Adult Health Med Surg Nursing Test Banks

Correct Answer: C

Rationale: Erythropoietin-stimulating agents (ESAs) are prescribed to manage anemia in patients with chronic kidney disease. Monitoring the hemoglobin level closely during ESA therapy is crucial to ensure that the treatment is effective in increasing red blood cell production without causing excessive elevation. Hemoglobin levels should be checked regularly to adjust the ESA dosage accordingly and prevent risks associated with high hematocrit levels, such as increasing blood viscosity and cardiovascular events. Monitoring serum potassium, creatinine, and platelet count are important in the management of chronic kidney disease for different reasons, but for ESA therapy, monitoring hemoglobin is the most essential parameter.

Correct Answer: A

Rationale: The patient's presentation of recurrent episodes of sudden, severe vertigo lasting hours with nausea, vomiting, and nystagmus, along with unilateral weakness on vestibular function tests, is most consistent with vestibular neuritis. Vestibular neuritis is characterized by inflammation of the vestibular nerve leading to sudden onset vertigo that can last for hours to days. It is often associated with nausea, vomiting, and nystagmus. Unilateral weakness on vestibular function tests indicates dysfunction of one vestibular system. Differential diagnosis for this type of presentation includes other conditions such as Meniere's disease, BPPV, and acoustic neuroma. However, the combination of symptoms and unilateral vestibular weakness makes vestibular neuritis the most likely diagnosis in this case.

Correct Answer: D

Rationale: Postpartum hemorrhage (PPH) is a significant complication after childbirth. The risk factors for PPH that are typically included in the list are uterine atony, overdistended uterus (e.g., multiple gestation or polyhydramnios), and ruptured uterus. Retroversion of the uterus is not a known risk factor for PPH. Retroversion refers to the position of the uterus, where it is tilted back towards the rectum. While retroverted uterus can sometimes lead to other issues or complications during pregnancy, it is not directly associated with an increased risk of postpartum hemorrhage.

Correct Answer: C

Rationale: Breach of duty is the element of malpractice that occurs when the nurse does not act as a reasonable, prudent person would have acted in a similar circumstance. This means that the nurse failed to uphold the standard of care expected in their practice. In a malpractice case, it must be proven that the nurse breached their duty of care towards the patient by not providing the expected level of skill and care that another reasonable nurse in the same situation would have provided.

Correct Answer: A

Rationale: The presentation described indicates a candidal infection, which commonly occurs in warm, moist body areas like inguinal folds and gluteal cleft. The pruritic, erythematous rash with scaly plaques and satellite papules and pustules is characteristic of cutaneous candidiasis. The recent antibiotic use for urinary tract infection likely disrupted the normal skin flora, predisposing the patient to a Candida overgrowth. Tinea cruris (jock itch) can also present similarly, but the presence of satellite papules and pustules is more indicative of candidiasis. Erythrasma typically presents as well-defined brown-red patches without satellite lesions, and intertrigo is a more generic term referring to inflammation of skin folds that can have various causes, including candidiasis.