Adult Health Nursing Answer Key

Correct Answer: A

Rationale: The statement "I will have to avoid drinking nonalcoholic beer" indicates a potential misunderstanding as nonalcoholic beer is generally permitted on most diets. The client may need further teaching to clarify this misconception. The other statements indicate a good understanding of the dietary guidelines and do not raise concerns about misunderstanding.

Correct Answer: B

Rationale: The patient can tell all information to the nurse once the feeling of security is established in the nurse-patient relationship. Open communication and sharing of information are essential components of nursing care. Patients are more likely to disclose personal information, concerns, and feelings when they trust their nurse and feel secure in the relationship. Building trust and creating a safe and supportive environment are crucial for effective therapeutic communication and holistic patient care. It is important for the nurse to establish a trusting relationship with the patient to encourage open communication and provide patient-centered care.

Correct Answer: A

Rationale: The clinical findings of inspiratory crackles (also known as rales) and dullness to percussion are most consistent with a diagnosis of pneumonia. Inspiratory crackles are abnormal lung sounds heard on auscultation and are typically due to the presence of fluid or mucus in the alveoli. Dullness to percussion can indicate consolidation of lung tissue, which is a common finding in pneumonia where the alveolar spaces are filled with inflammatory exudate. These findings suggest localized lung pathology and are commonly observed in patients with pneumonia. Hemoptysis and pleuritic chest pain (Choice B) are more suggestive of pulmonary embolism or pleurisy. Clubbing of the fingers and cyanosis (Choice C) are signs of chronic hypoxemia and are not specific to pneumonia. Decreased breath sounds and tracheal deviation (Choice D) are more indicative of conditions such as a pneumoth

Correct Answer: D

Rationale: The main goal of ethical practice in the nursing profession, including in the community setting, is centered on the welfare of clients and protecting their rights. Nurses have a professional and ethical obligation to prioritize the well-being and best interests of their patients. This includes providing high-quality care, advocating for their patients, supporting their autonomy, and upholding their rights. Ethical nursing practice is not focused on protecting the nurse or co-workers, preventing reprimand from physicians, or solely meeting the satisfaction of patients' families. Ensuring the welfare and rights of clients is the fundamental ethical principle that guides nursing practice.

Correct Answer: B

Rationale: The most likely diagnosis in this scenario is epididymitis. Epididymitis is an inflammation of the epididymis, a coiled tube at the back of the testicle that stores and carries sperm. Common symptoms include scrotal pain, swelling, erythema (redness), and a tender, fluctuant mass in the scrotum due to an abscess. Risk factors for epididymitis include urinary tract infections, sexually transmitted infections (such as gonorrhea or chlamydia), and recent urological procedures. It is important to differentiate epididymitis from testicular torsion, which would present with sudden, severe testicular pain, absent cremasteric reflex, and a high-riding testicle. Testicular cancer typically presents as a painless mass or swelling in the scrotum, and hydrocele presents as painless scrotal swelling due to a collection of fluid