Ella states'I will hang my self' this is a manifestation of:

Questions 164

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Adult Health Nursing Quizlet Final Questions

Question 1 of 9

Ella states'I will hang my self' this is a manifestation of:

Correct Answer: B

Rationale: Ella's statement "I will hang myself" directly indicates a desire and intent to commit suicide. This is classified as a suicidal intent, which is a serious concern that requires immediate attention and intervention. It is crucial to take any mention or indication of suicide seriously and seek help from mental health professionals or crisis intervention services.

Question 2 of 9

When there is respiratory depression resulting from drug overdose, the nurse have to watch for which of the following?

Correct Answer: D

Rationale: Respiratory depression resulting from drug overdose typically leads to a decrease in the respiratory rate, known as bradypnea. This is characterized by abnormally slow breathing, which can be dangerous as it may lead to decreased oxygen levels in the blood. Bradypnea indicates a slowing down of the respiratory drive, in contrast to hyperventilation, biot's respiration, or tachypnea. It is crucial for the nurse to monitor a patient experiencing respiratory depression for signs of bradypnea and intervene promptly to prevent further complications.

Question 3 of 9

Upon history-taking, the nurse notes that the cough of a patient with lung cancer usually STARTS off to be ___________.

Correct Answer: D

Rationale: The cough of a patient with lung cancer typically starts off as dry and persistent. This is because lung cancer can irritate the airways, leading to a persistent dry cough as an early symptom. As the cancer progresses, the cough may become more productive with blood-tinged or dark yellow sputum. However, in the early stages, the cough is often dry and persistent, which can be a warning sign for healthcare providers to further investigate potential underlying issues such as lung cancer.

Question 4 of 9

A patient with a history of chronic kidney disease presents with weakness, anorexia, and confusion. Laboratory tests reveal severe anemia, low reticulocyte count, elevated serum creatinine, and decreased erythropoietin levels. Which of the following conditions is most likely to cause these findings?

Correct Answer: D

Rationale: The clinical presentation of a patient with chronic kidney disease (CKD) presenting with weakness, anorexia, confusion, severe anemia, low reticulocyte count, elevated serum creatinine, and decreased erythropoietin levels is most consistent with renal failure-associated anemia. In CKD, the kidneys are unable to produce adequate amounts of erythropoietin, a hormone responsible for stimulating red blood cell production in the bone marrow. The decreased erythropoietin levels lead to a state of anemia, characterized by low hemoglobin levels and subsequent symptoms of fatigue and weakness. The anemia in renal failure is typically normocytic and normochromic. Additionally, the elevated serum creatinine in this patient is a hallmark of kidney dysfunction.

Question 5 of 9

A patient with a history of peptic ulcer disease is prescribed famotidine (Pepcid) for gastric acid suppression. Which instruction should the nurse include in patient education about famotidine therapy?

Correct Answer: B

Rationale: Famotidine belongs to a class of medications known as H2 blockers which work to reduce the production of stomach acid. Antacids, on the other hand, work by neutralizing stomach acid. Taking antacids in conjunction with famotidine can decrease the effectiveness of famotidine as they can interfere with its absorption. Therefore, it is important for the patient to avoid taking antacids while on famotidine therapy to ensure optimal treatment outcomes for gastric acid suppression.

Question 6 of 9

Select nurses action in keeping with principle of confidentiality

Correct Answer: C

Rationale: Maintaining patient confidentiality is a foundational principle in healthcare ethics. Nurses are obligated to keep all information about patients confidential, which means not disclosing any patient-related information to unauthorized individuals. This includes refraining from discussing patient cases with others who are not directly involved in the care of the patient. Sharing patient information without consent can be a breach of trust and privacy, which can have legal and ethical implications. Therefore, in order to uphold the principle of confidentiality, nurses must keep all matters about the patient as a secret.

Question 7 of 9

A patient presents with fever, headache, myalgia, and a skin lesion resembling a "bull's eye" rash at the site of a tick bite. Which of the following is the most likely causative agent?

Correct Answer: C

Rationale: The presentation described in the question, including the skin lesion resembling a "bull's eye" rash at the site of a tick bite, is characteristic of Lyme disease. Lyme disease is caused by the spirochete bacterium Borrelia burgdorferi, which is transmitted to humans through the bite of infected black-legged ticks (Ixodes scapularis). The symptoms of Lyme disease include fever, headache, myalgia, and the erythema migrans rash, which appears as a red circular rash with central clearing resembling a bull's eye.

Question 8 of 9

A patient is exposed to the hepatitis B virus (HBV) and develops immunity against future infections. Which type of immunity is primarily responsible for this protection?

Correct Answer: C

Rationale: Humoral immunity is primarily responsible for protecting against infections by pathogens like viruses. In the case of the hepatitis B virus (HBV), the individual is exposed to the virus and develops immunity, which is typically mediated by antibodies produced by B cells. These antibodies circulate in the blood and can neutralize the virus, preventing future infections. This type of immunity is known as humoral immunity, as it involves the production of antibodies that target specific antigens, such as those present on the surface of the hepatitis B virus. In contrast, passive immunity is when antibodies are transferred from an external source, innate immunity provides immediate, non-specific defenses against pathogens, and cell-mediated immunity involves the activation of T cells to combat intracellular pathogens.

Question 9 of 9

The nurse has failed to obtain informed consent before performing a procedure on a patient. Which type of torts result from this nursing action?

Correct Answer: B

Rationale: Malpractice is a type of tort that involves professional negligence or misconduct by a professional such as a nurse that results in harm to a patient. In this scenario, failing to obtain informed consent before performing a procedure is considered a breach of the standard of care expected from a healthcare professional, which falls under malpractice. This failure to obtain informed consent deprives the patient of the right to make an informed decision about their treatment and can lead to legal consequences for the nurse.

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