PrepU : Infection - ML7

When an infection is bloodborne, the manifestations include which symptom?

Chills

The nurse is encouraging the client with recurrent urinary tract infections to increase fluid intake to 8 large glasses of fluids daily. Which beverage would the nurse discourage for this client?

Coffee in the morning

Culture of client's vaginal discharge reveals Gardnerella vaginalis. Which of the following would the nurse expect to assess?

Fishy smelling watery discharge

A client in the emergency department is diagnosed with a communicable disease. When complications of the disease are discovered, the client is admitted to the hospital and placed in respiratory isolation. Which infection warrants airborne isolation?

Measles

Which drug is the most effective treatment for trichomoniasis?

Metronidazole

Which is an accurate rationale for why older adults are more susceptible to serious infections?

They have less efficient defense mechanisms.

A nurse is caring for a client who is at high risk for developing pneumonia. Which intervention should the nurse include on the client's care plan?

Using strict hand hygiene

A client has had surgical repair of a hip injury after joint manipulation was unsuccessful. After surgery, the nurse implements measures to prevent complications. Which complications is the nurse seeking to prevent? Select all that apply.

skin breakdown wound infection pneumonia

The nurse in the clinic is caring for a 38-year-old client with an inflammation of the right external ear secondary to a bug bite 1 week ago. 1215 External ear around the bug bite is red and swollen. External ear hurts when touched during examination. Client reports that sound is muffled in the right ear. Heart rate, 72 beats/minute; respiratory rate, 16 breaths/minute; blood pressure, 132/86 mm Hg; temperature, 97.8°F (36.6°C). External ear canal without redness or swelling. Cervical lymph nodes not palpable. Health care provider diagnosed external otitis of the right ear and prescriptions for care given. Educated client how to take oral analgesic for pain, apply warm compresses to the external ear, and administer the antibiotic/corticosteroid otic solution. Explained signs and symptoms that require urgent medical attention. One week later 0900 Client seen in the clinic 1 week ago and treated for right external otitis. Client now reports constant external ear pain of 4/10. States that chewing food is painful. External ear has generalized redness and swelling extending to the right side of face that the health care provider has diagnosed as cellulitis. Cervical lymph nodes on the right side are palpable. Ear canal is red and swollen. Heart rate, 74 beats/minute; respiratory rate, 16 breaths/minute; blood pressure, 138/82 mm Hg; temperature, 99.8°F (37.7°C). The nurse is discussing the plan of care for this client with the health care provider. Which action(s) does the nurse anticipate teaching the client? For each potential nursing intervention, click to specify whether the intervention is indicated or contraindicated for the client.

Clean ear canal daily with a cotton-tipped applicator. Contraindicated Apply warm soaks to affected ear and right side of face. Indicated Avoid swimming until healed. Indicated Take oral antibiotics until facial redness is cleared. Contraindicated Return to the clinic if symptoms worsen or fever develops. Indicated Consume soft foods that minimize chewing. Indicated Monitor nutritional intake. Indicated

A patient is suspected to have diverticulosis without symptoms of diverticulitis. What diagnostic test does the nurse anticipate educating the patient about prior to scheduling?

Colonoscopy

The nurse in the urology clinic is caring for a 58-year-old male client with acute prostatitis. 1115 Client reports fever, urinary frequency and urgency, perineal pain, and pain with urination. States getting up several times each night to urinate, which is unusual for the client. Urine sent to the laboratory for culture and sensitivity. Heart rate, 78 beats/minute; respiratory rate, 16 breaths/minute; blood pressure, 138/82 mm Hg; temperature, 99.2°F (37.3°C). Prostate examination by health care provider revealed a tender and enlarged prostate. Urinalysis showed the presence of white and red blood cells. The health care provider diagnosed acute prostatitis and prescribed trimethoprim-sulfamethoxazole. Taught client how to take antibiotics correctly, signs and symptoms that require prompt medical attention, sitz baths for relief of pain, and the need to drink fluids. 5 days later Client returned to the clinic with fever, malaise, urinary retention, and dysuria. Client reports taking the antibiotics for 3 days and stopped taking them because symptoms resolved. Has had difficulty starting a stream of urine for the last 24 hours. Heart rate, 84 beats/minute; respiratory rate, 18 breaths/minute; blood pressure, 128/78 mm Hg; temperature, 100.2°F (37.9°C). Urine culture from the previous visit shows Escherichia coli. The nurse is reviewing with the health care provider the Nurses' Notes from the client's clinic visit 5 days ago and today. Which prescription(s) for care should the nurse anticipate? Select all that apply.

