Adult Health Nursing Test Bank

Correct Answer: C

Rationale: Step 1: Incongruent message occurs when verbal and nonverbal communication do not align. Step 2: Choice C states "When what the nurse says and does do not agree," indicating a lack of alignment. Step 3: This inconsistency can lead to confusion or mistrust in communication. Step 4: Choices A, B, and D all describe situations with alignment between words and actions, making them congruent. Summary: Choice C is correct as it exemplifies incongruent communication, while Choices A, B, and D are incorrect as they describe congruent messages.

Correct Answer: D

Rationale: The correct answer is D because an ethical dilemma arises when there is a conflict between two or more ethical principles, leading to a difficult decision-making situation for Nurse Mauve. This involves weighing the benefits and consequences of each ethical principle to determine the best course of action. Choice A is incorrect as time pressure does not define an ethical dilemma. Choice B is incorrect because ethical dilemmas involve conflicting choices, not unclear ones. Choice C is incorrect as the conflict in an ethical dilemma is not necessarily with a superior but can be internal or with other stakeholders.

Correct Answer: B

Rationale: The correct answer is B: Neglect. Failure to supervise a child adequately falls under the category of neglect, which is the failure to provide for a child's basic needs such as supervision, food, shelter, and medical care. In this scenario, the lack of proper supervision constitutes neglect as it puts the child at risk of harm or danger. Emotional abuse (A) involves harming a child's emotional well-being through actions like verbal abuse. Sexual abuse (C) involves inappropriate sexual behavior towards a child. Physical abuse (D) involves causing physical harm or injury to a child. In this case, the failure to supervise the child adequately is best categorized as neglect, making choice B the correct answer.

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: 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.