Foundations and Adult Health Nursing Study Guide Answers

Correct Answer: B

Rationale: Phlebitis is the most common complication that patients may contract while on IV therapy. Phlebitis is the inflammation of the vein where the IV is inserted, which can cause redness, pain, and swelling along the vein. It can be caused by mechanical irritation, chemical irritation, or infection from the IV catheter. Prompt removal of the IV catheter and appropriate treatment are necessary to manage phlebitis and prevent further complications. While embolism, cardiac overload, and aneurysm are potential complications of IV therapy, phlebitis is more commonly seen in clinical practice.

Correct Answer: C

Rationale: When a patient is at risk of falls due to an impaired gait, a physical therapist would be the most appropriate member of the multidisciplinary team for the nurse to collaborate with. Physical therapists specialize in improving mobility, balance, and coordination through exercises, gait training, and other interventions. They can assess the patient's gait pattern, strength, and balance, and develop a personalized plan to address the impairments contributing to the fall risk. By working closely with a physical therapist, the nurse can help the patient improve their gait and reduce the risk of falls, ultimately promoting safety and independence.

Correct Answer: A

Rationale: The clinical presentation of fatigue, pallor, exertional dyspnea along with the laboratory findings of severe anemia, low serum iron, low transferrin saturation, and elevated TIBC are consistent with iron deficiency anemia. In iron deficiency anemia, there is inadequate iron available for erythropoiesis leading to microcytic hypochromic anemia. The low serum iron and transferrin saturation, along with the elevated TIBC, indicate decreased iron stores and increased iron-binding capacity as the body tries to compensate for the deficiency by increasing absorption and recycling of iron. Anemia of chronic disease typically presents with mild to moderate anemia, normal to low TIBC, and low transferrin saturation due to iron sequestration in macrophages. Sideroblastic anemia usually has elevated serum iron, high saturation, and normal to low TIBC. Thalassemia presents with microcytic hyp

Correct Answer: B

Rationale: The presentation of a painful, vesicular rash in a dermatomal distribution on the left thorax, specifically in a patient with a history of chickenpox, is most suggestive of herpes zoster, commonly known as shingles. Herpes zoster is caused by the reactivation of the varicella-zoster virus, the same virus responsible for chickenpox. After a person recovers from chickenpox, the virus remains dormant in the nerve cells and can reactivate years later to cause shingles. The rash in herpes zoster typically progresses through different stages, including red patches leading to fluid-filled blisters. The characteristic rash typically appears unilaterally and is usually preceded by pain, burning, or tingling in the affected area. Unlike herpes simplex virus infection, which can cause similar lesions but is not typically localized to a specific dermatome, herpes zoster presents as a distinct unilateral cluster of vesicles along

Correct Answer: A

Rationale: Given the sudden-onset severe scrotal pain, swelling, and erythema, along with the physical examination findings of a tender, swollen, and high-riding testicle, the most likely diagnosis is testicular torsion. Testicular torsion occurs when the spermatic cord twists, leading to compromised blood flow to the testicle, causing ischemia and severe pain. It is considered a surgical emergency that requires prompt diagnosis and intervention to salvage the affected testicle. Prompt surgical detorsion is necessary to prevent irreversible testicular damage. While epididymitis, testicular trauma, and testicular tumors can also present with scrotal pain and swelling, the presence of a high-riding testicle in this context is highly suggestive of testicular torsion.