Final Study Guide

A client is admitted to the hospital with malaise, headache, and cough followed by fever, chills, dyspnea, chest discomfort, myalgia, vomiting, and diarrhea. The physician makes the diagnosis of legionellosis (legionnaires' disease). The client asks, "How did I get this?" Which response by the nurse is most accurate?

" The bacteria thrive in warm water environments and are inhaled from contaminated water droplets"

A young male client comes to the clinic with a bite he received in a fight. He has a bite mark on his forearm and the skin is broken. His last tetanus shot was about 8 years ago. What should the recommended treatment include?

administration of 0.5ml of tetanus toxoid I.M.

Which treatment is recommended by the CDC for bacterial vaginosis in pregnancy?

300mg clindamycin P.O. twice a day for 7 days

A 5-year old child brought clinic with several superficial sores on the front of the left leg is diagnosed with impetigo. Which of the following instructions should the nurse give the parent?

Allow the child to go back to school after 24 hours of treatment

Bacterial conjunctivitis has affected several children at a local day care center. A nurse should advise which measure to minimize the risk of infection?

perform thorough hand washing before and after touching any child in the day care center

The parents of a 9 month old Brin the infant to the clinic for a regular checkup. The infant has received no immunizations. Which of the following would be appropriate for the nurse to administer at the visit?

DTap, Hib, IPV, PPD

A 5 month-old infant is brought to the emergency department with vomiting and diarrhea, which the mother states started three days ago. Which of the following are signs of dehydration in a child who has had vomiting and diarrhea for 3 days? select all that apply

Dry mucous membranes, sunken fontanel, decreased or absent tearing

A client at 34 weeks' gestation visits the clinic complaining of flulike symptoms and bulls eye like rash. she reports that she went camping last weekend and may have gotten a tick bite. The client is diagnosed with Lyme disease. Which of the following medications should the nurse expect the physician to order?

Penicillin (Pen-Vee K)

A newborn is diagnose with meningitis. You remember back to the applied microbiology and know that the meningitis is more than likely caused by: select all that apply

Group B streptococcus, E. coli, Listeria monocytogenes

The client asks the nurse what causes a peptic ulcer to develop. The nurse responds that recent researching indicates that many peptic ulcers are the result of which of the following?

H. pylori infection

A female client with which condition would be at increased risk for vulvovaginal candidiasis? select all

HIV, immunosuppression due to cancer, uncontrolled diabetes

Which question should the nurse ask the parents of child suspected of having glomerulnephritis?

Has the child had a sore throat or a throat infection in the last few weeks'

Assessment of a 36 y/o woman complaining of malaise and dysuria reveals a temperature of 100F and painful blisters on the outside of her vagina. The client tells the nurse she had intercourse with a new partner 5 days ago. Which of the following should the nurse suspect as most likely?

Herpes genitalis

The nurse is teaching a 17 year old girl who has sever gonorrheal infection. The nurse realizes that the girl understands the implications of her disease when she tells the nurse:

I could have trouble getting pregnant

The nurse is evaluating client's understanding how to prevent STD's. Which of the following statements indicates that the client understands how to protect herself?

I will be sure my partner uses a condom

Which of the following client statements indicates that the client with hepatitis B understands his discharge teaching?

I will not drink alcohol for at least 1 year

A parent asks why it is recommended that the second dose of measles, mumps, and rubella (MMR) vaccine be given at 4 to 6 years of age? the nurse should explain to the parent that the second dose is given at this age for what reason?

If the child reaches puberty and becomes pregnant when receiving the vaccine, the risks to the fetus are high

An elderly patient has been ill with the flu, experiencing headache, fever, and chills. After 3 days, she develops a cough producing yellow sputum. The nurse auscultates her lungs and hears diffuse crackles. How would the nurse best interpret these assessment findings?

It is likely that the client is developing a secondary bacterial pneumonia

The nurse prepares a teaching plan for the mother of a child diagnosed with bacterial conjunctivitis. which, is stated by the mother, indicates a need for further teaching ?

It is okay to share towels and washcloths

The school nurse has provided an instructional session about impetigo to parents of the children attending the School. Which statement, if made by a parent, indicates a need for further instruction?

Lesions most often are located on the arms and chest

A client was treated for a strep throat infection 2 weeks ago. The client now has been diagnosed with acute post strep glomerulonephritis. The client asks the nurse how he could have prevented this condition. What should the nurse tell the client?

