NUR2214 Module 5 EAQs

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A patient with recurrent tonsillitis is admitted to the hospital with a peritonsillar abscess. The patient asks the nurse if surgery will be necessary. How does the nurse respond?

"Antibiotics are usually an effective treatment for this disease."

A female client is upset with her diagnosis of gonorrhea and asks the nurse, "What can I do to prevent getting another infection in the future?" Which is the most practical response the nurse can give to someone who plans to be sexually active?

"Insist that your partner use a condom."

A patient with terminal cancer asks about the potential for chronic pain. Which response by the nurse is most accurate?

"Pain can be a major problem for those with terminal cancer."

A patient with metastatic breast cancer experiences severe nausea and vomiting after chemotherapy and is unable to eat. What is the nurse's most appropriate action?

Administer antiemetic medications as prescribed.

The clinic nurse is planning care for a client found to have chlamydia. Which treatment should the nurse plan to implement?

Administration of 1 g of azithromycin orally in a single dose

Which chemotherapy drug is an alkylating agent?

Altretamine

A client's chest tube has accidentally dislodged. What is the nursing action of highest priority?

Apply a petroleum gauze dressing over the site.

Which conditions result in humoral immunity? Select all that apply.

Atopic diseases Bacterial infection Anaphylactic shock

Which medication is used to treat hypercalcemia temporarily in a patient who has cancer?

Bisphosphonate

Which method of radiation treatment delivery uses radioactive isotopes either in solid form or within body fluids?

Brachytherapy

A nurse is assessing a client and finds the following (see image). Which abnormal finding can be identified from the given figure?

Hordeolum

What does the nurse observe in the image?

acne vulgaris

What are the common side effects of chemotherapy on the bone marrow? Select all that apply.

anemia neutropenia thrombocytopenia

A female patient presents to the ambulatory clinic with complaints of a cough. Which other signs or symptoms, if present, would cause the nurse to begin wearing an N-95 mask and place the patient in an isolated environment? Select all that apply.

anorexia blood-streaked sputum menstrual irregularities

The nurse is counseling a patient whose parent has just been diagnosed with tuberculosis (TB). The patient tells the nurse that the parent was exposed several years ago, but developed symptoms only recently. What does the nurse tell this patient about the risk of contracting the disease?

"People are infectious to others only when symptoms are present."

A patient is being admitted for pneumonia. The sputum culture is positive for streptococcus, and the patient asks about the length of the treatment. What is the best answer the nurse can give?

"You will be treated for 5 to 7 days."

The occupational nurse is discussing a recent influenza outbreak with employees. Which medications are given to prevent influenza in individuals if they are exposed to someone with influenza? Select all that apply.

Amantadine Rimantadine

What recommendations will the nurse make for a patient and his or her family about the prevention of pneumonia? Select all that apply.

Avoid indoor pollutants. Eat a healthy, balanced diet. Avoid crowded areas during flu season and holidays.

The nurse is caring for a patient who received bacille Calmette-Guérin (BCG) vaccine 2 years ago while living in another country. This patient is exhibiting signs and symptoms of tuberculosis. What methods does the nurse expect to be used to effectively evaluate this patient? Select all that apply.

Chest x-ray QuantiFERON-TB Gold test

For which illness should airborne precautions be implemented?

Chickenpox

A client who is scheduled for a surgical resection of the colon and creation of a colostomy for a bowel malignancy asks why preoperative antibiotics have been prescribed. The nurse explains that the primary purpose is to do what?

Decrease bacteria in the intestines

What is a possible reason for cachexia in a cancer patient?

Decreased food intake and increased catabolism

Which nursing interventions are critical in caring for individuals with influenza? Select all that apply.

Encouraging the patient to rest and increase fluid intake Supporting the patient and preventing the spread of the disease Monitoring pulse rate and quality and urine output during rehydration in a patient with diarrhea

What education will be provided for the family of a patient being treated for tuberculosis convalescing at home?

Everyone must undergo tuberculosis testing.

How is cancer-related cachexia defined?

