Infectious

What clinical manifestations does a nurse expect a client with systemic lupus erythematosus (SLE) most likely to exhibit? (Select all that apply.) 1. Joint pain 2. Facial rash 3. Pericarditis 4. Weight gain 5. Hypotension

1. Joint pain 2. Facial rash 3. Pericarditis

A nurse is caring for a client who has been taking several antibiotic medications for a prolonged time. Because long-term use of antibiotics interferes with the absorption of fat, the nurse anticipates a prescription for: 1. High fat diet 2. Supplemental cod liver oil 3. Total parenteral nutrition (TPN) 4. Water-soluble forms of vitamins A and E

4. Water-soluble forms of vitamins A and E

A nurse is assessing clients who are to be given the smallpox vaccination. Which client should the nurse remove from the immunization line for medical counseling? 1. 20-year-old healthy woman 2. 45-year-old woman with breast cancer 3. 50-year-old man with diabetes mellitus 4. 75-year-old man who has Parkinson disease

2. 45-year-old woman with breast cancer

What is the primary focus of nursing care for a client admitted with tetanus caused by a puncture wound? 1. Monitoring urinary output 2. Decreasing external stimuli 3. Maintaining body alignment 4. Encouraging high intake of fluid

2. Decreasing external stimuli

A mother with the diagnosis of acquired immunodeficiency disease (AIDS) states that she has been caring for her baby even though she has not been feeling well. What important information should the nurse determine? 1. If she has kissed the baby 2. If the baby is breastfeeding 3. When the baby last received antibiotics 4. How long she has been caring for the baby

2. If the baby is breastfeeding

Which test result should a nurse review to determine if the antibiotic prescribed for the client will be effective? 1. Serologic test 2. Sensitivity test 3. Serum osmolality 4. Sedimentation rate

2. Sensitivity test

A client is diagnosed with gastroenteritis. What does the nurse determine is the basic intention underlying the unique dietary management for this client? 1. Provide optimal amounts of all important nutrients. 2. Increase the amount of bulk and roughage in the diet. 3. Eliminate chemical, mechanical, and thermal irritation. 4. Promote psychological support by offering a wide variety of foods.

3. Eliminate chemical, mechanical, and thermal irritation.

A client with multiple myeloma who is receiving chemotherapy has a temperature of 102.2° F. The temperature was 99.2° F when it was taken six hours ago. A priority nursing intervention is to: 1. Administer the prescribed antipyretic and notify the charge nurse or primary health care provider 2. Obtain the respirations, pulse, and blood pressure; recheck the temperature in one hour 3. Assess the amount and color of urine; obtain a specimen for a urinalysis 4. Note the consistency of respiratory secretions and obtain a specimen for culture

1. Administer the prescribed antipyretic and notify the charge nurse or primary health care provider

A chronically ill, older client tells the home care nurse that the daughter with whom the client lives seems run-down and disinterested in her own health, as well as the health of her children, who are 5, 7, and 12 years old. The client tells the nurse that the daughter coughs a good deal and sleeps a lot. Why is it important that the nurse pursue the daughter's condition for potential case finding? 1. Older adults with chronic illness are more susceptible to tuberculosis. 2. Tuberculosis has been rising dramatically in the general population. 3. There is a high incidence of tuberculosis in children less than 12 years of age. 4. Death from tuberculosis has been generally on the decrease in the United States.

1. Older adults with chronic illness are more susceptible to tuberculosis.

A nurse is preparing a teaching plan for a client with syphilis. The nurse includes that syphilis is not considered contagious in the: 1. Tertiary stage 2. Primary stage 3. Secondary stage 4. Incubation stage

1. Tertiary stage

A nurse is caring for a client with a diagnosis of acute salpingitis. Which condition most commonly causing inflammation of the fallopian tubes should the nurse include when planning a teaching program for this client? 1. Syphilis 2. Gonorrhea 3. Hydatidiform mole 4. Spontaneous abortion

2. Gonorrhea

After surgery a client is to receive an antibiotic by intravenous (IV) piggyback in 50 mL of a diluent. The piggyback is to infuse in 20 minutes. The drop factor of the IV set is 15 gtts/mL. The nurse should set the piggyback to flow at how many gtts/min? Record your answer using a whole number. __________ gtts/min

38 gtts/min is the flow rate to deliver the correct amount of medication. Solve the problem by dividing the total number of drops (50 x 15 = 750) by the total number of minutes (20); because a half drop cannot be administered, the answer must be rounded up to the next number.

