Adult Health Nursing Test Bank

Correct Answer: B

Rationale: The most appropriate initial management for the patient described is hemodialysis. Hemodialysis is essential for managing chronic kidney disease with severe symptoms and electrolyte imbalances like hyperkalemia and metabolic acidosis. Hemodialysis helps to remove urea and creatinine from the blood, correct electrolyte abnormalities, and improve symptoms such as fatigue, dyspnea, and peripheral edema. Initiation of ACE inhibitor therapy (Choice A) is contraindicated in severe kidney disease due to the risk of worsening renal function. Intravenous administration of calcium gluconate (Choice C) is used for acute hyperkalemia with cardiac toxicity, not for initial management. Sodium bicarbonate administration (Choice D) may help correct metabolic acidosis, but it does not address the underlying cause or the need for urgent renal replacement therapy.

Correct Answer: B

Rationale: The correct answer is B: 20-Gauge. The smaller the gauge number, the larger the diameter of the catheter. Blood transfusions typically require a larger catheter size to prevent hemolysis and ensure proper flow. A 20-Gauge catheter is larger than 22-Gauge, 18-Gauge, and 12-Gauge, making it suitable for administering blood. 22-Gauge is too small and can cause hemolysis, 18-Gauge is smaller than the recommended size for blood transfusions, and 12-Gauge is too large and can cause damage to the vein.

Correct Answer: A

Rationale: The correct answer is A: Hashimoto's thyroiditis. This autoimmune disorder results in chronic inflammation of the thyroid gland, leading to thyroid nodules and hypothyroidism. The colloid-filled spaces seen in the biopsy are characteristic of Hashimoto's. Choice B: Graves' disease is an autoimmune disorder causing hyperthyroidism, not hypothyroidism. Choice C: Diabetes mellitus is a metabolic disorder unrelated to the thyroid. Choice D: Thyroid nodules is a general term and does not explain the presence of colloid-filled spaces.

Correct Answer: C

Rationale: The correct answer is C: Renal colic due to ureteral calculus. The sudden-onset severe colicky flank pain radiating to the groin along with tenderness over the costovertebral angle and hematuria are classic symptoms of kidney stones (ureteral calculus). The pain results from the obstruction of urine flow by the stone, leading to increased pressure and spasm in the ureter. Acute pyelonephritis (choice A) presents with fever, chills, and systemic symptoms. Renal artery embolism (choice B) typically presents with acute onset severe flank pain but is associated with risk factors like atrial fibrillation. Renal infarction (choice D) presents with sudden-onset severe flank pain but is less likely than ureteral calculus in a patient with a history of nephrolithiasis.

Correct Answer: D

Rationale: The correct answer is D because informed consent should be obtained from both the participants and their parents to ensure full understanding and agreement from all parties involved. This is crucial when working with minors to protect their rights and ensure ethical standards are met. Choice A is incorrect as it excludes parental consent, which is necessary for minors. Choice B is also incorrect as it neglects the participants' direct involvement in consenting to participate. Choice C is incorrect because it only includes available relatives, which may not be legally authorized to provide consent on behalf of the participants.