Extreme body wasting and malnutrition

Which skin infection is caused by bacteria?

Folliculitis

What information is important to share with a patient who is being discharged after treatment for pneumonia? Select all that apply.

Get an annual influenza immunization Avoid contact with all persons with colds or influenza Stop or reduce any intake of tobacco and tobacco products

A community health nurse is preparing a community education class on bioterrorism and the use of inhalation anthrax. When preparing to discuss the manifestations of the fulminant stage of the infection, what manifestation does the nurse include in the teaching?

Hypotension

A patient with an abdominal tumor is given nutritional support. What finding is most likely to indicate improvement in the patient's condition?

Increase in body weight

What consideration is important for the nurse to remember when managing the care of a patient with hospital-acquired pneumonia?

Monitor for early signs of sepsis.

A patient who has begun standard multidrug treatment for tuberculosis (TB) reports orange-tinged sputum and urine. The nurse tells the patient that this symptom represents which response to the treatment regimen?

Normal drug side effects of rifampin

A patient presents with severe throat pain and edema. There is difficulty swallowing as well as difficulty opening the mouth. Place the steps for managing this patient in the correct order.

Percutaneous needle aspiration and drainage of the abscess antibiotic therapy Intravenous (IV) opioids and IV steroids to control pain and edema Hospitalization, if the patient is showing slow response to the drugs Incision and drainage to control infection Additional antibiotic therapy if the patient is showing slow response to initial treatment

A patient returns to the clinic to have the tuberculosis (TB) Mantoux test analyzed by the nurse, which was administered 2 days ago. The patient's left forearm shows a red raised area, which measures 10 mm in diameter. How does the nurse document this finding?

Positive reaction that indicates exposure to and the possible presence of TB infection

A child recovering from a severe asthma attack is given oral prednisone 15 mg twice daily. What is the priority nursing intervention?

Preventing exposure of the child to infection

A nurse is caring for a 13-year-old child who has an external fixation device on the leg. What is the nurse's priority goal when providing pin care?

Preventing infection

Which type of surgery is performed to remove tissues that are at risk of becoming cancerous?

Prophylactic

What is the function of the dermis?

Provides cells for wound healing

Which therapy given to a patient with cancer may alter taste and cause fatigue?

Radiation therapy

The nurse in the long-term care facility is concerned about the health status of an 80-year-old resident. What early symptom would alert the nurse that this patient is developing pneumonia?

Recent onset of confusion

What does the phrase chemo brain refer to?

Reduction in cognitive function related to chemotherapy

The nurse is caring for a patient with end-stage ovarian cancer who needs clarification on the purpose of palliative surgery. Which outcome should the nurse teach the patient regarding the goal of palliative surgery?

Relief of symptoms or improved quality of life

Which upper respiratory infection is often triggered by a hypersensitivity reaction to airborne allergens?

Rhinitis

Following a bioterrorism attack with anthrax, the emergency department nurse checks the medication room for ample supply of which medications? Select all that apply.

Rifampin Amoxicillin Vancomycin Doxycycline Ciprofloxacin

A client with erythematous papules in the interdigital spaces reports severe itching at night. Which insect is responsible for this condition?

Sarcoptes scabiei

The nurse is preparing a patient for discharge who has been treated for the prodromal stage of inhalation anthrax. What information is most important for the nurse to communicate to this patient?

Seek medical attention immediately if you begin to feel breathless.

A patient with a transhumeral prosthesis is diagnosed with cancer. What risk does the nurse expect in the patient?

Sepsis

A patient reports experiencing chest pain, headache, and cough with sputum production, fever, and dyspnea. What does the nurse anticipate upon assessment? Select all that apply.

Tachycardia Crackles upon auscultation Diminished chest expansion

A nurse finds the following (see image) upon assessment of a client. Which organism is responsible for the condition that is illustrated in the image?

Treponema pallidum

A nurse is caring for a client with acquired immunodeficiency syndrome (AIDS). What precautions should the nurse take when caring for this client?

Use standard precautions.

