A patient with a history of chronic kidney disease is prescribed erythropoietin-stimulating agents (ESAs) for anemia management. Which parameter should the nurse monitor closely during ESA therapy?

Questions 165

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Foundations and Adult Health Nursing Test Bank Questions

Question 1 of 9

A patient with a history of chronic kidney disease is prescribed erythropoietin-stimulating agents (ESAs) for anemia management. Which parameter should the nurse monitor closely during ESA therapy?

Correct Answer: B

Rationale: When a patient with chronic kidney disease is prescribed erythropoietin-stimulating agents (ESAs) for anemia management, the parameter that should be monitored closely by the nurse is the hemoglobin levels. Hemoglobin levels indicate the patient's response to ESA therapy and are essential in assessing the effectiveness of the treatment in addressing anemia. Monitoring hemoglobin levels helps ensure that the patient's anemia is controlled within the target range to avoid both the risks of under-treatment (resulting in persistent anemia) and over-treatment (increased risk of adverse outcomes such as hypertension, stroke, or cardiovascular events).

Question 2 of 9

While positioning the patient for surgery, the nurse notices that the patient's arms are not adequately padded. What should the nurse do?

Correct Answer: C

Rationale: If the nurse notices that the patient's arms are not adequately padded while positioning for surgery, the nurse should immediately take action to prevent pressure injuries. Applying soft padding to the patient's arms will help distribute the pressure more evenly, reducing the risk of skin breakdown and potential harm to the patient during the surgical procedure. It is essential to prioritize the patient's safety and comfort in such situations. Simply proceeding with the positioning as planned could lead to complications, so addressing the inadequate padding promptly is the appropriate course of action.

Question 3 of 9

Type I IgE-mediated immediate hypersensitivity reaction is promptly managed with ____.

Correct Answer: B

Rationale: Type I IgE-mediated immediate hypersensitivity reactions, such as anaphylaxis, are promptly managed with epinephrine. Epinephrine is the first-line treatment for anaphylaxis as it helps counteract the severe symptoms by relaxing the muscles in the airways, constricting blood vessels, and decreasing swelling. It acts quickly to reverse the potentially life-threatening effects of the allergic reaction and is crucial in managing anaphylaxis effectively. Other medications like antihistamines (e.g., diphenhydramine) and corticosteroids may be used as adjuncts, but epinephrine remains the primary treatment for immediate hypersensitivity reactions.

Question 4 of 9

The FIRST PRIORITY nursing intervention during the immediate postpartum period is focused on

Correct Answer: C

Rationale: Postpartum hemorrhage is a serious complication that can occur within the first 24 hours after childbirth. It is the leading cause of maternal mortality worldwide. Therefore, during the immediate postpartum period, the first priority nursing intervention should be focused on observing for signs and symptoms of postpartum hemorrhage, such as excessive bleeding, abnormal vital signs, and changes in uterine tone. Early detection and prompt intervention can prevent severe complications and save the mother's life. Monitoring urinary output, taking vital signs, and checking level of responsiveness are important aspects of postpartum care but observing for postpartum hemorrhage takes precedence due to its critical nature.

Question 5 of 9

A patient presents with gradual, painless visual field loss in both eyes, particularly in the peripheral vision. Tonometry reveals elevated intraocular pressure (IOP). Which of the following conditions is most likely responsible for this presentation?

Correct Answer: A

Rationale: The patient presents with gradual, painless visual field loss in both eyes, particularly in the peripheral vision, which is characteristic of glaucoma. The elevated intraocular pressure (IOP) on tonometry further supports a diagnosis of glaucoma. Open-angle glaucoma is the most common type of glaucoma and typically presents insidiously with a slow progression of vision loss. In open-angle glaucoma, the drainage angle of the eye remains open but becomes less efficient over time, leading to increased intraocular pressure and optic nerve damage. This results in peripheral visual field loss. Closed-angle glaucoma, on the other hand, presents more acutely with sudden eye pain, redness, and blurred vision due to a sudden increase in intraocular pressure from a blocked drainage angle. Age-related macular degeneration and diabetic retinopathy typically do not present with elevated IOP or peripheral visual field loss.

Question 6 of 9

Which assessment by the nurse would cause a concern for Meperidine Overdosed?

Correct Answer: C

Rationale: Meperidine (Demerol) is an opioid analgesic. Overdose of Meperidine can lead to respiratory depression, characterized by slow and shallow breathing. As a result of respiratory depression, hypercapnia, which is an increased level of carbon dioxide in the blood, can occur. This is a serious concern and requires immediate medical intervention to support respiratory function. Therefore, hypercapnia would be the assessment by the nurse that causes a concern for Meperidine overdose.

Question 7 of 9

Charting are important documents that are used in court proceedings a Nurse Chona should take note that the following entry recorded would be MOST defensible in court?

Correct Answer: A

Rationale: Of the options provided, documenting objective, observable findings such as large bruises on the thigh upon assessment is the most defensible entry in court. This type of entry is based on the nurse's direct observation and assessment of the patient's physical condition, which can be corroborated by other healthcare providers or evidence. It provides clear, factual information without making assumptions or subjective judgments. In court, this type of documentation can help support the nurse's credibility and reliability as a witness.

Question 8 of 9

Despite the reaction of the patient, which of the ethical principle that the nurse is responsible of providing all patients with caring attention and information?

Correct Answer: D

Rationale: Advocacy is the ethical principle that the nurse is responsible for providing all patients with caring attention and information, despite the reaction of the patient. Advocacy involves supporting and speaking up for the patient's best interests, ensuring they receive the care and information they need to make informed decisions about their health and well-being. Providing caring attention and information is essential in advocating for the patient's autonomy and well-being, even if the patient may not initially appreciate or react positively to these efforts.

Question 9 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.

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