Adult Health Nursing Answer Key

Correct Answer: A

Rationale: The priority nursing intervention for a postpartum client who experienced a perineal laceration and reports pain and discomfort during defecation is to recommend the use of stool softeners or laxatives. Perineal lacerations can lead to pain and discomfort during bowel movements due to the strain that passing stools may cause on the tender area. Stool softeners or laxatives can help soften the stool, making it easier and less painful for the client to have bowel movements. It is important to alleviate the discomfort and promote bowel regularity to prevent complications such as constipation, which can further exacerbate the pain and delay healing of the perineal laceration.

Correct Answer: B

Rationale: Enamel hypoplasia is a common oral manifestation of celiac disease characterized by defects in the enamel of the teeth. These defects can appear as horizontal or vertical grooves on the teeth. Enamel hypoplasia is caused by disruptions in the formation of enamel during tooth development, leading to thin enamel or localized pitting. It can affect the appearance and strength of the teeth, making them more prone to sensitivity and breakdown. In individuals with celiac disease, enamel hypoplasia may occur due to malabsorption of essential nutrients like calcium and vitamin D. Therefore, when observing oral manifestations such as enamel defects with grooves, it is important to consider the possibility of celiac disease as an underlying cause.

Correct Answer: C

Rationale: Among the given options, teratoma (dermoid cyst) is the most common type of ovarian tumor in women of reproductive age. Dermoid cysts are a type of ovarian teratoma that contains tissues derived from the ectoderm (skin), mesoderm (bone, muscle), and endoderm (mucous membranes). They are usually benign and can contain a variety of elements such as hair, teeth, bone, and sebaceous material. Serous cystadenomas and mucinous cystadenomas are more commonly seen in older women, whereas endometriomas are typically associated with endometriosis rather than being the most common ovarian tumor type in women of reproductive age.

Correct Answer: A

Rationale: The patient is most likely experiencing Type 1 diabetes mellitus based on the presentation of polyuria, polydipsia, polyphagia, hyperglycemia, and glycosuria. Type 1 diabetes is characterized by autoimmune destruction of the beta cells in the pancreas, leading to absolute insulin deficiency. This results in high blood sugar levels (hyperglycemia) and glucose spilling into the urine (glycosuria). Patients with Type 1 diabetes often present with the classic symptoms of polyuria (increased urination), polydipsia (increased thirst), and polyphagia (increased hunger) due to the body's inability to utilize glucose for energy effectively. Management of Type 1 diabetes typically involves lifelong insulin therapy to maintain blood sugar levels within a target range.

Correct Answer: D

Rationale: The given clinical presentation of chest pain that worsens with swallowing and is relieved by leaning forward along with diffuse ST-segment elevation on an ECG is highly suggestive of pericarditis. Pericarditis is the inflammation of the pericardium, the thin sac surrounding the heart. The symptoms of pericarditis can mimic those of myocardial infarction (heart attack) but can also be differentiated by certain characteristics such as the described positional chest pain, which is worsened by swallowing and relieved by leaning forward.