Which nursing interventions are focused on preventing the spread of severe acute respiratory syndrome (SARS) caused by coronaviruses? Select all that apply.

Using strict airborne isolation techniques Handwashing before and after all patient care Disinfecting contaminated surfaces and equipment Using Contact Precautions with people suspected to have SARS

A client is diagnosed with herpes genitalis. What should the nurse do to prevent cross-contamination?

Wear a gown and gloves when giving direct care.

What manifestations may indicate spinal cord compression (SCC) in a patient with cancer? Select all that apply.

back pain muscle weakness sensation of heaviness in arms and legs

A nurse is reviewing the laboratory reports of four clients. Which client's laboratory report indicates acquired immunodeficiency syndrome (AIDS)?

client 3 - less than 200

Which medication does the nurse anticipate will be effective for a patient with post-chemotherapy fatigue?

darbepoetin alfa

What disorder is the cancer patient receiving chemotherapy at risk for?

decreased platelets

What can be the consequences if superior vena cava syndrome is left untreated? Select all that apply.

engorgred blood vessels erythema of the upper body edema in the arms and hands

Which is an early manifestation of super vena cava syndrome in a patient with cancer?

facial edema

Which potential side effects does the nurse include in the teaching plan for a patient undergoing radiation therapy for laryngeal cancer? Select all that apply.

fatigue change in taste changes in skin of the neck difficulty swallowing

What are the symptoms of tuberculosis? Select all that apply.

fatigue nausea low-grade fever

The nurse suspects that a patient is in the prodromal stage of inhalation anthrax. Which assessment findings support the nurse's suspicion? Select all that apply.

fever fatigue mild chest pain

The patient reports a metallic taste to the nurse. What disease-related consequence is the patient likely experiencing? Select all that apply.

food aversions reduced appetite

Which sexually transmitted disease is caused by a virus?

genital warts

The nurse monitors fluid overload in a patient with a cancer-associated syndrome of inappropriate antidiuretic hormone. What risk does the nurse prevent in the patient through this intervention?

heart failure

A nurse is caring for a client with scabies. Which information about scabies should the nurse consider when planning care for this client?

highly contagious

A patient with a lung tumor is suspected of having thickening in the alveolar membrane and damaged pulmonary vessels. Which condition is most likely to develop in the patient?

hypoxia

Which bacterial skin infections are caused by group A β-hemolytic streptococci? Select all that apply.

impetigo erysipelas

A nurse who is admitting a newborn to the nursery observes a fetal scalp monitor site on the scalp. Which complication should the nurse monitor this newborn for?

infection

What risk is associated with a low leukocyte count following chemotherapy?

infection

A nurse is caring for a patient with coccidioidomycosis who has recently migrated from Mexico. When planning care for this patient, what manifestation noted on assessment does the nurse recognize as a sign of more severe coccidioidomycosis infection?

joint pain

A patient with suspected initial infection of tuberculosis (TB) is admitted to the respiratory intensive care unit (ICU). The nurse caring for the patient reviews the patient's recent chest x-ray. Where on the patient's chest x-ray will the nurse most likely find evidence of the patient's infection? Select all that apply.

left lower lobe right lower lobe right middle lobe

Which cancers may most often increase the risk for impaired immunity and blood-producing functions of the body? Select all that apply.

leukemia lymphoma myeloma

The radiology report of a patient who has had a chest x-ray shows consolidation in a segment of the patient's left lung. This is typical of which type of pneumonia?

lobar

A client is concerned about contracting malaria while visiting relatives in Southeast Asia. What should the nurse teach the client to avoid to prevent malaria?

mosquito bites

Which actions known as the "ventilator bundle" have been shown to reduce the incidence of ventilator-associated pneumonia (VAP)? Select all that apply.

oral care hand hygiene head-of-bed elevation

Which hormone secretion releases calcium from the bones in cancer?

parathyroid hormone

reast reconstruction after a mastectomy is an example of which surgery type?

reconstructive

The nurse is caring for a patient with cancer who developed an infection in the bloodstream. Which term does the nurse expect to see documented in the health record to describe this condition?

