Adult Health Med Surg Nursing Test Banks

Correct Answer: B

Rationale: A prolapsed umbilical cord is a medical emergency during labor because it can cause compression of the umbilical cord, leading to decreased oxygen supply to the fetus. The priority nursing action in this situation is to prepare for an immediate cesarean section. This is necessary to quickly deliver the baby and relieve pressure on the cord, preventing potential fetal distress or death. Elevating the mother's hips may help reduce pressure on the cord temporarily, but it is not the definitive treatment for a prolapsed cord. Administering intravenous fluids rapidly may be necessary, but it is not the priority intervention when the fetus is at risk due to a prolapsed cord. Performing a vaginal examination to assess cervical dilation is contraindicated in the presence of a prolapsed umbilical cord as it can further compress the cord and worsen the situation.

Correct Answer: C

Rationale: Cryptosporidium parvum is a protozoan parasite that commonly causes waterborne illness characterized by watery diarrhea, abdominal cramps, and nausea. This parasite is often transmitted through contaminated water sources such as streams or lakes. Laboratory tests identifying oocysts in the stool sample are indicative of Cryptosporidium infection. Giardia lamblia can also cause similar symptoms, but the presence of oocysts points more towards Cryptosporidium in this case. Entamoeba histolytica causes amoebic dysentery with bloody diarrhea and is usually associated with fecal-oral transmission through contaminated food or water. Cyclospora cayetanensis typically causes prolonged watery diarrhea and is associated with the ingestion of contaminated food or water.

Correct Answer: C

Rationale: Sensitivity refers to the ability of an instrument to detect small or fine differences among the subjects being studied. In the context of research or measurement tools, sensitivity is crucial for identifying subtle variations in the data that may hold importance in the analysis. A sensitive instrument can accurately measure and record even the smallest changes, making it a valuable criterion when assessing the quality of a measurement tool in research studies. High sensitivity indicates that the instrument is more likely to pick up on nuances and variations in the data, providing researchers with more detailed and accurate information to work with.

Correct Answer: B

Rationale: When managing a conscious patient with a foreign object lodged in the eye, the appropriate action is to rinse the eye with sterile saline solution. This helps to flush out the foreign object and reduce the risk of further injury or infection. Attempting to remove the object with tweezers or applying pressure to the eyelid can potentially cause more harm to the eye. Placing a bandage over the affected eye is not beneficial in this situation as it does not address the presence of the foreign object. Rinsing the eye with sterile saline solution is the safest and most effective initial step to take in managing a foreign object lodged in the eye.

Correct Answer: C

Rationale: Preoperative nursing intervention that is essential for preparing a patient with a history of coronary artery disease for coronary artery bypass graft (CABG) surgery is assisting the patient with deep breathing and coughing exercises. These exercises are crucial to prevent postoperative complications such as atelectasis and pneumonia, which are common risks after surgery. Deep breathing exercises help to expand the lungs and improve ventilation, while coughing exercises help to clear secretions and prevent respiratory complications. By assisting the patient with these exercises preoperatively, the nurse can help optimize the patient's respiratory function and decrease the risk of complications during and after surgery. Administering aspirin, providing education about pain management, and obtaining informed consent are also important aspects of preoperative care, but assisting with deep breathing and coughing exercises is particularly essential for patients undergoing CABG surgery due to the increased risk of respiratory complications in this population.