Which patients are at risk of developing health care-associated infections (HAIs)? Select all that apply. A. A patient with an arm fracture B. A patient with a very high fever C. A patient with laryngeal cancer D. A patient with diabetes mellitus E. A patient with an indwelling urinary catheter

C. A patient with laryngeal cancer D. A patient with diabetes mellitus E. A patient with an indwelling urinary catheter

A client has a prescription for an antibiotic in an intravenous (IV) piggyback of 50 mL of D5W to run for 30 minutes. The microdrip tubing has a drop factor of 60 gtt/mL. At what rate should the nurse set the IV infusion? Record your answer using a whole number. __________ gtts/min

The total drops per minute should be divided by the total time in minutes: 50 mL x 60 gtt/mL 3000 ----------------------- = ------ = 100 gtt/minute 30 minutes 30

The health care provider prescribes peak and trough levels of an antibiotic for a client who is receiving the medication intravenous piggyback (IVPB). For peak levels the nurse should have the laboratory obtain a blood sample from the client: 1. Between 30 and 60 minutes after the IVPB 2. Halfway between two IVPB administrations 3. Immediately before administering the IVPB 4. Anytime it is convenient for the client and laboratory

1. Between 30 and 60 minutes after the IVPB

A nurse is teaching a client about drug therapy for gonorrhea. Which fact about drug therapy should the nurse emphasize? 1. Cures the infection 2. Prevents complications 3. Controls its transmission 4. Reverses pathological changes

1. Cures the infection

A nurse is concerned about the public health implications of gonorrhea diagnosed in a 16-year-old adolescent. Which should be of most concern to the nurse? 1. Finding the client's contacts 2. Interviewing the client's parents 3. Instructing the client about birth control measures 4. Determining the reasons for the client's promiscuity

1. Finding the client's contacts

A client with a recent history of sinusitis develops meningitis and demonstrates a positive Brudzinski sign. The priority nursing care is: 1. Controlling intracranial pressure 2. Adding pads to the side of the bed 3. Administering prescribed antibiotics 4. Hydrating the client with hypotonic saline

3 Administering prescribed antibiotics

Isoniazid (INH) is prescribed as a prophylactic measure for a client whose spouse has active tuberculosis (TB). What statements by the client indicate that there is a need for further teaching? (Select all that apply.) 1. "I plan to start taking vitamin B6 (NesTrex) with breakfast." 2. "I'll still be taking this drug six months from now." 3. "I sometimes allow our children to sleep in our bed at night." 4. "I know I also have tuberculosis because the skin test was positive." 5. "I'll be skipping the wine but enjoying the cheese at my neighbor's party."

3. "I sometimes allow our children to sleep in our bed at night." 4. "I know I also have tuberculosis because the skin test was positive." 5. "I'll be skipping the wine but enjoying the cheese at my neighbor's party."

When assessing the oral cavity of a newly admitted client with acquired immunodeficiency syndrome (AIDS), the nurse identifies areas of white plaque on the client's tongue and palate. What is the nurse's initial response? 1. Scrape an area of one of the lesions and send the specimen for a biopsy. 2. Instruct the client to perform meticulous oral hygiene at least once daily. 3. Document the presence of the lesions, describing their size, location, and color. 4. Consider that these lesions are universally found in clients with AIDS and require no treatment

3. Document the presence of the lesions, describing their size, location, and color.

A client who has been diagnosed with Lyme disease is started on doxycycline (Vibramycin) as part of the therapy. What should the nurse do when administering this drug? 1. Administer the medication with meals or a snack. 2. Provide orange or other citrus fruit juice with the medication. 3. Give the medication an hour before milk products are ingested. 4. Offer antacids 30 minutes after administration if gastrointestinal side effects occur.

