Adult Health Nursing Test Bank

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: C

Rationale: The correct answer is C: Malpractice. Malpractice refers to professional negligence or failure to perform duties according to accepted standards of practice. In this scenario, the surgeon's act of cutting the patient's bladder during an appendectomy could be considered a breach of duty and failure to provide the expected standard of care, which falls under malpractice. Battery (A) involves intentional harmful or offensive contact without consent. Negligence (B) is the failure to exercise reasonable care, but in this case, it was more than just a lack of care. Tort (D) refers to a civil wrong that causes harm, but malpractice is a specific type of tort related to professional negligence.

Correct Answer: A

Rationale: The correct answer is A because obtaining the client's own consent is the first step in ensuring the client's autonomy and right to make decisions about their own care. This is in line with ethical principles of informed consent. Choices B, C, and D are incorrect because consent should come directly from the client, not from a spouse, family member, or social worker. Choice B violates the principle of individual autonomy, choice C is not the priority before admission, and choice D is not the appropriate person to provide consent.

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: B

Rationale: The correct answer is B: Psoriasis. Psoriasis is characterized by pruritic, erythematous patches with silvery scales, commonly found on the elbows, knees, and scalp. This presentation matches the patient's symptoms. Eczema (choice A) typically presents with red, inflamed, and itchy skin patches. Pityriasis rosea (choice C) manifests as a herald patch followed by smaller scaly patches in a "Christmas tree" distribution. Seborrheic dermatitis (choice D) involves oily, yellowish, scaly patches mainly on the scalp, face, and ears, and does not typically present with silvery scales.