See your physician for an early diagnosis and treatment of a sore throat

A postpartum client is Rh-negative and has delivered an Rh-positive infant. The client is being educated concerning the RhoGAM, which has been ordered. The nurse realizes the client understands the purpose of RhoGAM when she states:

RhoGAM will prevent antibody formation in my blood

The nurse is preparing a community education program about preventing hepatitis B infections. Which of the following would be appropriate to incorporate into the teaching plan?

The use of condom is advised for sexual intercourse

A client complains fo severe vuvlar itching. The nurse recognizes that a client with candidiasis (Candida albicans infection) has a vaginal discharge that is:

Thick and white

A cline with TB whose status is being monitored in an ambulatory care clinic asks the nurse when it is permissible to return to work. What forcer should the nurse include with responding to the client?

Three sputum cultures are negative

The client complains of ra sever vulvar pruritus and a yellow-green, malodorous vaginal discharge. the nurse recognizes that the symptoms suggest:

Trichomoniasis

The typical chancre of syphillis appears as;

a painless, moist ulcer

A schoolteacher calls the nurse and asks whether all the children at school need treatment after exposure to a 7 y/o with bacterial meningitis. The nurse responds that chemoprophylaxis should be given to :

all household and close contacts

An adult client has bacterial conjunctivitis. What should the nurse teach him to do? select all that apply

avoid touching his eyes, apply topical antibiotic without touching the tip of the tube to his eye, wash hands after touching his eyes

Which nursing action is important is preventing cross-contamination?

change gloves immediately after use

When instilling erythromycin ointment into the eyes of a neonate 1 hour old, the nurse would explain to the parents that the medication is used to prevent which of the following?

blindness secondary gonorrhea

A 20 year old client who reports vaginal itching and a thick white cheese like vaginal discharge beginning 2 days ago tells the nurse that she has been taking oral contraceptives for 2 months. The nurse determines that the client is most likely exhibiting signs of which of the following?

candidiasis

A primigravida client in early labor tells the nurse that she was exposed to rubella at about 14 weeks' gestation. After delivery, the nurse should assess the neonate for which of the following?

cardiac disorders

When developing a teaching plan about sexually transmitted diseases for an 18 year old female client, which of the following treatments would the nurse need to keep in mind?

ceftriaxone sodium (rocephin) may be used to treat neisseria gonorrhoeae infections

Women who have HPV are at risk for development of :

cervical cancer

Which of the following measures would prevent transmissions of the hepatitis C virus to healthcare personnel ?

decreasing contact with blood and blood-contaminated fluids

The cyanosis that accompanies bacterial pneumonia is primarily caused by which of the following?

decreased oxygenation of the blood

Rho(D) immune globulin (RhoGAM) is ordered for a client before she is discharged after a spontaneous abortion. The nurse understands that the rationale for administration is to prevent which of the following?

developments of Rh-positive antibodies

The nurse is caring for a client who has been diagnosed with atypical pneumonia. When conducting a client assessment, which of the following symptoms should the nurse anticipate observing?

dry cough

A client who had an exploratory laparotomy 3 days ago has a WBC diff with a shift to the left. The nurse instructs the UAP to report which of the clinical manifestations?

elevated temperature

The nurse plans care for the client with hepatitis A with the understanding that the causative virus will be excreted from the client's body primarily through the :

feces

When assessing an infant diagnosed with bacterial meningitis, which findings should the nurse most likely expect? select all that apply

fever, poor feeding

The nurse is planning a community education program on how to prevent the transmission of viral hepatitis. Which of the following types of hepatitis is considered to be primarily a sexually transmitted disease?

hepatits B

A client with a history of diabetes mellitus and COPD should have which of the following immunizations?

influenza

A child is admitted with a tentative diagnosis of shigella. The nurse should do which fo the following ? select all that apply

initiate an intake and output record, monitor the child for signs and symptoms of dehydration, collect a stool sample for WBC's, assess the child for nausea and vomiting

A 3 year old had been admitted with diarrhea. He has mild dehydration (less than 5%). the nurse is reviewing the lab report fo the stool specimen, as indicated in the chart below .