Continue taking the antibiotic. Start taking tamsulosin 0.4 mg each day. Seek urgent medical care if unable to void. Teach the importance of finishing the prescribed course of antibiotics. Change positions from lying down to standing slowly.

A client reports experiencing vulvar pruritus. Which assessment factor may indicate that the client has an infection caused by Candida albicans?

Cottage cheese-like discharge

A patient has a wound that has hemorrhaged. What does the nurse understand is the cause of the patient's increased risk of infection?

Dead space and dead cells provide a culture medium

The nurse is monitoring a client's postoperative course after an appendectomy. The nurse's assessment reveals that the client has vomited, has abdominal tenderness and rigidity, and has tachycardia. The nurse reports to the physician that the client has signs/symptoms of which complication?

Peritonitis

The nurse has received several laboratory studies back at the clinic. Which of these results should be reported to the local health department?

Positive gonorrhea

The nurse is caring for an 86-year-old female client with a possible urinary tract infection (UTI), dehydration, and lethargy. 0900 Client admitted from home with possible UTI and dehydration. The client's adult child has noticed increased lethargy in the past 24 hours. Client alert and oriented to time, place, and person but lethargic and dozing. Easily arousable. Lungs clear. Skin warm and dry, tents easily. Peripheral pulses strong. Abdomen soft, non-tender. Heart rate, 88 beats/minute; respiratory rate, 15 breaths/minute; blood pressure, 128/74 mm Hg; temperature, 99.8°F (37.7°C). Oxygen saturation by pulse oximetry 97% on room air. Urine sent to laboratory for culture and sensitivity and Gram stain. 1030 Called to room by adult child who states the client is confused and trying to climb out of bed. Heart rate, 102 beats/minute; respiratory rate, 24 breaths/minute; blood pressure, 96/62 mm Hg; temperature, 101°F (38.3°C). Oxygen saturation by pulse oximetry 95% on room air. Skin warm, flushed, and dry. Peripheral pulses strong. Lungs clear. Client agitated, and confused about time and place. Performed Quick Sequential Organ Failure Assessment (qSOFA) per protocol. The nurse is reviewing with the health care provider the Nurses' Notes of 0900 and the results of the qSOFA tool performed at 1030. Which prescription(s) for care will the nurse anticipate? Select all that apply.

Prepare the client for transfer to the intensive care unit (ICU). Check vital signs every 15 minutes. Monitor level of consciousness every 15 minutes. Administer broad-spectrum antibiotics as prescribed. Obtain a serum lactate level.

In chronic osteomyelitis, antibiotics are adjunctive therapy in which situation?

Surgical debridement

An instructor is teaching a group of students about the incidence of sexually transmitted infections (STIs) and those that must be reported by law. The instructor determines that the students have understood the information when they state that which STI must be reported?

Syphilis

A nurse, caring for a client with human immunodeficiency virus (HIV), reviews the client's differential WBC count. What type of WBC will the nurse check the level of?

T lymphocytes

A nurse who works in a gynecologist's office frequently cares for patients who are diagnosed with vulvovaginal candidiasis. The nurse should teach the patients how to manage and treat the most common symptom of:

Vulvar pruritus.

What should the school nurse working in the elementary school setting be aware is one of the most frequent health care problems to affect this population?

You Selected: Infections

The nurse is caring for a client who may have a lice infestation. The nurse is using a bright light focused on an area of the head to confirm the presence of lice. In which manner is it easiest to differentiate nits from dandruff?

Nits are difficult to move from hair shafts.

A client has been taking a 10-day course of antibiotics for pneumonia. The client has been having white patches that look like milk curds in the mouth. What treatment will the nurse educate the client about?

Nystatin

The nurse is providing education to a 65-year-old female client with pneumococcal pneumonia being discharged from the health clinic on oral antibiotics. The client is a nonsmoker, takes levothyroxine for Hashimoto disease, and is otherwise in good health. **For each client statement, click to specify if the finding indicates understanding or the need for reinforcement of the teaching.**

"I will take the antibiotics until the secretions clear up." REINFORCE TEACHING "I should get the PPSV23 this year because I got the PCV13 last year." UNDERSTANDING "I will drink 1 liter of fluid each day." REINFORCE TEACHING "Sleeping with a humidifier can help loosen secretions." UNDERSTANDING "I will seek medical attention if my cough worsens." UNDERSTANDING "I will rest and avoid overexertion." UNDERSTANDING "A persistent or recurring fever is normal after starting antibiotics." REINFORCE TEACHING "I will perform deep-breathing exercises once per day." REINFORCE TEACHING

A 47-year-old male client presented to the medical unit and the health care team suspects tuberculosis (TB). The nurse is admitting the client to a reverse isolation room. QuantiFERON testing and chest x-ray are pending. Urinalysis results are negative. No other testing was performed prior to admission to isolation. The client denies any chest pain, shortness of breath (SOB), or respiratory difficulty. The client presents with productive yellow sputum. Complete the following sentence by choosing from the lists of options. Based on the provided assessment status, the nurse should utilize 1._______________ to prevent exposure and 2.__________to collect specimens for additional testing.