3. Give the medication an hour before milk products are ingested.

A nurse is reviewing the physical examination and laboratory tests of a client with malaria. For which important clinical indicators should the nurse be alert when reviewing data about this client? (Select all that apply.) 1. Polyuria 2. Leukopenia 3. Hyperthermia 4. Splenomegaly 5. Erythrocytosis

3. Hyperthermia 4. Splenomegaly

While on a hike, a rusty nail pierces the sole of an adolescent's foot and the adolescent is brought to the emergency department of a local hospital. Tetanus immune globulin is prescribed because the adolescent does not know when the last tetanus immunization was received. The nurse administers the prescribed dose of tetanus immune globulin and explains that it provides: 1. Lifelong passive immunity 2. Long-lasting active protection 3. Immediate passive short-term immunity 4. Stimulation for the production of antibodies

3. Immediate passive short-term immunity

A nurse is counseling a client who has gonorrhea. What additional fact about gonorrhea, besides the fact that it is highly infectious, should the nurse teach this client? 1. It is easily cured. 2. It occurs very rarely. 3. It can produce sterility. 4. It is limited to the external genitalia.

3. It can produce sterility.

A client scheduled for surgery has a history of methicillin-resistant Staphylococcus aureus (MRSA) since developing an infection in a surgical site nine months ago. The site is healed and the client reports having received antibiotics for the infection. What should the nurse do to determine if the infecting organism is still present? 1. Notify the infection control officer 2. Inform the operating room of the MRSA 3. Obtain a prescription to culture the client's blood 4. Call the surgeon for an infectious disease consultation

3. Obtain a prescription to culture the client's blood

What criteria should the nurse consider when determining if an infection should be categorized as a health care-associated infection? 1. Originated primarily from an exogenous source. 2. Is associated with a drug resistant microorganism. 3. Occurred in conjunction with treatment for an illness. 4. Still has the infection despite completing the prescribed therapy

3. Occurred in conjunction with treatment for an illness.

What criteria should the nurse consider when determining if an infection should be categorized as a health care-associated infection? 1. Originated primarily from an exogenous source. 2. Is associated with a drug resistant microorganism. 3. Occurred in conjunction with treatment for an illness. 4. Still has the infection despite completing the prescribed therapy.

3. Occurred in conjunction with treatment for an illness.

The nurse cares for a client who develops pyrexia three days after surgery. The nurse should monitor the client for which signs and symptoms commonly associated with pyrexia? (Select all that apply.) 1. Dyspnea 2. Chest pain 3. Tachypnea 4. Increased pulse rate 5. Elevated blood pressure

3. Tachypnea 4. Increased pulse rate

A nurse is caring for a client who has been taking several antibiotic medications for a prolonged time. Because long-term use of antibiotics interferes with the absorption of fat, the nurse anticipates a prescription for: 1. High fat diet 2. Supplemental cod liver oil 3. Total parenteral nutrition (TPN) 4. Water-soluble forms of vitamins A and E

3. Total parenteral nutrition (TPN)

Ampicillin 250 mg by mouth every six hours is prescribed for a client who is to be discharged. Which statement indicates to the nurse that the client understands the teaching about ampicillin? 1. "I should drink a glass of milk with each pill." 2. "I should drink at least six glasses of water every day." 3. "The medicine should be taken with meals and at bedtime." 4. "The medicine should be taken one hour before or two hours after meals."

4. "The medicine should be taken one hour before or two hours after meals."

A client arrives for a vaccination at an influenza prevention clinic. A nursing assessment identifies a current febrile illness with a cough. The nurse should: 1. Give the vaccine 2. Administer aspirin with the vaccine 3. Hold the vaccine and notify the health care provider 4. Reschedule administration of the vaccine for the next month

4. Reschedule administration of the vaccine for the next month

A client is to receive an intravenous (IV) antibiotic in 50 mL of 0.9% sodium chloride to be administered over 20 minutes. At what rate should the nurse set the infusion pump? Record your answer using a whole number. __________ mL/hr

An infusion device delivers a specific volume of fluid to be infused over the period of one hour; calculate the answer by using ratio and proportion: 50 mL x mL -------- = ------ 20 min 60 min 20x = 50 x 60 x = 3000 ÷ 20 x = 150 mL/hr