Ch. 28 Infectious Resp Problems

A, B, C, E

Which factors or conditions will the nurse identify as increasing the risk for clients to develop aspiration pneumonia? (Select all that apply.) A. Continuous nasogastric (NG) tube feedings B. Bronchoscopy procedure C. Decreased level of consciousness D. Magnetic resonance imaging (MRI) procedure E. Stroke F. Chest tube

A

Development of which symptoms indicates to the nurse that a 48-year-old client with seasonal influenza may actually have COVID-19? A. Chest tightness and SpO2 of 86% B. Productive cough and yellow-colored sputum C. Anorexia and weight loss D. Intermittent fever and sweating

D

Which drug will the nurse expect to teach about to a client who has been exposed to inhalation anthrax but does not have symptoms? A. Vancomycin B. Oseltamivir C. Rifampin D. Ciprofloxacin

A

The nurse has just received report on a group of clients. Which client is the nurse's first priority? A. A 45 year old with a peritonsillar abscess who can no longer swallow. B. A 65 year old with rhinosinusitis and a fever of 102° F (38.9° C) C. A 25 year old who had endoscopic sinus surgery 8 hours ago. D. A 55 year old with tuberculosis who is standard first-line therapy.

A

Which condition indicates to the nurse that the treatment plan for a client with streptococcal pneumonia is effective? A. Client has been afebrile for 48 hours. B. Oxygen saturation ranges between 90% and 92% on room air. C. White blood cell count is 16, 000 cells/mm3 (16 × 109/L). D. Bronchial breath sounds present in lung periphery.

B

What is the most important personal infection control measure that the nurse will take when suctioning a client with COVID-19 or any other pandemic influenza? A. Performing oral care before, as well as after, suctioning the oropharynx B. Wearing a disposable particulate mask N95 respirator with face shield or goggles C. Washing hands and donning gloves prior to the procedure D. Keeping the door to the client room closed

B

What is the nurse's first priority action to prevent harm when an 82-year-old client with pneumonia has become increasingly confused with an SpO2 change from 91% 1 hour ago to 88% now, and a respiratory rate that has increased from 26 to 32 breaths/min? A. Increasing the flow rate of the IV piggy-back antibiotic B. Increasing the oxygen flow rate by 2 L and reassessing in 5 minutes C. Assisting the client to a more upright position D. Reporting the change in status to the client's primary health care provider

B

Which action to prevent harm is has the highest priority for the nurse to include when teaching a client with tuberculosis about the prescribed first-line drug therapy regimen? A. Be sure to drink at least 2 L of fluids daily. B. Take these drugs daily exactly as prescribed. C. Expect a change in urine color. D. Wear use sunscreen and wear protective clothing when you are out-of-doors.

B

Which action will the nurse take first when caring for a client with pneumonia who has ineffective airway clearance related to fatigue, chest pain, excessive secretions, and muscle weakness? A. Administer oxygen to prevent hypoxemia and atelectasis. B. Administer the prescribed bronchodilator therapy to decrease bronchospasms. C. Encourage oral fluids to greater than 3000 mL/day to ensure adequate hydration. D. Maintain semi-Fowler position to facilitate breathing and prevent further fatigue.

A

Which action will the nurse take to ensure that a client who requires drug therapy for multi-drug resistant tuberculosis and also is addicted to heroin adheres to the treatment regimen? A. Arranging for a health care worker to directly observe the client take the drugs B. Giving the client written instructions about how and when to take the drugs C. Instructing the client about the consequences of not taking the drugs D. Having the client repeat the drug names and side effects

A, B, C, E, F

Which adults will the nurse identify as having a higher risk for active tuberculosis? (Select all that apply.) A. Those who were treated previously for active tuberculosis B. Kidney transplant recipients C. Homeless adults D. Those who have received bacille Calmette-Guérin (BCG) vaccine E. Those in the local prison F. Recent immigrants to the United States

C

Which assessment finding in an older client with pneumonia will the nurse report immediately to the primary health care provider? A. Productive cough and normal temperature B. Flushed cheeks and increased respiratory rate C. Hypotension and rapid, weak pulse D. SpO2 of 86% and confusion

A

Which client will the nurse recognize as being at risk for bacterial sinusitis? A. A 45 year old with multiple dental caries and infected gums B. A 25 year old with seasonal pollen allergies C. A 65 year old who has a poor gag reflex after a stroke D. A 35 year old with a 20-pack-year smoking history who now vapes

B

Which complication of seasonal influenza will the nurse suspect in a 78-year-old client whose temperature remains elevated and now has new-onset confusion? A. Tuberculosis B. Pneumonia C. Emphysema D. Heart failure

A

Which is the priority action for the nurse to take first after applying oxygen when caring for an older client admitted with symptoms of possible seasonal influenza accompanied by vomiting and high fever? A. Starting an IV line to begin hydration therapy B. Administering IM influenza vaccination C. Asking the client when symptoms began D. Placing the client in a negative air pressure room

C

Which order or prescription will the nurse perform first for a client admitted with pneumonia who is febrile and also agitated as a result of alcohol intoxication? A. Assessing the need for an immediate dose of lorazepam B. Requesting a referral to a social worker for alcohol counseling C. Drawing blood for aerobic and anaerobic blood cultures D. Administering intravenous antibiotics

C

Which symptom will the nurse expect as typical in an 82-year-old client with pneumonia? A. High fever B. Profound bradycardia C. Acute confusion D. Coughing spasms