1. airborne precautions 2. SPUTUM

The herpes simplex virus type 1 (HSV-1), which produces a cold sore (fever blister), has an incubation period of

2 to 12 days

The nurse is educating a patient who will be started on an antituberculosis medication regimen. The patient asks the nurse, "How long will I have to be on these medications?" What should the nurse tell the patient?

6 to 12 months

A nurse is caring for four clients on the cardiac unit. Which client has the greatest risk for contracting infective endocarditis?

A client 4 days postoperative after mitral valve replacement

A nurse is having a yearly employee tuberculin skin test. Which skin test results would indicate a positive result?

An induration of 12mm ** 10 or greater **

A client is admitted with bacterial meningitis. Which hospital room is the best choice for this client?

An isolation room three doors from the nurses' station

A nurse educator is teaching a group of nurses about assessing critically ill clients for multiple organ dysfunction syndrome (MODS). The nurse educator evaluates understanding by asking the nurses to identify which client would be at highest risk for MODS. It would be the client who is experiencing septic shock and is

An older adult man with end-stage renal disease and an infected dialysis access site

A client with a trichomoniasis infection is prescribed metronidazole. Which teaching will the nurse provide to the client about this medication?

Avoid all alcohol for 24 hours after taking the medication.

A nurse is examining a client's scalp for evidence of lice. The nurse should pay particular attention to which part of the scalp?

Behind the ears

A nurse is caring for a client who had an aortic balloon valvuloplasty. The nurse should inspect the surgical insertion site closely for which complication(s)?

Bleeding and infection

The nurse instructs a client with genital herpes on self-care management. Which client statement indicates that teaching has been effective?

"I will not touch the lesions when they occur."

A patient taking isoniazid (INH) therapy for tuberculosis demonstrates understanding when making which statement?

"It is all right if I have a grilled cheese sandwich with American cheese."

Which would be least likely to contribute to a case of hospital-acquired pneumonia?

A nurse washes her hands before beginning client care.

The single modality of pharmacologic therapy for chronic type B viral hepatitis is:

Alpha-interferon

Which of the following is the most common organism implicated in prostatitis?

Escherichia coli

The nurse is caring for victims who have inhaled anthrax. The nurses assesses for symptoms that mimic which disease processes?

Flu

A client is diagnosed with rheumatic endocarditis. What bacterium is the nurse aware causes this inflammatory response?

Group A, beta-hemolytic streptococcus

A woman infected with HIV comes into the clinic. What symptoms may be the focus of a medical complaint in women infected with HIV?

Gynecologic problems

A client with human immunodeficiency virus (HIV) comes to the clinic and is experiencing white patches on the lateral border of the tongue. What type of lesions does the nurse document?

Hairy leukoplakia

Which is the most common cause of acute encephalitis in the United States?

Herpes simplex virus

A nurse is obtaining health history from a woman with suspected cervical cancer. Which of the following would the nurse identify as a possible risk factor?

History of chronic pelvic infections

Which type of shock is caused by an infection?

Septic

During an internal vaginal examination, the nurse practitioner notes a frothy and malodorous discharge. The nurse suspects the odor is caused by which bacteria?

Trichomonas

When discussing diseases of the middle ear, the nursing instructor distinguishes the different types of otitis media. What generally causes purulent otitis media?

Upper respiratory infections

The nurse is instructing the parents of a child with head lice. Which statement should the nurse include?

Use shampoo with piperonyl butoxide.

The patient wants to be prescribed an anti-infective drug for the flu. The nurse understands that anti-infective medications would not be useful against which biologic agents?

Viruses

The client returns to the clinic for a follow-up appointment following a permanent pacemaker insertion and reports tenderness and throbbing around the incision. The nurse observes mild swelling, erythema, and warmth at the pacemaker insertion site. What does the nurse suspect?

pacemaker site infection

The nurse working on the neurological unit is caring for a client with a basilar skull fracture. During the assessment, the nurse expects to observe Battle's sign, which is a sign of basilar skull fracture. Which of the following correctly describes Battle's sign?

