molluscum contagiosum is a viral skin infection caused by the poxvirus. It commonly presents as flesh-colored, dome-shaped papules with central umbilication on the face, trunk, and extremities. The central umbilication indicates the presence of a crater-like indentation in the center of the lesion. It is a benign condition and usually self-limited, but it can be persistent and contagious. Treatment options include cryotherapy, curettage, topical therapies, and observation. Acne vulgaris presents with comedones, papules, pustules, and nodules primarily on the face, chest, and back. Sebaceous hyperplasia is characterized by yellowish papules with central dell on the face. Basal cell carcinoma typically presents as a pearly papule with telangiectasias and may have ulceration or bleeding.

Correct Answer: C

Rationale: The patient's presentation of swelling of the ankles, dyspnea on exertion, and orthopnea is highly suggestive of heart failure. The echocardiogram findings of decreased left ventricular ejection fraction and dilated left ventricle are characteristic of heart failure with reduced ejection fraction (HFrEF), also known as systolic heart failure. In this condition, the heart's ability to pump blood effectively is compromised, leading to symptoms of congestion and decreased cardiac output. The decreased ejection fraction indicates that the heart is not able to efficiently pump out blood with each contraction. Dilatation of the left ventricle is a compensatory mechanism in response to increased volume overload.