sepsis

The nurse is caring for several patients with cancer. Which conditions does the nurse monitor for due to their status as oncological emergencies? Select all that apply.

sepsis DIC SIADH

Which class of medications treats chemotherapy-induced nausea and vomiting?

serotonin antagonist

The laboratory report of a client reveals the presence of 350 cells/mm 3 (350 cells/uL) of CD4+ T-cell count. According to the Centers for Disease Control and Prevention (CDC), which stage of human immunodeficiency virus (HIV) disease is present in the client?

stage 2

Which treatment should be provided to a patient with spinal cord compression to rearrange the bony tissue?

surgery

When widely distributed during a pandemic flu, which drugs reduce the severity of infection and mortality rate? Select all that apply.

zanamivir oseltamivir

A client comes to the clinic because of signs and symptoms of a respiratory infection. The client says to the nurse, "How can I prevent my roommate from getting my cold?" What is the nurse's best response?

"Cover your cough with your forearm."

The nurse is instructing a patient with tuberculosis about combination drug therapy. What are common instructions that the patient should follow for all the anti-tubercular drugs? Select all that apply.

"Refrain from drinking alcoholic beverages." "Report yellowing of the skin and any darkened urine immediately."

An adult has been diagnosed as having pulmonary tuberculosis. What direction should the nurse provide before the patient is started on isoniazid (INH) therapy? Select all that apply.

"Take a daily multivitamin." "Avoid alcoholic beverages."

A nurse is providing discharge instructions for a patient with active tuberculosis (TB) who has been prescribed isoniazid. What information about medication administration does the nurse include when providing discharge instructions?

"Take the drug on an empty stomach."

A patient has an obstructive airway tumor. The family asks the nurse to explain the patient's condition. What information should the nurse provide to the family to prepare them for the patient's imminent death?

"The tumor is closing off the airway and causing poor gas exchange."

A nurse is giving discharge instructions to a new mother. What is the most important instruction to address the prevention of postpartum infection?

"Wash your hands before and after changing your sanitary napkins."

The nurse performs follow-up care for a group of patients who have previously had tuberculosis. Which patients are most at risk for developing secondary tuberculosis (TB)? Select all that apply.

A 34-year-old with HIV infection A 75-year-old who is recovering from a hip replacement A 7-year-old who is undergoing chemotherapy for leukemia

Which treatment strategy increases the risk of developing tumor lysis syndrome?

Chemotherapy

A client has been prescribed tacrolimus for immunosuppressant therapy. Which drug safety alert should the nurse mention?

Do not consume grapefruit or grapefruit juice.

A patient with pneumonia has difficulty clearing secretions in his airway, which are quite thick. Which nursing intervention does the nurse include in this patient's plan of care?

Encourage an intake of 2 liters of fluid per day.

Which laboratory test will be elevated in a client with inflammatory arthritis?

Erythrocyte sedimentation rate (ESR)

Which factors are pathophysiologic bases for the clinical manifestations of pneumonia? Select all that apply.

Fluid accumulation in the receptors of the individual's respiratory system triggers the coughing mechanism. Stimulation of chemoreceptors and decreased lung compliance lead to an increased respiratory rate and dyspnea.

Which statement is true about community-acquired pneumonia (CAP) as compared to health care-associated pneumonia (HAP)?

HAPs are more likely to be resistant to some antibiotics.

An older patient has a persistent cough with hemoptysis and has a known exposure to tuberculosis. A tuberculin skin test reveals a reaction of 5 mm. The nurse documents that this test result indicates which condition?

Human immunodeficiency disease

A client will be taking nitrofurantoin 50 mg orally every evening at home to manage recurrent urinary tract infections. What instructions should the nurse give to the client?

Increase the intake of fluids.

Incentive spirometry for the treatment of pneumonia has which outcome objective?

Increased inspiratory muscle action and decreased atelectasis

Which groups are at greatest risk for drug-resistant Streptococcus pneumoniae? Select all that apply.

