Adult Health Nursing Test Bank

Correct Answer: B

Rationale: The correct answer is B: How the nurse will behave. Standards of nursing care refer to the expected behaviors and practices that nurses should adhere to in providing quality care to patients. This encompasses ethical principles, professional conduct, and best practices in nursing. It is essential for nurses to follow these standards to ensure patient safety and quality outcomes. Explanation: - A: What protects the nurse. This choice is incorrect because standards of nursing care primarily focus on patient care and outcomes, rather than protecting the nurse. - C: How much work is done. This choice is incorrect as it does not directly relate to the behaviors and practices expected of nurses in providing quality care. - D: Ask the local officials. This choice is unrelated to the concept of standards of nursing care and is not relevant to the question.

Correct Answer: A

Rationale: The correct answer is A because obtaining the client's own consent is the first step in ensuring the client's autonomy and right to make decisions about their own care. This is in line with ethical principles of informed consent. Choices B, C, and D are incorrect because consent should come directly from the client, not from a spouse, family member, or social worker. Choice B violates the principle of individual autonomy, choice C is not the priority before admission, and choice D is not the appropriate person to provide consent.

Correct Answer: C

Rationale: In a postpartum client complaining of persistent, heavy vaginal bleeding, the most appropriate nursing action is to assess vital signs and uterine tone. This is important to determine if the bleeding is within normal limits or if there is a potential postpartum hemorrhage (PPH) occurring. Monitoring vital signs can help identify signs of shock, while assessing uterine tone can help determine if the uterus is contracting effectively to control bleeding. Prompt assessment and early detection of PPH are crucial for effective management and prevention of complications. Encouraging increased fluid intake, applying a cold compress, and administering pain medication may be appropriate interventions in some situations, but assessing vital signs and uterine tone take priority in this scenario.

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: C

Rationale: The correct answer is C: Food and water. Typhoid fever is primarily transmitted through contaminated food and water by the bacterium Salmonella typhi. The bacteria are shed in the feces of infected individuals and can contaminate water sources or food prepared with contaminated water. This transmission route aligns with the typical epidemiology of typhoid fever outbreaks. Now, let's discuss why the other choices are incorrect: A: A vector - Typhoid fever is not transmitted by a vector such as mosquitoes or ticks. B: Blood and body fluids - Typhoid fever is not typically spread through blood or body fluids but rather through ingestion of contaminated food or water. D: Air - Typhoid fever is not an airborne disease and is not transmitted through the air.