D444 Adult Health I
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Free D444 Adult Health I Questions
What is a common clinical sign associated with venous insufficiency?
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Numbness in the fingers
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Swelling in the feet and ankles
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Shortness of breath
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Chest pain
Explanation
If a patient post-prostatectomy is experiencing pain, what intervention related to bowel habits could be recommended?
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Recommend bed rest for several days.
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Encourage a high-fiber diet to prevent constipation.
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Suggest a low-fiber diet to ease digestion.
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Advise the patient to avoid all fluids.
Explanation
After a prostatectomy, constipation can increase abdominal and pelvic pressure, worsening pain and straining the surgical site. To prevent this, patients should be encouraged to consume a high-fiber diet and maintain adequate fluid intake. Fiber helps promote regular bowel movements, preventing the discomfort and potential complications associated with constipation. Stool softeners may also be prescribed to reduce straining during bowel movements.
What condition should be avoided to minimize pain following a prostatectomy?
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Dehydration
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Nausea
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Diarrhea
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Constipation
Explanation
After a prostatectomy, constipation should be avoided because straining during bowel movements increases intra-abdominal and pelvic pressure, which can cause significant pain and may disrupt the surgical site or sutures. Additionally, constipation can contribute to urinary retention, further increasing discomfort. To prevent this, patients are encouraged to maintain adequate hydration, consume a high-fiber diet, and, if necessary, use stool softeners as prescribed.
A patient in the ICU requires potassium replacement. What is the safest method to administer potassium to this patient?
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Administer potassium as an IV push to quickly correct levels.
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Infuse potassium through an IV drip over a specified period of time.
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Mix potassium with other medications for simultaneous administration.
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Use a syringe to inject potassium directly into the IV line.
Explanation
Potassium must never be given as an IV push or direct injection because it can cause fatal cardiac arrhythmias and cardiac arrest. The safest method is to dilute potassium in an appropriate IV solution and infuse it slowly through an IV drip over a controlled period. This allows for gradual correction of serum potassium levels and minimizes the risk of cardiac complications. The infusion should be administered using a pump to ensure accurate flow rates, and continuous cardiac monitoring is recommended, especially in critically ill patients.
Describe the significance of a recent strep infection in the context of acute glomerulonephritis diagnosis.
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A recent strep infection has no relevance to kidney issues.
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A recent strep infection can trigger an immune response leading to glomerulonephritis.
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A recent strep infection is a sign of chronic kidney disease.
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A recent strep infection indicates a viral cause of glomerulonephritis.
Explanation
Acute post-streptococcal glomerulonephritis (APSGN) often occurs after a recent streptococcal infection, such as strep throat or skin infection. The body’s immune response to the bacteria leads to the formation of immune complexes that deposit in the glomeruli, causing inflammation and impaired kidney function. Symptoms may include hematuria, edema, hypertension, and decreased urine output. Identifying a recent strep infection is significant for diagnosis and helps distinguish APSGN from other forms of kidney disease.
Why is it important for patients diagnosed with diabetic ketoacidosis (DKA) get an IV of normal saline right away?
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To increase metabolic acidosis.
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To decrease urine output and increase ketones.
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To establish a vein in order to prepare for other medications.
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To correct fluid and electrolyte imbalance, raise blood pressure and restore urine output.
Explanation
Patients with DKA often present with severe dehydration due to osmotic diuresis caused by hyperglycemia. Administering normal saline IV immediately helps to restore circulating blood volume, correct electrolyte imbalances, improve perfusion, raise blood pressure, and restore urine output. Fluid replacement is a critical first step in DKA management before insulin administration and electrolyte correction. It stabilizes the patient and reduces the risk of complications such as shock or renal failure. Establishing a vein is important, but the primary purpose of IV fluids is hemodynamic and metabolic stabilization.
In severe respiratory problems, what can happen to air movement, especially in conditions like severe asthma?
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Air movement is enhanced
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Air movement can be so diminished that no lung sounds are heard
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Air movement remains normal
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Air movement becomes erratic
Explanation
In conditions such as severe asthma or respiratory failure, air movement can be so diminished that no lung sounds are heard—a phenomenon known as a “silent chest.” This occurs when bronchoconstriction and airway obstruction become so severe that airflow nearly ceases, indicating life-threatening respiratory compromise. Immediate interventions such as administration of bronchodilators, oxygen therapy, and possibly mechanical ventilation may be required to restore airway patency and adequate gas exchange.
A patient on digoxin presents with an apical pulse of 55 bpm and reports feeling dizzy. What should the nurse do next?
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Hold the digoxin medication and assess the patient further.
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Administer the digoxin medication as prescribed.
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Document the pulse and continue with the medication.
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Increase the patient's fluid intake.
Explanation
Digoxin can slow the heart rate and cause bradycardia, especially if the patient is experiencing toxicity or is sensitive to the medication. An apical pulse below 60 bpm combined with symptoms such as dizziness warrants holding the medication and further assessment. The nurse should notify the physician and monitor the patient for additional signs of digoxin toxicity, including visual disturbances, nausea, or further changes in heart rhythm. Administering digoxin or simply documenting the pulse without intervention could worsen bradycardia and potentially lead to adverse cardiac events.
What is one of the key early symptoms of laryngeal cancer that lasts for more than two weeks?
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Shortness of breath
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Chest pain
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Nausea
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Hoarseness
Explanation
Describe how Kayexalate functions in the treatment of hyperkalemia.
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Kayexalate replaces potassium with sodium in the body.
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Kayexalate increases potassium absorption in the intestines.
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Kayexalate is a diuretic that eliminates potassium through urine.
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Kayexalate binds potassium in the gut, reducing its levels in the bloodstream.
Explanation
Kayexalate (sodium polystyrene sulfonate) is a potassium-binding resin used to treat hyperkalemia, a condition characterized by elevated potassium levels in the blood. It works by binding potassium ions in the gastrointestinal tract in exchange for sodium ions. This prevents potassium from being absorbed and promotes its excretion through the feces, thereby reducing serum potassium levels. While effective, it acts slowly and is typically used alongside other rapid interventions such as insulin with glucose or calcium gluconate in cases of severe hyperkalemia.
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