A patient with chronic kidney disease presents with fatigue, dyspnea on exertion, peripheral edema, and hypertension. Laboratory findings reveal elevated serum creatinine and urea levels, metabolic acidosis, and hyperkalemia. What is the most appropriate initial management for this patient?

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Adult Health Nursing Test Bank Questions

Question 1 of 9

A patient with chronic kidney disease presents with fatigue, dyspnea on exertion, peripheral edema, and hypertension. Laboratory findings reveal elevated serum creatinine and urea levels, metabolic acidosis, and hyperkalemia. What is the most appropriate initial management for this patient?

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.

Question 2 of 9

A Patients to take regularly Lithium after discharged. The MOST important information to impart to the patient and his family is that the patient should

Correct Answer: C

Rationale: The correct answer is C, to have a limited intake of sodium. Lithium can lead to increased sodium levels in the body, potentially causing toxicity. By limiting sodium intake, the patient can maintain a balance and prevent adverse effects. Choice A is incorrect as tyramine content is not directly related to lithium intake. Choice B is incorrect as fluid intake does not have a significant impact on lithium levels. Choice D is incorrect because an adequate intake of sodium can lead to worsening lithium toxicity.

Question 3 of 9

During a surgical procedure, the nurse notices a sudden decrease in the patient's oxygen saturation on the monitor. What immediate action should the nurse take?

Correct Answer: A

Rationale: The correct immediate action is to inform the surgeon and anesthesiologist (Choice A) because a sudden decrease in oxygen saturation during surgery is a critical situation that requires prompt attention from the entire surgical team. The surgeon and anesthesiologist need to be made aware of the situation so that they can assess the patient's condition and make any necessary adjustments to the surgical procedure or anesthesia delivery. Increasing the flow rate of oxygen (Choice B) may help temporarily but does not address the underlying cause of the oxygen desaturation. Checking the endotracheal tube placement (Choice C) is important but may not be the immediate priority in this critical situation. Assessing the patient's respiratory status (Choice D) is important but should be done after informing the surgeon and anesthesiologist to ensure coordinated and timely interventions.

Question 4 of 9

Which of the following conditions is characterized by inflammation of the plantar fascia, resulting in heel pain that is typically worse with the first steps in the morning?

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.

Question 5 of 9

Which of the following regulates the practice of the nursing profession?

Correct Answer: D

Rationale: The correct answer is D: Professional Regulatory Board of Nursing. This board is specifically tasked with regulating the practice of the nursing profession, ensuring that nurses adhere to ethical and professional standards. The Department of Health (A) focuses on public health policies, not individual professional regulation. The Professional Regulation Commission (B) oversees various professions but does not specialize in nursing. The Civil Service Commission (C) deals with civil service matters, not professional nursing regulation. Therefore, the Professional Regulatory Board of Nursing is the most appropriate choice for regulating the nursing profession.

Question 6 of 9

A nurse is teaching a patient about medication adherence. What approach by the nurse promotes patient empowerment and active participation in self-care?

Correct Answer: C

Rationale: The correct answer is C because encouraging the patient to ask questions and express concerns promotes patient empowerment and active participation in self-care. This approach fosters communication, understanding, and collaboration between the nurse and patient, leading to better medication adherence. Choice A is incorrect as it lacks patient involvement. Choice B is helpful but does not necessarily empower the patient. Choice D is directive and does not encourage active participation or empowerment.

Question 7 of 9

Sensitivity is the ability of a screening test to accurately identify what aspect of the screening?

Correct Answer: B

Rationale: The correct answer is B: Persons who have the disease. Sensitivity measures how well a test correctly identifies individuals who have the disease (true positives). It is essential in determining the test's ability to detect the presence of the disease accurately. Choices A, C, and D are incorrect because sensitivity focuses on correctly identifying individuals who have the disease, not those with symptoms, those without the disease, or those with a diagnosis of the disease.

Question 8 of 9

Norse Sophie checks the gauge of the patient ' s intravenous catheter. Which is the smallest gauge catheter that the nurse can use to administer blood?

Correct Answer: B

Rationale: The correct answer is B: 20-Gauge. The smaller the gauge number, the larger the diameter of the catheter. Blood transfusions typically require a larger catheter size to prevent hemolysis and ensure proper flow. A 20-Gauge catheter is larger than 22-Gauge, 18-Gauge, and 12-Gauge, making it suitable for administering blood. 22-Gauge is too small and can cause hemolysis, 18-Gauge is smaller than the recommended size for blood transfusions, and 12-Gauge is too large and can cause damage to the vein.

Question 9 of 9

Which of the following statements is INCORRECT of collaboration in a health care settings?

Correct Answer: D

Rationale: The correct answer is D because interprofessional collaboration and multidisciplinary collaboration are not interchangeable terms. Interprofessional collaboration involves professionals from different disciplines working together to provide comprehensive care, while multidisciplinary collaboration involves professionals from various disciplines working alongside each other but not necessarily working together in a coordinated manner. This distinction is crucial in healthcare settings to ensure effective teamwork and patient-centered care. A: Trust and respect are core values of a collaborative organization - This statement is correct because trust and respect are essential for effective collaboration in healthcare settings. B: A shared vision is essential for collaboration in any health care operations - This statement is correct as a shared vision helps align team members towards common goals. C: Successful conflict resolution can help collaborative teams overcome differences - This statement is correct as resolving conflicts constructively can strengthen team dynamics and improve collaboration.

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