Adult Health Nursing Quizlet Final

Correct Answer: B

Rationale: Guillain-Barré Syndrome (GBS) is characterized by ascending motor weakness, starting typically in the lower extremities and progressing upwards. Patients with GBS often verbalize the early onset of symptoms as weakness starting in the legs and potentially spreading to involve the arms and sometimes the face. Therefore, the common verbalization of the patient with GBS regarding the early onset of symptoms is ascending motor weakness. Acute hemiplegia (choice A) and acute hemiparesis (choice D) involve weakness or paralysis typically limited to one side of the body, which is not a characteristic presentation of GBS. Weakness of the four lower extremities (choice C) is also not a typical description in GBS as the weakness usually starts distally and progresses proximally.

Correct Answer: C

Rationale: The most appropriate intervention for a patient with end-stage dementia experiencing agitation and restlessness is to create a calm and soothing environment to promote relaxation. Patients with dementia often respond positively to a familiar and tranquil setting, which can help reduce their symptoms of agitation and restlessness. This approach is preferred over administering antipsychotic medications or recommending physical exercise, as these may not be feasible or beneficial for patients in the advanced stages of dementia. Referring the patient to a psychiatrist may not address the immediate need for symptom management and can be considered if other interventions are ineffective. Creating a calm environment, such as dim lighting, soft music, and familiar objects, can help provide comfort and reduce distress for the patient.

Correct Answer: B

Rationale: Total care nursing is a nursing care delivery model where one nurse is assigned to provide comprehensive care to a patient for an entire shift. In this case, the private duty nurse is providing holistic care to the post-caesarian patient during the shift, which aligns with the principles of total care nursing. This approach allows the nurse to focus on the individual needs of the patient and provide all aspects of care, promoting continuity and personalized attention. Total care nursing ensures that the patient receives consistent and dedicated care from the same nurse, enhancing the patient's overall experience and outcomes.

Correct Answer: C

Rationale: In a pregnant patient with suspected pulmonary embolism (PE), the most appropriate imaging modality for evaluation is contrast-enhanced computed tomography (CT) pulmonary angiography. This imaging technique has been shown to be safe for the fetus when necessary, especially if the benefits of making a diagnosis outweigh the minimal risks associated with radiation exposure. It provides quick and accurate detection of PE with high sensitivity and specificity.

Correct Answer: C

Rationale: Acute appendicitis is the most likely cause of the symptoms described in the pregnant woman. The classic presentation of acute appendicitis includes fever, chills, abdominal pain localized to the right lower quadrant, rebound tenderness, and guarding. Pregnant women are at a slightly higher risk of developing appendicitis due to anatomic changes and increased abdominal pressure during pregnancy, which can lead to an atypical presentation of symptoms. Prompt diagnosis and surgical intervention are crucial to prevent complications such as perforation, which can be detrimental for both the mother and the fetus.