Ecchymosis over the mastoid

A nurse is caring for a client who was admitted with pneumonia, has a history of falls, and has skin lesions resulting from scratching. The priority nursing diagnosis for this client should be:

Ineffective airway clearance.

A patient comes to the emergency department with a large scalp laceration after being struck in the head with a glass bottle. After assessment of the patient, what does the nurse do before the physician sutures the wound?

Irrigates the wound to remove debris

Which of the following information regarding the transmission of lice would the nurse identify as a myth?

Lice can jump from one individual to another.

A client with infective endocarditis (IE) and a fever is admitted to the intensive care unit. Which of these physician orders should the nurse implement first?

Order blood cultures drawn from two sites

A client with infective endocarditis is assessed by the nurse for the presence of Janeway lesions. On inspection, the nurse recognizes these lesions by identifying which characteristic sign?

Red or purple macules found on the palms of the hands

A client with renal failure is undergoing continuous ambulatory peritoneal dialysis. Which nursing diagnosis is the most appropriate for this client?

Risk for infection

A nurse has pharyngitis and will be providing self care at home. It is most important for the nurse to

Seek medical help if he experiences inability to swallow

A client with chronic obstructive pulmonary disease (COPD) visits the health care center with breathing difficulties. Which part of the client profile relates to the client's view of himself or herself and the impact of COPD?

Self-concept

The nurse is caring for a client who has a diagnosis of human immunodeficiency virus (HIV). Part of this client's teaching plan is educating the client about his or her medications. What is essential for the nurse to include in the teaching of this client regarding medications?

Side effects of drug therapy

After 48 hours, a Mantoux test is evaluated. At the site, there is a 10 mm induration. This finding would be considered:

Significant

A nurse is caring for a client receiving chemotherapy. Which assessment finding places the client at the greatest risk for an infection?

Stage 3 pressure ulcer on the left heel

A client with chronic osteomyelitis has undergone 6 weeks of antibiotic therapy. The wound appearance has not improved. What action would the nurse anticipate to promote healing?

Surgical debridement

A client with vaginitis reports itching and burning of the perineum. Which suggestion would be most appropriate to relieve the client's symptoms?

Take sitz baths frequently.

A client has been hospitalized for treatment of acute bacterial pneumonia. Which outcome indicates an improvement in the client's condition?

The client has a partial pressure of arterial oxygen (PaO2) value of 90 mm Hg or higher.

You work on a long-term care unit. In the last two weeks more than half the clients on your unit have been diagnosed with gastroenteritis. What is the most likely reason?

The infection is being transmitted by healthcare personnel.

A client with diabetes mellitus develops sinusitis and otitis media accompanied by a temperature of 100.8° F (38.2° C). What effect do these findings have on his need for insulin?

They increase the need for insulin.

The nurse is caring for a client with chronic gastritis. The nurse monitors the client knowing that this client is at risk for which vitamin deficiency?

Vitamin B12

Which vitamin is usually administered with isoniazid (INH) to prevent INH-associated peripheral neuropathy?

Vitamin B6

In chronic osteomyelitis, antibiotics are adjunctive therapy in which situation?

You Selected: Surgical debridement

The primary source of microorganisms for catheter-related infections are the skin and the

You Selected: catheter hub.

Which of the following nursing instructions is most important for the nurse to emphasize to the client with a new HSV-2 diagnosis?

You must inform all sexual partners.

Over the past 2 months, a client has been receiving treatment for multiple ear infections and tonsillitis. The client reports vaginal discharge and itching. What is likely the cause of the client's vaginitis?

antibiotics

The nurse cares for a client with an intra-arterial blood pressure monitoring device. The nurse recognizes the most preventable complication associated with hemodynamic monitoring includes which condition?

catheter-related bloodstream infections

Statistics show an increase in the prevalence of infective endocarditis among older adults. Which factor places older adults at risk for developing infective endocarditis?

increased use of prosthetic valve replacements

A female patient comes to the clinic with the complaint that she is having a greenish-colored discharge from the nipple and the breast feels warm to touch. What does the nurse suspect these symptoms may indicate?

infection

A client is being seen by the physician because of an unrelenting headache, facial tenderness, low-grade fever, and dark yellow nasal discharge. The client reports seeming to develop sinus infections "all the time." Which factor may predispose the client to sinusitis?

interference with sinus drainage

The nurse is talking with a group of teens about transmission of human immunodeficiency virus (HIV). What body fluids does the nurse inform them will transmit the virus? Select all that apply.

semen breast milk blood vaginal secretions

The nurse in the ICU is caring for a client with a nasotracheal tube. Because of the tube placement, the nurse understands that the client is at risk for developing

sinus infection.