Adult Health Med Surg Nursing Test Banks

Correct Answer: C

Rationale: The patient's presentation of urinary frequency, urgency, dysuria, and suprapubic pain along with the urinalysis findings of pyuria (pus in the urine) and bacteriuria (bacteria in the urine) are highly suggestive of a urinary tract infection (UTI). UTIs are one of the most common types of bacterial infections seen in clinical practice. The symptoms described are classic for a lower urinary tract infection. The presence of pyuria and bacteriuria on urinalysis further supports the diagnosis of a UTI. Acute glomerulonephritis typically presents with hematuria, proteinuria, hypertension, and edema. Chronic kidney disease is often asymptomatic in early stages and presents with symptoms like fatigue, edema, and changes in urination later on. Renal calculi are associated with severe colicky flank pain that can radiate to the groin, and they may present with

Correct Answer: C

Rationale: The correct information that the incoming nurse should chart is that she received 800 cc of IV fluid. It is crucial for the charting to accurately reflect the actual situation to provide an accurate record for the patient's care. In this scenario, the discrepancy between the endorsed amount (400 cc) and the observed amount (800 cc) should be documented to ensure transparency and continuity of care. This deviation from the expected amount should be clearly recorded for proper monitoring and evaluation of the patient's condition.

Correct Answer: B

Rationale: Normal saline is the preferred solution for wound irrigation because it is isotonic and will not damage healthy tissue or delay wound healing. It helps to remove debris and pathogens from the wound, promoting a clean environment for healing. Sterile water can be used if normal saline is not available, but it may cause cellular damage if used in large volumes. Hydrogen peroxide and Betadine solution are not recommended for wound irrigation as they can be cytotoxic to the tissues and interfere with the wound healing process. It's important for the nurse to use evidence-based practice and follow recommended guidelines to promote optimal wound healing outcomes.

Correct Answer: C

Rationale: Naloxone, also known by the brand name Narcan, is used to reverse the effects of opioid overdose. Opioids can cause respiratory depression, sedation, and other signs of toxicity. Administering naloxone can quickly reverse these effects, restoring the patient's breathing and consciousness. This makes it the appropriate choice for reversing all signs of toxicity related to opioids. Digibind (Digoxin) is used to reverse toxicity from digoxin specifically. Atropine sulfate is used for bradycardia. Diazepam (Valium) is a benzodiazepine used for anxiety, seizures, and muscle relaxation, not for reversing toxicity.

Correct Answer: B

Rationale: When managing a conscious patient with a foreign object lodged in the eye, the appropriate action is to rinse the eye with sterile saline solution. This helps to flush out the foreign object and reduce the risk of further injury or infection. Attempting to remove the object with tweezers or applying pressure to the eyelid can potentially cause more harm to the eye. Placing a bandage over the affected eye is not beneficial in this situation as it does not address the presence of the foreign object. Rinsing the eye with sterile saline solution is the safest and most effective initial step to take in managing a foreign object lodged in the eye.