Final Exam

The father of an infant states that the physician told him that his child has a urinary tract infection. The father calls the clinic to ask about signs and symptoms 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

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 human immunodeficiency virus (HIV) infection. Which of the following signs and symptoms of infection should the nurse detect during this stage?

whitish 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

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

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

The nurse is teaching a 17-year-old girl who has a severe 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".

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

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

Which treatment is recommended by the Centers for Disease Control and Prevention (CDC) for bacterial vaginosis in pregnancy?

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

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

A client with a history of diabetes mellitus and chronic obstructive pulmonary disease should have which of the following immunizations?

influenza

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 to gonorrhea

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

is an acquired immunodeficiency virus (AIDS)-defining illness

The nurse is evaluating the laboratory results of a client who was recently admitted to the hospital. Which one of the following results indicates the presence of infection?

leukocytosis

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

Decreased oxygenation of the blood

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

Helicobacter pylori infection

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?

Hepatitis B

Assessment of a 36-year-old woman complaining of malaise and dysuria reveals a temperature of 100°F (37.4°C) 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 the pregnant client the importance of seeking treatment for suspected bacterial vaginosis during pregnancy because it has been associated with:

Preterm labor

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 croup now has a respiratory rate of 48 breaths/minute, a heart rate of 120 bpm, and a temperature of 100.8F(38.2C) rectally. The nurse is having difficulty calming the child. Which of the following should the nurse do next?

notify the physician immediately

When interviewing a client with newly diagnosed syphilis, 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 assesses the mouth and oral cavity of a client with human immunodeficiency virus (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

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

- Group B Streptococcus -E. coli -Listeria monocytogenes

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

- Trichomoniasis - Bacterial vaginosis -Candidiasis

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

tell family members to wash their hands frequently

Two hours ago, a neonate at 38 weeks' gestation and weighing 3,175 g (7lb) was born to a primiparous client who tested positive for beta-hemolytic Streptococcus. Which of 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

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

the use of a condom is advised for sexual intercourse

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

thick and white

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

three sputum cultures are negative

A client diagnosed with tuberculosis (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 of the chemotherapy regimen?

two to 3 weeks after initiation of bacteriocidal 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 (TSS) is:

using only tampons at night

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

-avoid touching his eyes -use warm saline soaks four times a day to remove crusting -apply topical antibiotic without touching the tip of the tube to his eye -wash hands after touching his eyes

A 5-month-old infant is brought to the emergency department with vomiting and diarrhea, which the mother states started 3 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

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

-fever -vomiting -poor feeding

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

-human immunodeficiency virus (HIV) infection -immunosuppression due to cancer -uncontrolled diabetes

A child is admitted with a tentative diagnosis of shigella. The nurse should do which of 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 white blood cells (WBC's) -assess the child for nausea and vomiting

The nurse is evaluating client's understanding of how to prevent sexually transmitted diseases (STDs). 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".

The nurse prepares a teaching plan for the mother of a child diagnosed with bacterial conjunctivitis. Which, if 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 streptococcal throat infection 2 weeks ago. The client now has been diagnosed with acute poststreptococcal glomerulonephritis. The client asks the nurse hoe 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 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 the most accurate?

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

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 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 5-year-old child brought to the 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

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

A 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 an examination

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

serous drainage

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

A client at 34 weeks' gestation visits the clinic complaining of flulike symptoms and a bull's 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 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.

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

Trichomoniasis

The typical chancre of syphilis appears as;

a painless, moist ulcer

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 0.5 ml of tetanus toxoid I.M.

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

all household and close contacts

A primigravid 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

Women who have human papillomavirus (HPV) are at risk for development of:

cervical cancer

Which nursing action is important in preventing cross-contamination?

change gloves immediately after use

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

decreasing contact with blood and blood-contaminated fluids

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?

development of Rh-positive antibodies

The parents of a 9-month-old bring 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?

diphtheria, tetanus, and acellular pertussis (DTap); Haemophilusinfluenzae type B (Hib); inactivated poliomyelitis vaccine (IPV); and purified protein derivative (PPD)

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 white blood cell count (WBC) differential with a shift to the left. The nurse instructs unlicensed personnel 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

A 3-year-old has been admitted with diarrhea. He has mild dehydration (less that 5%). The nurse is reviewing the laboratory report of the stool specimen, as indicated in the chart below.

institute enteric precautions