Adult Health Nursing Test Bank

Correct Answer: A

Rationale: Precipitous labor is characterized by rapid cervical dilation and descent of the fetal presenting part, leading to a shortened labor duration of less than 3 hours. This rapid progression can increase the risk of maternal complications, such as postpartum hemorrhage. Postpartum hemorrhage is defined as excessive bleeding of more than 500 ml after vaginal delivery or more than 1000 ml after cesarean delivery. The rapid delivery in precipitous labor can result in inadequate uterine contractions after delivery, leading to poor uterine tone and potential postpartum hemorrhage due to uterine atony. Therefore, the nurse should anticipate postpartum hemorrhage as a potential maternal complication in a woman experiencing precipitous labor.

Correct Answer: D

Rationale: The correct answer is D: Bronchodilator therapy. Bronchodilators help to relax and open up the airways, which can improve airflow and reduce symptoms such as cough, sputum production, and dyspnea in patients with chronic bronchitis. This intervention can help manage the patient's symptoms and improve their quality of life by making it easier for them to breathe. A: Smoking cessation counseling is important for overall management of chronic bronchitis, but it does not directly address the patient's current symptoms. B: Oral antibiotic therapy may be indicated if there is evidence of a bacterial infection, but it is not the first-line treatment for managing chronic bronchitis symptoms. C: Home oxygen therapy may be necessary for patients with severe hypoxemia, but it is not typically the first intervention for managing symptoms of chronic bronchitis without evidence of significant oxygen desaturation.

Correct Answer: B

Rationale: The correct answer is B: Threatened abortion. Vaginal spotting and abdominal cramps are common symptoms of a threatened abortion, which occurs when there is a risk of miscarriage but the pregnancy remains viable. This diagnosis is likely after a vaginal examination to assess the cervix and presence of fetal heartbeat. A: Eclampsia is characterized by seizures in pregnancy due to high blood pressure, not typically presenting with vaginal spotting and cramps. C: Placenta previa involves the placenta covering the cervix, leading to painless vaginal bleeding, not associated with cramps. D: Abruptio placenta is premature separation of the placenta from the uterus, manifesting as painful bleeding, not typically with vaginal spotting and cramps.

Correct Answer: D

Rationale: The correct immediate action for the nurse is to notify the anesthesia provider immediately (Option D). This is crucial because a sudden change in the patient's level of consciousness during surgery could indicate a serious issue related to anesthesia administration. Notifying the anesthesia provider promptly allows for quick assessment and intervention to address the underlying cause, potentially preventing complications or even saving the patient's life. Administering a reversal agent (Option A) without proper evaluation by the anesthesia provider could be dangerous. Documenting the change in the patient's chart (Option B) is important but not the most immediate action. Checking the patient's vital signs (Option C) is also important but may not provide immediate insight into the cause of the change in consciousness.

Correct Answer: D

Rationale: The correct answer is D because confirming the insertion site and direction using imaging guidance ensures precise placement of the chest tube, minimizing the risk of complications. Imaging guidance allows the nurse to visualize the exact location of the pneumothorax and guide the tube insertion accurately. A: Positioning the patient in a semi-Fowler's position with arms elevated may be beneficial for comfort but does not directly ensure proper chest tube placement. B: Marking the insertion site with a pen may help as a reference point but does not guarantee accurate placement. C: Administering analgesia is important for the patient's comfort but does not impact the placement of the chest tube. In summary, choice D is the most critical step to ensure the chest tube is correctly placed and effectively treats the pneumothorax.