Pharmacology and the Nursing Process 10th Edition Test Bank

Correct Answer: A

Rationale: The correct answer is A because signs and symptoms listed are indicative of disseminated intravascular coagulation (DIC), which is a serious condition where blood clotting and bleeding occur simultaneously. Change in level of consciousness can indicate hypoperfusion from clotting in blood vessels. Tachypnea and tachycardia can result from tissue hypoxia. Petechiae are small red or purple spots on the skin due to bleeding under the skin. Choices B, C, and D are incorrect because they do not align with the typical signs and symptoms of DIC. Choice B suggests a possible myocardial infarction or acute coronary syndrome. Choice C indicates a possible thrombotic thrombocytopenic purpura (TTP) or acute limb ischemia. Choice D suggests a mix of symptoms that do not typically present together in DIC.

Correct Answer: D

Rationale: The correct action for the nurse to take is to notify the physician stat (choice D). Firstly, the patient presents with painful bladder spasms and blood-tinged urine, indicating a potential complication post-TURP. This warrants immediate medical attention to assess for possible bladder injury or hemorrhage. Giving Demerol (choice A) or B&O suppository (choice B) may provide symptomatic relief but does not address the underlying issue. Warming the irrigation solution (choice C) is not a priority in this situation and does not address the potential serious complications. Notifying the physician immediately allows for prompt evaluation and appropriate intervention to address the patient's condition effectively.

Correct Answer: D

Rationale: The correct answer is D: Lymphocyte. Lymphocytes are a type of white blood cell that play a crucial role in adaptive immunity. They include T cells and B cells, which are responsible for recognizing and attacking specific pathogens. T cells help regulate the immune response and directly attack infected cells, while B cells produce antibodies to target pathogens. Neutrophils (A), monocytes (B), and basophils (C) are important for innate immunity, not adaptive immunity. Neutrophils are phagocytic cells that engulf and destroy pathogens, monocytes differentiate into macrophages to engulf pathogens, and basophils are involved in allergic reactions. Therefore, the correct answer is D because lymphocytes are key players in adaptive immunity.

Correct Answer: A

Rationale: The correct answer is A because it follows the correct format of a nursing diagnosis: "Problem related to Etiology." In this case, "Decreased cardiac output" is the problem, and "altered myocardial contractility" is the cause. This format helps identify the specific issue and its underlying cause, allowing for targeted interventions. Choice B is incorrect as it doesn't follow the problem-etiology format and lacks specificity. Choice C is also incorrect as it lacks a clear nursing diagnosis and specific etiology. Choice D is incorrect as it presents a symptom rather than a nursing diagnosis with an associated cause. Overall, choice A is the best option as it provides a clear, specific nursing diagnosis that guides appropriate nursing interventions.

Correct Answer: D

Rationale: The correct answer is D: Ankylosing spondylitis. This disease process is characterized by chronic progressive inflammation of the sacroiliac and costovertebral joints and adjacent soft tissue. Ankylosing spondylitis specifically affects the spine and large joints. Rheumatoid arthritis (A) is characterized by joint inflammation and primarily affects small joints. Scoliosis (B) is a condition characterized by an abnormal lateral curvature of the spine, not inflammation of the sacroiliac and costovertebral joints. Kyphosis (C) is an excessive outward curvature of the spine, not related to inflammation of the sacroiliac and costovertebral joints.