Individuals older than age 65 years Older adults exposed to children from a daycare environment

Which are potential problems for patients who are receiving hormonal therapy for cancer? Select all that apply.

Liver dysfunction Thromboembolism acne

In a patient with pneumonia, what is the most important nursing intervention?

Managing hypoxemia

A client in a nursing home is diagnosed with urethritis. What should the nurse plan to do before initiating antibiotic therapy prescribed by the primary healthcare provider?

Obtain a urine specimen for culture and sensitivity.

For individuals with cancer who are undergoing chemotherapy, bone marrow suppression places these individuals at risk for life-threatening infections. What is the most common cause of these infections?

Overgrowth of the patient's own normal flora

What could be the possible diagnosis for a patient who presents with pain in the throat, difficulty swallowing, swelling in the throat, and difficulty in opening the mouth?

Peritonsillar abscess

A client being treated for influenza A (H1N1) is scheduled for a computed tomography (CT) scan. To ensure client and visitor safety during transport, the nurse should take which precaution?

Place a surgical mask on the client.

The nurse is caring for a patient who was admitted with pneumonia. Which position assumed by the patient leads the nurse to suspect that the patient is developing hypoxia?

Sitting in tripod position

A male client has discharge from the penis. Gonorrhea is suspected. To obtain a specimen for a culture, what should the nurse do?

Swab the drainage directly from the urethra to obtain a specimen.

Which action by a patient with thrombocytopenia would require the nurse to intervene?

The patient blows his nose forcefully.

The nurse is caring for a patient who comes to the clinic because of a cough. What symptom of the cough will lead the nurse to believe that the health care practitioner will order testing for pertussis?

The patient reports that the cough has lasted more than 3 weeks.

A client who sustained a burn injury involving 36% of the body surface area is receiving hydrotherapy. Which is the best nursing intervention when providing wound care?

Use a consistent approach to care and encourage participation.

A patient with asthma reports diarrhea and vomiting. Which drug should be used with caution?

Zanamivir

Which treatment is recommended for a patient with severe cancer-induced hypercalcemia?

dialysis

Which assessment findings does the nurse anticipate for the patient suspected of having pneumonia? Select all that apply.

myalgia dyspnea hemoptysis

Which condition in a patient with cancer facilitates the entry of its own normal flora through a site of skin breakdown to cause severe infection?

neutropenia

Which pathological findings associated with pneumonia result in an increased respiratory rate and dyspnea? Select all that apply.

pain anxiety stimulation of J receptors

A 65-year-old patient with chronic obstructive pulmonary disease (COPD) asks the nurse about the best way to prevent pneumonia. What is the nurse's best response?

"You should get the pneumococcal polysaccharide vaccine."

Which component is released into the bloodstream after the destruction of tumor cells?

Potassium

Which area in a client is most commonly affected by the skin condition given in the image?

buttocks

A family member of a patient who has been diagnosed with severe acute respiratory syndrome (SARS) asks the nurse why the patient is not receiving an antibiotic. How does the nurse respond to this family member?

"Antibiotics are not effective because SARS is caused by a virus."

A patient is about to begin drug therapy for the treatment of tuberculosis (TB). What information is most important for the nurse to give to this patient prior to the start of therapy?

"Do not drink alcohol."

Which statement made by a patient allows the nurse to recognize whether the patient receiving brachytherapy for ovarian cancer understands the treatment plan?

"I will have a radioactive device in my body for a short time."

Which medication class helps to prevent human immunodeficiency virus (HIV) incorporating its genetic material into the client's cell?

Integrase inhibitors

A patient who has been homeless and has spent the past 6 months living in shelters has been diagnosed with confirmed tuberculosis (TB). Which medications does the nurse expect to be ordered for the patient?

Isoniazid, rifampin, pyrazinamide (PZA), ethambutol

A nurse instructs a client with viral hepatitis about the type of diet that should be ingested. Which lunch selected by the client indicates understanding about dietary principles associated with this diagnosis?

Salad, sliced chicken sandwich, gelatin dessert


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