Adult Health Nursing Test Bank

Correct Answer: A

Rationale: The correct answer is A: Enhances the delivery of quality nursing care. Supervision and delegation are essential in ensuring efficient and effective healthcare delivery. By supervising and delegating tasks appropriately, the head nurse can ensure that staff members are performing their duties competently, which ultimately leads to improved quality of patient care. Supervision helps in monitoring staff performance, providing feedback, and offering guidance when needed. Delegation ensures that tasks are allocated to the right staff members based on their skills and abilities, optimizing the workflow. Choices B, C, and D are incorrect because they do not directly relate to the primary purpose of supervision and delegation, which is to enhance the quality of nursing care through effective oversight and task allocation.

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: In this scenario, the pregnant woman is presenting with severe abdominal pain, passage of tissue, and cervical dilation with products of conception protruding through the cervical os at 12 weeks gestation. These are classic signs and symptoms of an incomplete abortion. Incomplete abortion occurs when not all of the products of conception are expelled from the uterus. It can present with vaginal bleeding, abdominal pain, cervical dilation, and passage of tissue. The management of incomplete abortion may involve expectant, medical, or surgical options depending on the clinical context and the patient's condition.

Correct Answer: B

Rationale: The correct answer is B: Threatened abortion. Vaginal spotting and abdominal cramps are common symptoms of a threatened abortion, which occurs when there is a risk of miscarriage but the pregnancy remains viable. This diagnosis is likely after a vaginal examination to assess the cervix and presence of fetal heartbeat. A: Eclampsia is characterized by seizures in pregnancy due to high blood pressure, not typically presenting with vaginal spotting and cramps. C: Placenta previa involves the placenta covering the cervix, leading to painless vaginal bleeding, not associated with cramps. D: Abruptio placenta is premature separation of the placenta from the uterus, manifesting as painful bleeding, not typically with vaginal spotting and cramps.

Correct Answer: D

Rationale: The correct answer is D: Diabetic retinopathy. This condition is a common complication of diabetes that occurs due to the thickening of capillaries and arterioles in the eye, leading to damage to the retina. This can result in vision problems and even blindness if left untreated. A: Papilledema is the swelling of the optic disc due to increased intracranial pressure, not related to diabetes. B: Glaucoma is a condition characterized by increased pressure within the eye, not directly caused by diabetes. C: Retinal detachment is the separation of the retina from the underlying tissues, which is not primarily caused by diabetes-related capillary changes.