Adult Health Med Surg Nursing Test Banks

Correct Answer: A

Rationale: It is important for the nurse to provide the PACU nurse with the patient's intraoperative vital signs and hemodynamic parameters as this information gives insight into the patient's stability during the surgical procedure. The PACU nurse needs this data to monitor the patient's postoperative recovery, assess for any potential complications, and establish appropriate care interventions. Understanding the patient's intraoperative status allows the PACU nurse to provide a seamless continuation of care from the operating room to the post-anesthesia care unit. The details of the surgical procedure and anesthesia administration are also important but are typically conveyed through the surgical and anesthesia records. The plan for postoperative pain management and analgesic medications is essential but can be discussed and adjusted based on the patient's current status in the PACU. Documentation of the surgical count and instrument inventory is crucial for ensuring patient safety but is typically managed by the operating room team and may not be the immediate

Correct Answer: C

Rationale: Uterine rupture is the most likely cause of these symptoms in a pregnant woman presenting with sudden onset of severe abdominal pain, vaginal bleeding, rigidity of the abdomen, and palpable fetal parts abdominally. Uterine rupture is a rare but serious complication of pregnancy, typically occurring during labor in women with a previous cesarean delivery or other uterine scars. The sudden onset of severe abdominal pain can be associated with vaginal bleeding due to the tearing of the uterine wall, causing fetal parts to be palpable abdominally. This is a life-threatening emergency that requires immediate medical intervention. Ectopic pregnancy, pelvic inflammatory disease, and ovarian torsion may present with abdominal pain and vaginal bleeding but would not typically present with palpable fetal parts abdominally in a pregnant woman.

Correct Answer: A

Rationale: Turning and repositioning the patient every 2 hours is the most effective nursing intervention in preventing pressure ulcers in a patient with a history of stroke and immobility. Pressure ulcers, also known as bedsores, are caused by prolonged pressure on the skin, leading to reduced blood flow and tissue damage. By regularly turning and repositioning the patient, pressure is relieved from specific areas of the body, helping to prevent the development of pressure ulcers. This intervention helps to redistribute pressure, improve blood flow, and reduce the risk of skin breakdown, thus promoting skin integrity in immobile patients.

Correct Answer: A

Rationale: The most significant contributory factor to the development of lung cancer is being a cigarette smoker. Cigarette smoking is directly linked to approximately 85% of lung cancer cases. The harmful substances in tobacco smoke, such as carcinogens, damage the cells in the lungs, leading to the development of cancer over time. Smokers are at a significantly higher risk of developing lung cancer compared to non-smokers. Therefore, being a cigarette smoker is the primary and most influential risk factor for developing lung cancer.

Correct Answer: D

Rationale: In this scenario, the mother, who is 35 years old and illiterate but with on and off seizure, is the best candidate to sign the informed consent for a surgical procedure for the child. The mother is the primary caregiver and decision-maker for the child in most cases, and her relationship to the child is most crucial in this situation. Despite her illiteracy, she can still comprehend the importance of the procedure for her child's well-being. Additionally, accommodations can be made for an illiterate person to sign the consent form by using an "X" as a signature. It is important that the person signing the consent form has a clear understanding of the risks and benefits involved, as well as the ability to make decisions in the best interest of the child.