Adult Health Med Surg Nursing Test Banks

Correct Answer: C

Rationale: When planning for Jose's oxygen therapy, the nurse should consider the need for a humidifier to prevent drying of the mucous membranes, the appropriate length of tubing for mobility and safety reasons, and the manner of administering oxygen (continuous or intermittent) based on Jose's condition and oxygen requirements. However, determining Jose's age is not a relevant factor in planning for his oxygen therapy. The decision-making process should be based on his specific medical needs and condition rather than his age.

Correct Answer: A

Rationale: The clinical presentation of gross hematuria, flank pain, palpable abdominal mass, along with imaging findings of a large heterogeneous renal mass with necrosis and calcifications are highly suggestive of renal cell carcinoma (RCC). RCC is the most common type of kidney cancer in adults. The presence of necrosis and calcifications are characteristic features of RCC. Imaging modalities such as CT scans or MRI can confirm the diagnosis by showing the typical features of RCC, including a solid mass with areas of necrosis and calcifications. It is important to further evaluate this patient, likely with a biopsy, to confirm the diagnosis and determine the extent of the disease for appropriate management.

Correct Answer: A

Rationale: Menopause is the most important risk factor for osteoporosis because it leads to a decrease in estrogen levels, which plays a crucial role in maintaining bone density. After menopause, women are at a higher risk of developing osteoporosis due to loss of estrogen's protective effects on bone mass. Other risk factors like history of previous fracture, being male, and short stature can also contribute to osteoporosis, but menopause has the strongest association with the development of the condition. It is essential for postmenopausal women to be aware of this risk factor and take preventive measures such as regular exercise, adequate calcium and vitamin D intake, and appropriate medical evaluation and treatment as needed.

Correct Answer: A

Rationale: The clinical presentation of recurrent episodes of epistaxis, gum bleeding, and easy bruising, along with laboratory findings of prolonged bleeding time, normal platelet count, and normal coagulation studies (PT and aPTT) are highly suggestive of Von Willebrand disease. Von Willebrand disease is the most common inherited bleeding disorder and is characterized by a deficiency or dysfunction of von Willebrand factor (vWF), which plays a key role in platelet adhesion and aggregation. The prolonged bleeding time is due to impaired platelet adhesion to the damaged vessel wall in the absence of functional vWF. Normal platelet count and normal PT/aPTT help differentiate Von Willebrand disease from other bleeding disorders such as hemophilia and platelet function disorders like Glanzmann thrombasthenia and Bernard-Soulier syndrome.

Correct Answer: C

Rationale: Breach of duty is the element of malpractice that occurs when the nurse does not act as a reasonable, prudent person would have acted in a similar circumstance. This means that the nurse failed to uphold the standard of care expected in their practice. In a malpractice case, it must be proven that the nurse breached their duty of care towards the patient by not providing the expected level of skill and care that another reasonable nurse in the same situation would have provided.