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: C

Rationale: The scenario described in the question is consistent with acute cholecystitis, which is inflammation of the gallbladder usually caused by an impacted gallstone in the cystic duct. The key clinical features of acute cholecystitis include fever, chills, right upper quadrant abdominal pain (which can be localized to the right upper quadrant), tenderness in the right upper abdomen, and a positive Murphy's sign (pain and inspiratory arrest upon palpation of the right upper quadrant). This condition is more common in pregnant women due to hormonal changes that can lead to gallstone formation and subsequent inflammation of the gallbladder. Ectopic pregnancy, pelvic inflammatory disease, and ovarian torsion typically present with different clinical features compared to those described in acute cholecystitis.

Correct Answer: A

Rationale: The correct answer is A: Malpractice. The nurse's failure to document and remove the over-the-counter medication, which led to a serious adverse drug reaction, constitutes malpractice. Malpractice refers to negligence or failure to provide the standard of care expected in a professional setting. In this case, the nurse's actions directly resulted in harm to the client, which is a clear example of malpractice. Incorrect Choices: B: Failure of duty to warn - This choice implies that the nurse had a duty to warn the client about the potential drug interaction, which may not necessarily be the case. The primary issue here is the nurse's failure to document and remove the medication, not a failure to warn. C: Assault - Assault involves intentional harm or threat of harm, which is not applicable in this scenario where the harm was due to negligence. D: Incompetence - While the nurse's actions may demonstrate incompetence, the more specific legal term for this situation would be malpractice, as it directly

Correct Answer: A

Rationale: The correct answer is A: Identify and count cases. In the initial stages of an outbreak investigation, it is crucial to identify and count cases to understand the scope and magnitude of the outbreak. By counting cases, Nurse Rona and her team can track the spread of the disease, identify common characteristics among those affected, and determine the extent of the outbreak. This step helps in guiding further investigation and control measures. Summary of other choices: B: Define and identify cases - While defining cases is important, it is not the initial step in outbreak investigation. C: Verify diagnosis - Verifying diagnosis is important but comes after identifying and counting cases. D: Prepare for field work - Field work is important in outbreak investigations, but it typically comes after the initial step of identifying and counting cases.

Correct Answer: D

Rationale: The correct answer is D: advocacy. Advocacy involves actively supporting and promoting the welfare and rights of the patient. Nurses advocate for their patients by ensuring their health, safety, and personal rights are upheld. This ethical principle goes beyond just fulfilling responsibilities or being accountable for one's actions. Responsibility (A) focuses on duties and tasks, accountability (B) is about being answerable for one's actions, and confidentiality (C) pertains to maintaining patient privacy. In this context, advocacy is the most appropriate choice as it encompasses actively working to protect and promote the best interests of the patient.