Adult Health Nursing Test Bank

Correct Answer: B

Rationale: Plantar fasciitis is the correct answer. It is characterized by inflammation of the plantar fascia, leading to heel pain, especially in the morning. The plantar fascia is a band of tissue that connects the heel bone to the toes. The pain is usually worse with the first steps after resting. Achilles tendinitis involves inflammation of the Achilles tendon, which connects the calf muscles to the heel bone, causing pain at the back of the heel and ankle. Morton's neuroma is a condition involving a thickening of tissue around a nerve in the ball of the foot, leading to sharp, burning pain in the toes. Stress fracture of the calcaneus refers to a small crack in the heel bone due to repetitive stress or overuse, resulting in heel pain that may worsen with activity, but not specifically with the first steps in the morning.

Correct Answer: D

Rationale: The correct answer is D because referring the patient to a pain management specialist for evaluation is essential in this scenario. The specialist can conduct a comprehensive assessment to identify the underlying causes of the intractable pain and recommend a tailored pain management plan. This approach ensures a multidisciplinary approach to address the complex nature of the patient's pain. Choice A is incorrect because simply increasing the dosage of the current opioid medication may not effectively address the underlying cause of the pain and can lead to potential side effects or opioid tolerance. Choice B is incorrect as switching to a different opioid medication without a thorough evaluation may not guarantee better pain control and can increase the risk of adverse effects or inadequate pain relief. Choice C is incorrect as administering adjuvant analgesic medications without addressing the root cause of the pain may not provide adequate pain relief and does not address the need for a specialized pain management plan.

Correct Answer: C

Rationale: The correct answer is C: Renal colic due to ureteral calculus. The sudden-onset severe colicky flank pain radiating to the groin along with tenderness over the costovertebral angle and hematuria are classic symptoms of kidney stones (ureteral calculus). The pain results from the obstruction of urine flow by the stone, leading to increased pressure and spasm in the ureter. Acute pyelonephritis (choice A) presents with fever, chills, and systemic symptoms. Renal artery embolism (choice B) typically presents with acute onset severe flank pain but is associated with risk factors like atrial fibrillation. Renal infarction (choice D) presents with sudden-onset severe flank pain but is less likely than ureteral calculus in a patient with a history of nephrolithiasis.

Correct Answer: A

Rationale: The correct answer is A: Initiate non-invasive positive pressure ventilation (NIPPV). This intervention is prioritized as it helps improve oxygenation and ventilation in COPD exacerbation without the need for invasive mechanical ventilation, reducing the risk of ventilator-associated complications. NIPPV also decreases the work of breathing and can prevent the need for intubation. Administering bronchodilator medications (B) is important in COPD exacerbation but may not address the immediate need for ventilatory support. Endotracheal intubation (C) should be reserved for cases of respiratory failure not responding to NIPPV. Chest physiotherapy (D) may be beneficial in some cases but is not the first-line intervention for managing acute COPD exacerbation.

Correct Answer: A

Rationale: Encouraging early ambulation and progressive activity as tolerated is the most appropriate nursing intervention to promote optimal recovery for a postpartum client who delivered via cesarean section. Early ambulation helps prevent complications such as blood clots, pneumonia, and constipation. It also promotes circulation and facilitates healing by reducing the risk of postoperative complications. Progressive activity helps the client regain strength, mobility, and independence, which are essential for a speedy recovery. Restoring normal movement will also help decrease discomfort and improve the client's overall well-being. In contrast, restricting movement may lead to complications and delayed recovery. Administering oral analgesics as needed is important for pain management, but promoting early ambulation is essential for optimal recovery. Heat packs should not be applied to the incision site as they can increase the risk of infection and interfere with proper wound healing.