A patient is brought to the emergency department experiencing a possible stroke. What initial diagnostic test for a stroke , usually performed in the emergency department would the nurse prepare the patient for?

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Foundations and Adult Health Nursing Test Bank Questions

Question 1 of 9

A patient is brought to the emergency department experiencing a possible stroke. What initial diagnostic test for a stroke , usually performed in the emergency department would the nurse prepare the patient for?

Correct Answer: C

Rationale: In the emergency department setting, the initial diagnostic test typically performed for a patient suspected of having a stroke is a noncontrast computed tomography (CT) scan of the head. This imaging study is crucial in evaluating and diagnosing stroke because it can quickly identify whether the person is having a hemorrhagic stroke (bleeding in the brain) or an ischemic stroke (blood clot blocking a blood vessel). The results of the CT scan help guide immediate treatment decisions, such as administering clot-busting medications for ischemic strokes or preparing for surgical interventions for hemorrhagic strokes. Carotid ultrasound studies and transcranial Doppler flow studies may be performed after the initial CT scan to further assess the extent of damage and the underlying cause of the stroke. The 12-lead electrocardiogram is useful in assessing the heart's electrical activity but is not the primary test for diagnosing stroke.

Question 2 of 9

A patient presents with chest pain that occurs at rest and is exacerbated by deep breathing or changes in body position. The pain improves with leaning forward. Which cardiovascular disorder is most likely responsible for these symptoms?

Correct Answer: C

Rationale: Pericarditis is the inflammation of the pericardium, the sac surrounding the heart. Patients with pericarditis typically present with sharp chest pain that worsens with deep breathing, changes in body position, and coughing. The pain tends to improve when the patient leans forward. This characteristic symptom of pericarditis is known as "pleuritic" chest pain. In contrast, stable angina presents as predictable chest pain that occurs with exertion and is relieved by rest or medications. Unstable angina is characterized by chest pain that occurs at rest or with minimal exertion and is considered a medical emergency. Myocarditis involves inflammation of the heart muscle and may present with symptoms such as chest pain, but it does not typically have the characteristic of worsening with deep breathing or changes in body position.

Question 3 of 9

Since nadine is Four years old, Nurse Alma needs to determine the routines and rituals concerning, which of the following, EXCEPT ______.

Correct Answer: D

Rationale: Since Nadine is just four years old, determining her favorite toys is not a critical aspect for Nurse Alma to consider in terms of routines and rituals. While knowing Nadine's favorite toys may help provide comfort or distraction, it is not as essential as ensuring proper feeding, sleep patterns, and toilet training for a young child's well-being and development. The focus should primarily be on aspects that directly impact her physical health, growth, and daily routines at this age.

Question 4 of 9

Choose from the following the primary goals of TPN? I. promote weight gain II. improve nutritional status III. maintain muscle mass IV. establish nitrogen balance! V. enhance healing process

Correct Answer: C

Rationale: Total Parenteral Nutrition (TPN) is a method of providing nutrition to patients who cannot or should not obtain their nutrition through regular oral intake. The primary goals of TPN include promoting weight gain, improving nutritional status, maintaining muscle mass, and establishing nitrogen balance. These goals are crucial to support the overall health and well-being of the patient receiving TPN. Enhancing the healing process is an important aspect of TPN as well, but it is not considered one of the primary goals as weight gain, nutritional status, muscle mass, and nitrogen balance are typically the immediate priorities when administering TPN.

Question 5 of 9

Falls are one of the leader environmental hazards reported in health facilities. One of the MOST common occurrences that precipitate a patient fall is

Correct Answer: B

Rationale: Leaving the side rails down is one of the most common occurrences that can lead to a patient fall. Side rails are important safety measures designed to prevent patients from falling out of bed. When the side rails are left down, the patient is at a higher risk of accidentally rolling out of bed and falling. It is crucial for healthcare providers to always ensure that the side rails are up and secure to help prevent patient falls.

Question 6 of 9

A 22-year-old woman presents with cyclic pelvic pain, dysmenorrhea, and infertility. On pelvic examination, the uterus is retroverted and enlarged. Which of the following conditions is most likely to be responsible for these findings?

Correct Answer: B

Rationale: Adenomyosis is a condition characterized by the presence of endometrial tissue within the myometrium (muscle wall) of the uterus. It can present with symptoms such as cyclic pelvic pain, dysmenorrhea (painful periods), and infertility. On pelvic examination, the uterus may be retroverted (tilted backward) and enlarged due to the presence of adenomyotic nodules within the uterine muscle. Adenomyosis can also cause heavy menstrual bleeding (menorrhagia). Endometriosis, on the other hand, involves the presence of endometrial tissue outside the uterus and can cause similar symptoms but is less likely to result in uterine enlargement or retroversion. Leiomyomas (uterine fibroids) are benign tumors of the uterine muscle and can also cause pelvic pain and abnormal uterine enlargement but are less likely to be associated with dysmenorrhea and infertility

Question 7 of 9

Delegation is a critical component of leadership and governance. Which of the following empowering activities should the unit manager applies in delegation?

Correct Answer: A

Rationale: In delegation, facilitating the professional growth and development of a staff is necessary because it allows team members to gain new skills and experience, leading to overall improved productivity and job satisfaction. This empowers staff and helps them feel more engaged in their work, ultimately benefiting the entire unit. Effective delegation should aim to support individuals in their roles, encourage learning, and build competence, rather than modifying standards of care or only delegating tasks without considering individual growth. Starting delegation from top management to staff-nurse level may not always be practical or efficient, as delegation should be based on competencies and responsibilities. Accountability is indeed a crucial aspect of delegation, as individuals should be held responsible for the tasks they are delegated. However, without providing opportunities for professional growth and development, delegation may not be as effective in achieving organizational goals.

Question 8 of 9

Mr. Steve is brought to the medical ward. the next day, he wants to know about his illness. The nurse on duty replied,'You don't need to know your diagnosis'. Which of the following rights of the patient is violated? Right to_____.

Correct Answer: A

Rationale: The right being violated in this scenario is the right to obtain from his physician complete current information concerning his diagnosis, treatment, and prognosis. Patients have the right to be fully informed about their health status and to understand the details of their condition, treatment options, and likely outcomes. Withholding this information can prevent the patient from participating in their own care decisions and can violate their autonomy and right to make informed choices about their health.

Question 9 of 9

The patient with diagnosis of schizophrenia who has been taking Clozapine will inform the patients family that the positive effect of this drug is

Correct Answer: B

Rationale: Clozapine is an atypical antipsychotic medication primarily used in the treatment of schizophrenia. One of the positive effects of Clozapine is the reduction of psychotic symptoms experienced by the patient, such as hallucinations (not hearing loss). Clozapine is effective in managing both positive symptoms (hallucinations, delusions, disorganized thinking) and negative symptoms (apathy, social withdrawal, lack of motivation) of schizophrenia. It is known for its efficacy in reducing hallucinations and other psychotic symptoms, helping the patient to lead a more stable and functional life.

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