CH 28, Concepts of Care for Patients with Infectious Respiratory Problems

The nurse is learning about endemic pulmonary diseases. Which diseases are matched with correct information? Select all that apply .

A. Hanta virus: found in urine, droppings, and saliva of infected rodents. C. Histoplasmosis: sources include soil containing bird and bat droppings.

A hospital nurse is participating in a drill during which many "clients" with inhalation anthrax are being admitted. What drugs would the nurse anticipate administering? Select all that apply

A. Vancomycin. B. Ciprofloxacin. C. Doxycycline.

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."

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. A 22-year-old client with asthma C. Client with well-controlled diabetes D. Healthy 72-year-old client E. Client who is taking medication for hypertension

The emergency department (ED) manager is reviewing client charts to determine how well the staff perform when treating clients with community-acquired pneumonia. What outcome demonstrates that goals for this client type have been met?

A. Antibiotics started before admission.

A client has been hospitalized with tuberculosis (TB). The client's spouse is fearful of entering the room where the client is in isolation and refuses to visit. What action by the nurse is best?

A. Ask the spouse to explain the fear of visiting in further detail.

A client has been diagnosed with an empyema. What interventions would 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.

A client is taking ethambutol for tuberculosis. What instructions does the nurse provide the client regarding this drug? Select all that apply .

A. Contact the primary health care provider if preexisting gout becomes worse. B. Report any changes in vision immediately to the health care provider. E. You will take this medication along with some others for 8 weeks. F. Take this medicine with a full glass of water.

A client has been diagnosed with tuberculosis (TB). What action by the nurse takes highest priority?

A. Educating the client on adherence to the treatment regimen

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 primary health care provider orders a chest x-ray. The family member questions why this is needed since the symptoms seem so vague. What response by the nurse is best?

B. "Older people often have vague symptoms, so an x-ray is essential."

A client has been taking isoniazid for tuberculosis for 3 weeks. What laboratory results need to be reported to the primary health care provider immediately?

B. Alanine aminotransferase (ALT): 180 U/L

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?

B. Inform the client that oral antibiotics will be needed for 60 days.

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?

B. Inquire as to recent travel outside the United States.

A client in the emergency department is taking rifampin for tuberculosis. The client reports yellowing of the sclera and skin and bleeding after minor trauma. What laboratory results correlate to this condition? Select all that apply

B. International normalized ratio (INR): 6.3. C. Prothrombin time: 35 seconds.

Which teaching point is most important for the client with a peritonsillar abscess?

B. Take all antibiotics as directed.

A nurse has educated a client on isoniazid. What statement by the client indicates that teaching has been effective?

C. "I will take this medication on an empty stomach."

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?

C. "Try warm, moist heat packs on your face."

A nurse working in a geriatric clinic sees clients with "cold" symptoms and rhinitis. The primary health care provider (PHCP) often leaves a prescription for diphenhydramine. What action by the nurse is best?

C. Consult with the PHCP about the medication.

A charge nurse is rounding on several older clients on ventilators in the Intensive Care Unit whom the nurse identifies as being at high risk for ventilator-associated pneumonia. To reduce this risk, what activity would the nurse delegate to the assistive personnel (AP)?

C. Provide oral care every 4 hours.

The emergency department nurse is participating in a bioterrorism drill in which several "clients" are suspected to have inhalation anthrax. Which "clients" would the nurse see as the priorities? Select all that apply .

C. Stridor. D. Oxygen saturation of 91%. E. Diaphoresis.

A client has been admitted for suspected inhalation anthrax infection. What question by the nurse is most important?

D. "What is your occupation?"

A client is in the family practice clinic reporting a severe "cold" that started 4 days ago. On examination, the nurse notes that the client also has a severe headache and muscle aches. What action by the nurse is best?

D. Teach the client to sneeze in the upper sleeve.

A client is being discharged on long-term therapy for tuberculosis (TB). What referral by the nurse is most appropriate?

D. Visiting nurses for directly observed therapy