Chapter 31 (Care of infectious resp. problems)

A client is in the family medicine clinic reporting a dry, sore throat. The provider asks the nurse to assess for odynophagia. What assessment technique is most appropriate? a.Ask the client what foods cause trouble swallowing. b.Assess the client for pain when swallowing. c.Determine if the client can swallow saliva. d.Palpate the clients jaw while swallowing.

B

A client is in the family practice clinic reporting a severe cough that has lasted for 5 weeks. The client is so exhausted after coughing that work has become impossible. What action by the nurse is most appropriate? a.Arrange for immediate hospitalization. b.Facilitate polymerase chain reaction testing. c.Have the client produce a sputum sample. d.Obtain two sets of blood cultures.

B

A nurse in a family practice clinic is preparing discharge instructions for a client reporting facial pain that is worse when bending over, tenderness across the cheeks, and postnasal discharge. What instruction will be most helpful? a.Ice packs may help with the facial pain. b.Limit fluids to dry out your sinuses. c.Try warm, moist heat packs on your face. d.We will schedule you for a computed tomography scan this week.

C

A nurse is caring for several older clients in the hospital that the nurse identifies as being at high risk for healthcare-associated pneumonia. To reduce this risk, what activity should the nurse delegate to the unlicensed assistive personnel (UAP)? a.Encourage between-meal snacks. b.Monitor temperature every 4 hours. c.Provide oral care every 4 hours. d.Report any new onset of cough.

C

A nurse working in a geriatric clinic sees clients with cold symptoms and rhinitis. Which drug would be appropriate to teach these clients to take for their symptoms? a.Chlorpheniramine (Chlor-Trimeton) b.Diphenhydramine (Benadryl) c.Fexofenadine (Allegra) d.Hydroxyzine (Vistaril)

C

A client admitted for pneumonia has been tachypneic for several days. When the nurse starts an IV to give fluids, the client questions this action, saying I have been drinking tons of water. How am I dehydrated? What response by the nurse is best? a.Breathing so quickly can be dehydrating. b.Everyone with pneumonia is dehydrated. c.This is really just to administer your antibiotics. d.Why do you think you are so dehydrated?

A

The emergency department (ED) manager is reviewing client charts to determine how well the staff performs when treating clients with community-acquired pneumonia. What outcome demonstrates that goals for this client type have been met? a.Antibiotics started before admission b.Blood cultures obtained within 20 minutes c.Chest x-ray obtained within 30 minutes d.Pulse oximetry obtained on all clients

A

A hospital nurse is participating in a drill during which many clients with inhalation anthrax are being admitted. What drugs should the nurse anticipate administering? (Select all that apply.) a.Amoxicillin (Amoxil) b.Ciprofloxacin (Cipro) c.Doxycycline (Vibramycin) d.Ethambutol (Myambutol) e.Sulfamethoxazole-trimethoprim (SMX-TMP) (Septra)

A,B,C

A client has been diagnosed with an empyema. What interventions should the nurse anticipate providing to this client? (Select all that apply.) a.Assisting with chest tube insertion b.Facilitating pleural fluid sampling c.Performing frequent respiratory assessment d.Providing antipyretics as needed e.Suctioning deeply every 4 hours

A,B,C,D

A nurse is providing pneumonia vaccinations in a community setting. Due to limited finances, the event organizers must limit giving the vaccination to priority groups. What clients would be considered a priority when administering the pneumonia vaccination? (Select all that apply.) a.22-year-old client with asthma b.Client who had a cholecystectomy last year c.Client with well-controlled diabetes d.Healthy 72-year-old client e.Client who is taking medication for hypertension

A,C,D,E

A client seen in the emergency department reports fever, fatigue, and dry cough but no other upper respiratory symptoms. A chest x-ray reveals mediastinal widening. What action by the nurse is best? a.Collect a sputum sample for culture by deep suctioning. b.Inform the client that antibiotics will be needed for 60 days. c.Place the client on Airborne Precautions immediately. d.Tell the client that directly observed therapy is needed.

B

An older adult is brought to the emergency department by a family member, who reports a moderate change in mental status and mild cough. The client is afebrile. The health care provider orders a chest x-ray. The family member questions why this is needed since the manifestations seem so vague. What response by the nurse is best? a.Chest x-rays are always ordered when we suspect pneumonia. b.Older people often have vague symptoms, so an x-ray is essential. c.The x-ray can be done and read before laboratory work is reported. d.We are testing for any possible source of infection in the client.

B

The charge nurse on a medical unit is preparing to admit several clients who have possible pandemic flu during a preparedness drill. What action by the nurse is best? a.Admit the clients on Contact Precautions. b.Cohort the clients in the same area of the unit. c.Do not allow pregnant caregivers to care for these clients. d.Place the clients on enhanced Droplet Precautions.

B

Which teaching point is most important for the client with bacterial pharyngitis? a.Gargle with warm salt water. b.Take all antibiotics as directed. c.Use a humidifier in the bedroom. d.Wash hands frequently.

B

A client is admitted with suspected pneumonia from the emergency department. The client went to the primary care provider a few days ago and shows the nurse the results of what the client calls an allergy test, as shown below: What action by the nurse takes priority? a.Assess the client for possible items to which he or she is allergic. b.Call the primary care providers office to request records. c.Immediately place the client on Airborne Precautions. d.Prepare to begin administration of intravenous antibiotics.

C

A client has been admitted for suspected inhalation anthrax infection. What question by the nurse is most important? a.Are any family members also ill? b.Have you traveled recently? c.How long have you been ill? d.What is your occupation?

D

A client is in the family practice clinic reporting a severe cold that started 4 days ago. On examination, the nurse notes the client also has a severe headache and muscle aches. What action by the nurse is best? a.Educate the client on oseltamivir (Tamiflu). b.Facilitate admission to the hospital. c.Instruct the client to have a flu vaccine. d.Teach the client to sneeze in the upper sleeve.

D