Foundations and Adult Health Nursing Study Guide Answers

Correct Answer: A

Rationale: The correct instruction for using a metered-dose inhaler (MDI) with a spacer for a patient with COPD is to inhale slowly and deeply while pressing the canister. This technique helps ensure that the medication reaches the lungs effectively. Inhaling slowly and deeply allows the medication to be properly delivered to the airways, maximizing its effectiveness in treating the symptoms of COPD. This instruction helps the patient coordinate pressing the canister with their inhalation, which is crucial for proper medication delivery in COPD management.

Correct Answer: A

Rationale: Option A, "Can we talk about Mrs. Santos?" is indicative of a collaborative relationship between the nurse and the attending physician. It shows open communication and a willingness to discuss the patient's case together, which is essential for optimal patient care. This statement implies teamwork and a shared responsibility for the patient's well-being. The other options either lack a collaborative tone, show concern without inviting discussion, or suggest a dismissive attitude towards addressing the patient's needs.

Correct Answer: A

Rationale: Patients with COPD are at increased risk for developing ventilator-induced lung injury (VILI) due to their underlying lung pathology. Using a low tidal volume strategy (6-8 ml/kg predicted body weight) has been shown to reduce the risk of VILI in these patients. Additionally, applying high positive end-expiratory pressure (PEEP) helps to recruit collapsed alveoli, improve oxygenation, and decrease the risk of barotrauma by keeping the alveoli open throughout the respiratory cycle. Therefore, the most appropriate ventilator settings to minimize the risk of VILI in a COPD patient with acute exacerbation and respiratory failure requiring mechanical ventilation would be low tidal volume and high PEEP.

Correct Answer: A

Rationale: The patient's symptoms of fever, chills, headache, and myalgia after returning from sub-Saharan Africa are consistent with malaria. Intraerythrocytic ring forms and trophozoites observed on blood smear examination are characteristic of Plasmodium species, particularly Plasmodium falciparum, which is the most common and deadliest species causing malaria in sub-Saharan Africa. Plasmodium falciparum can lead to severe complications, such as cerebral malaria, if not promptly treated. Trypanosoma cruzi causes Chagas disease, not malaria. Borrelia burgdorferi is responsible for Lyme disease, which typically presents with a different set of symptoms like erythema migrans rash. Leishmania donovani causes visceral leishmaniasis, not malaria.

Correct Answer: A

Rationale: Given the sudden-onset severe scrotal pain, swelling, and erythema, along with the physical examination findings of a tender, swollen, and high-riding testicle, the most likely diagnosis is testicular torsion. Testicular torsion occurs when the spermatic cord twists, leading to compromised blood flow to the testicle, causing ischemia and severe pain. It is considered a surgical emergency that requires prompt diagnosis and intervention to salvage the affected testicle. Prompt surgical detorsion is necessary to prevent irreversible testicular damage. While epididymitis, testicular trauma, and testicular tumors can also present with scrotal pain and swelling, the presence of a high-riding testicle in this context is highly suggestive of testicular torsion.