institue enteric precautions

The primary reason that a herpes simplex virus (HSV) infection is a serious concern to a client with HIV infection is that it:

is an AIDS defining illness

The nurse assesses a client's surgical incision for signs of infection. Which findings by the nurse would be interpreted as a normal finding a the surgical site?

serous drainage

The nurse is evaluating the lab results of a client who has recently admitted to the hospital. Which fo the following results indicates the presence of infection?

leukocytosis

The father of an infant states that the physician told him that his child has urinary tract infection. The father calls the clinic to ask about s/s that he should watch out for in the future to indicate a recurrence. Which of the following should the nurse tell the father?

loss of appetite and fussiness

When educating a female client with gonorrhea, the nurse should emphasize that for women gonorrhea:

may not cause symptoms until serious complications occur

Initiation of which of the following immunizations is recommended prior to the adolescent entering college?

meningococcal

When interviewing the parents of a 2 year old child, a history of which of the following illnesses should lead the nurse to suspect pneumococcal meningitis?

middle ear infection

A 21 month old child admitted with the diagnosis of group now has a respiratory rate of 48 breaths/minute hr 120, and temp of 100F rectally. The nurse is having difficulty calming the child. Which fo the following should the nurse do next?

notify the physician immediately

When interviewing a client with newly diagnosed syphillis, the public health nurse should be aware that the spread of the disease can be controlled by:

obtaining a list of the client's sexual contacts

The nurse assess the mouth and oral cavity of a client with HIV infection because the most common opportunistic infection initially presents as:

oral candidiasis

Which of the following nursing diagnosis would most likely be a priority for a client with herpes genitalis?

pain

The nurse is teaching the pregnant client the importance of seeking treatment for suspected bacterial vaginosis during pregnancy because it has been associated with:

preterm labor

The nurse administers erythromycin ointment (0.5%) to the eyes of a newborn and the mother asks the nurse why this is performed. Which explanation is best for the nurse to provide about neonatal eye prophylaxis?

prevents an infection called ophthalmia neonatorum from occurring after birth in a newborn born to a woman with an untreated gonococcal infection

A nurse is planning care for a 12 year old with rheumatic fever. The nurse should teach the parents to:

provide for adequate periods of rest between activities

the client is diagnosed with genital herpes, (herpes simplex virus type 2, or HSV-2). The nurse should instruct the client that:

reducing stressful life events may decrease the incidence of herpetic outbreaks

After a preparation and parenting class session, a pregnant client tells the nurse that she has some yellow-gray frothy vaginal discharge and local itching. The nurse's best action is to advise the client to do which of the following?

schedule an appointment at the clinic for examination

A client with bacterial pneumonia is to be started on I.V. antibiotics. Which of the following diagnostic tests must be completed before antibiotic therapy begins?

sputum culture

The nurse develops a teaching plan for the client about to prevent the transmission fo hepatitis A. Which of the following discharge instructions is appropriate for for the client?

tell family members to wash their hands frequently

Two hours ago, a neonate at 38 weeks gestation and weight 7lbs was born to a primiparous client who tested positive for beta-hemolytic streptococcus. Which fo the following would alert the nurse to notify the pediatrician?

temperature instability

Griseofulvin (Grisactin) was ordered to treat a child's ringworm of the scalp. The nurse instructs the parents to use the medication for several weeks for which of the following reasons?

the growth of the causative organism into new cells is prevented with long-term

A nurse is assessing a client with vaginal discharge. Which of the following diseases are commonly associated with vaginal discharger? select all that apply

trichomoniasis, bacterial vaginosis, candidiasis

A client diagnosed with TB is taking medication for the treatment of TB. The nurse should instruct the client that he will be safe from infecting others approximately how long after initiation fo the chemotherapy regimen?

two to 3 weeks after initiation of bactericidal drugs

The nurse teaches girls age 10 to 12 about self-care during menses. The nurse emphasizes that a risk factor for toxic shock syndrome is (TSS) is:

using only tampons at night

Which of the following would be the best activity for the nurse to include in the plan of care for an infant experiencing severe diarrhea?

weighing the infant each day

The nurse is assessing a client who is suspected being in the early symptomatic stages of HIV infection. Which fo the following signs and symptoms of infection. Which of the following signs and symptoms of infection should the nurse detect during this stage?

whites yellow patches in the mouth

The nurse should expect the client to exhibit which of the following signs and symptoms during the icteric phase of viral hepatitis?

yellowed sclera