Foundations and Adult Health Nursing Test Bank

Correct Answer: C

Rationale: Sevelamer is a medication commonly prescribed to reduce serum phosphate levels in patients with chronic kidney disease. Sevelamer is a phosphate binder that works by binding to dietary phosphate in the gut, preventing its absorption into the bloodstream. By reducing serum phosphate levels, sevelamer helps manage complications associated with hyperphosphatemia in chronic kidney disease patients, such as mineral and bone disorders. Other medications like epoetin alfa are used to treat anemia commonly seen in chronic kidney disease patients, while cinacalcet is used to manage secondary hyperparathyroidism. Allopurinol, on the other hand, is used to treat gout by reducing uric acid levels and is not indicated for reducing serum phosphate levels in chronic kidney disease patients.

Correct Answer: C

Rationale: Sevelamer is a medication commonly prescribed to reduce serum phosphate levels in patients with chronic kidney disease. Sevelamer is a phosphate binder that works by binding to dietary phosphate in the gut, preventing its absorption into the bloodstream. By reducing serum phosphate levels, sevelamer helps manage complications associated with hyperphosphatemia in chronic kidney disease patients, such as mineral and bone disorders. Other medications like epoetin alfa are used to treat anemia commonly seen in chronic kidney disease patients, while cinacalcet is used to manage secondary hyperparathyroidism. Allopurinol, on the other hand, is used to treat gout by reducing uric acid levels and is not indicated for reducing serum phosphate levels in chronic kidney disease patients.

Correct Answer: B

Rationale: For a displaced femoral neck fracture, the most appropriate surgical procedure is usually an open reduction and internal fixation (ORIF). This procedure involves making an incision to reposition the fractured bone fragments and securing them in place with screws or other fixation devices. ORIF allows for better alignment of the fracture, which is crucial for proper healing and minimizing the risk of complications like avascular necrosis or nonunion. Closed reduction and internal fixation (CRIF) may not be as effective for displaced femoral neck fractures due to the complex nature of the fracture and the need for precise realignment and stability provided by an open surgical approach. External fixation is less commonly used for femoral neck fractures and is typically reserved for certain specific cases where internal fixation is not feasible. Closed reduction alone is unlikely to provide adequate stability for a displaced femoral neck fracture and is generally not recommended as the primary surgical treatment for this type of injury.

Correct Answer: A

Rationale: The given patient's symptoms of chest pain that occurs during heavy lifting or physical exertion and is relieved by rest are consistent with stable angina. Stable angina is characterized by predictable chest pain that occurs with exertion and is typically relieved by rest or nitroglycerin. The transient ST-segment depression on ECG is also a common finding in patients with stable angina, which reflects myocardial ischemia during episodes of chest pain triggered by exertion. In contrast, unstable angina is characterized by chest pain at rest or with minimal exertion that is of increasing frequency, severity, or duration. Acute myocardial infarction is associated with persistent ST-segment elevation or new Q-waves on ECG, and Prinzmetal's angina is characterized by chest pain at rest due to coronary artery spasm rather than exertion.

Correct Answer: B

Rationale: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an X-linked recessive disorder that leads to hemolytic anemia in response to oxidative stress. The patient's presentation of fatigue, weakness, and jaundice along with laboratory findings of hemolytic anemia (evidenced by schistocytes), elevated LDH, and decreased haptoglobin are all characteristic of G6PD deficiency. The oxidative stress causes red blood cell destruction, resulting in the release of LDH and bilirubin, leading to jaundice. Decreased haptoglobin is seen due to its consumption in binding free hemoglobin released from the lysed red blood cells. Additionally, the presence of schistocytes on a peripheral blood smear is indicative of red blood cell fragmentation, a common finding in hemolytic anemias including G6PD deficiency