Adult Health Nursing Test Bank

Correct Answer: C

Rationale: The correct answer is C: unfreezing. Unfreezing is the initial stage in Lewin's planned change model where individuals become open to change by recognizing the need for it. During this stage, the nurse identifies the need for change, plans strategies to implement it, and works on overcoming resistance by ensuring that the driving forces (reasons for change) outweigh the restraining forces (barriers to change). Refreezing (A) is the final stage where the changes are reinforced and integrated into the organization. Movement (B) is the stage where actual change occurs, and in activism (D) is not a recognized stage in Lewin's model.

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: A

Rationale: The correct answer is A because it includes all the major endocrine glands: pituitary, thyroid, parathyroid, adrenals, pancreatic islets, and hypothalamus. The pituitary gland is known as the "master gland" as it controls other endocrine glands. The thyroid gland regulates metabolism, while the parathyroid glands regulate calcium levels. The adrenal glands produce hormones involved in stress response. Pancreatic islets produce insulin and glucagon. The hypothalamus plays a key role in hormone regulation. Choice B is incorrect because it includes ovaries and testes, which are not endocrine glands. Choice C is incorrect because it omits the hypothalamus. Choice D is incorrect because it includes ovaries and testes which are not endocrine glands.

Correct Answer: C

Rationale: The correct answer is C: Nasal polyps. Nasal polyps are benign growths that form in the nasal cavity and sinuses, leading to symptoms such as chronic nasal congestion, hyposmia, and anosmia. The presence of polypoid masses seen on nasal endoscopy is characteristic of nasal polyps. Rationale: 1. Chronic nasal congestion, hyposmia, and anosmia are common symptoms of nasal polyps. 2. Nasal endoscopy revealing polypoid masses confirms the presence of nasal polyps. 3. Allergic rhinitis may cause nasal congestion but does not typically present with polypoid masses. 4. Chronic sinusitis can cause nasal congestion but is usually associated with inflammation of the sinuses, not just polypoid masses. 5. A deviated nasal septum can lead to nasal congestion but does not typically cause polypoid masses obstructing the nasal cavity and sinuses.

Correct Answer: A

Rationale: The correct answer is A: Hashimoto's thyroiditis. This autoimmune disorder results in chronic inflammation of the thyroid gland, leading to thyroid nodules and hypothyroidism. The colloid-filled spaces seen in the biopsy are characteristic of Hashimoto's. Choice B: Graves' disease is an autoimmune disorder causing hyperthyroidism, not hypothyroidism. Choice C: Diabetes mellitus is a metabolic disorder unrelated to the thyroid. Choice D: Thyroid nodules is a general term and does not explain the presence of colloid-filled spaces.