This sh*t is stup*d pt. iii

What is the most important information for the nurse to convey to a patient who is beginning pharmacological therapy for the treatment of tuberculosis to ensure suppression of the disease? 1 "Eat a diet rich in Vitamin K." 2 "Do not drink alcoholic beverages." 3 "Take the medication exactly as prescribed." 4 "Contact the health care provider if you become ill."

3

Which clinical manifestations are usually present when an older adult has pneumonia? Select all that apply. 1 Fever 2 Cough 3 Fatigue 4 Weakness 5 Confusion 6 Poor appetite

3, 4, 5, 6

Which factors are pathophysiologic bases for the clinical manifestations of pneumonia? Select all that apply. 1 A temperature greater than 38.5° C upon arising in the morning is typically present. 2 Suppression of fever with the use of acetaminophen will speed the recovery process in older adults. 3 Fluid accumulation in the receptors of the individual's respiratory system triggers the coughing mechanism. 4 Pulmonary capillary shunting and movement of red blood cells into the alveoli cause pleuritic chest discomfort. 5 Stimulation of chemoreceptors and decreased lung compliance lead to an increased respiratory rate and dyspnea.

3, 5

A healthy patient expresses worries about developing tuberculosis (TB) after spending time at a family reunion and learning later that a family member is being treated for the disease. What does the nurse tell this patient? 1 "You have most likely been exposed to TB and will need to be tested." 2 "You should receive TB prophylaxis until your provider rules out active disease." 3 "TB is spread from person to person by sharing drinking cups and eating utensils. 4 "Among people exposed to the disease, only a small percentage develop active TB."

4

A patient admitted to the medical surgical unit is suspected of having tuberculosis (TB). Which rapid screening for TB does the nurse anticipate to be ordered by the health care provider? 1 Mantoux test 2 Sputum culture 3 QuantiFERRON-TB Gold 4 Nucleic acid amplification test

4

A patient has lobar pneumonia. To help ensure that the expected outcome of maintaining an oxygen saturation of 95% or greater is met, which nursing intervention is most important? 1 Obtain complete blood count, sputum, and blood cultures. 2 Assess breath sounds and respiratory effort every 4 hours. 3 Monitor vital signs and effectiveness of antibiotics every 4 hours. 4 Assist with coughing, deep-breathing, and incentive spirometry every 2 hours.

4

A patient is admitted to the hospital with a streptococcal peritonsillar abscess following incomplete treatment with an oral antibiotic. The nurse notes that the patient is experiencing stridor. Which action should the nurse take next? 1 Provide clear, cool oral liquids to help soothe the throat. 2 Elevate the head of the bed to at least a 30-degree angle. 3 Contact the provider to request an order for a steroid medication. 4 Notify the Rapid Response Team to assist with airway management.

4

A patient with a recent history of a mild respiratory infection is admitted to the hospital after a sudden onset of breathlessness. The patient has a temperature of 104°F, is diaphoretic and dyspneic, and the nurse observes stridor and cyanosis. A chest x-ray reveals mediastinal widening. The nurse anticipates an order for administering which antibiotics for this patient? 1 Vancomycin and rifampin 2 Amoxicillin and doxycycline 3 Doxycycline and ciprofloxacin 4 Ciprofloxacin and clindamycin

4

A patient with nasal congestion, fever, and cough has been using over-the-counter medications for a week without improvement. The patient exhibits tenderness to percussion over the sinuses and referred pain to the back of the head. These findings may indicate which condition? 1 Rhinitis 2 Tonsilitis 3 Pharyngitis 4 Rhinosinusitis

4

A patient with pneumonia develops increased fever, chills, and night sweats. The nurse auscultates decreased breath sounds in the right lung and observes decreased chest wall movement in that area. The nurse reports these findings to the provider and suspects which secondary infection has likely developed? 1 Tuberculosis 2 Lung abscess 3 Fungal infection 4 Pulmonary empyema

4

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? 1 "You will most likely have a surgical tonsillectomy." 2 "Surgery will be delayed until the infection has been treated." 3 "The provider will drain the abscess and give you antibiotics." 4 "Antibiotics are usually an effective treatment for this disease."

4

Based on the clinical data provided below, which age is most likely for this patient with pneumonia? 1 10 years 2 30 years 3 50 years 4 70 years

4

Incentive spirometry for the treatment of pneumonia has which outcome objective? 1 Reduced sputum production and increased cough 2 Reduced crackles and wheezes and improved oxygenation 3 Improved expiratory air flow and increased respiratory effort 4 Increased inspiratory muscle action and decreased atelectasis

4

The medical-surgical unit has one negative airflow room. Which of these four newly arrived patients should the charge nurse admit to this room? 1 Patient with neutropenia and pneumonia caused by Candida albicans 2 Patient with bacterial pneumonia and a cough productive of green sputum 3 Patient with right empyema who has a chest tube and a fever of 103.2° F 4 Patient with possible pulmonary tuberculosis who currently has hemoptysis

4

The nurse is caring for a patient who has had abdominal surgery. Which action should the nurse take to help prevent pulmonary infection in this patient? 1 Provide adequate analgesia. 2 Give intravenous antibiotics. 3 Administer low-molecular-weight heparin. 4 Encourage regular use of an incentive spirometer.

4

The nursing instructor is preparing to teach a group of nursing students about treatment of patients infected during a pandemic outbreak of the H5N1 or "avian influenza." What should the nurse include in the teaching plan? 1 Oseltamivir vaccination is a two-step process. 2 Everyone should be vaccinated with Vepacel annually. 3 Once patients receive the initial dose of Vepacel, immunity follows. 4 Oseltamivir and zanamivir may reduce the mortality of the infection.

4

Which disorder of the lungs is caused by a fungus? 1 Pertussis 2 Tuberculosis 3 Inhalation anthrax 4 Coccidioidomycosis

4

Which viral agent is responsible for the most common community-acquired pneumonia? 1 Adenovirus 2 Rhinovirus 3 Parainfluenza virus 4 Respiratory syncytial virus

4

n 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? 1 Latent tuberculosis 2 Immunity to tuberculosis 3 Reduced immune function 4 Human immunodeficiency disease

4

A nurse is caring for a patient with community-acquired pneumonia. The patient's oxygen saturation is 88% on room air. The patient is writhing in pain and cries out, "It hurts so bad to take a deep breath. I can't even cough it hurts so bad." Understanding the patient's condition, what is the nurse's priority intervention for this patient? 1 Provide the patient with supplemental oxygen 2 Encourage the patient to deep breathe and cough 3 Administer the ordered opioid analgesic medication 4 Instruct the patient on splinting the chest when breathing

1

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? 1 "Take the drug on an empty stomach." 2 "Take the drug with food for better absorption." 3 "Take an antacid with the drug for better absorption." 4 "Take the drug with a full glass of water and increase your water intake."

1

A patient has an endotracheal tube in place for mechanical ventilation. Which nursing action is most important to prevent infection in this patient? 1 Brushing the patient's teeth every 12 hours 2 Assessing oxygen saturation every 4 hours 3 Turning the patient from side to side every 2 hours 4 Suctioning the endotracheal (ET) tube every 6 hours

1

A patient has been started on ethambutol for tuberculosis. What adverse effect requires the patient to notify the provider? 1 Changes in vision 2 Darkening of the urine 3 Yellowing appearance of skin 4 Increased bruising or bleeding

1

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? 1 "Do not drink alcohol." 2 "Eat foods high in carbohydrates." 3 "Take medications in the morning." 4 "Limit ingestion of orange or grapefruit juice."

1

A patient is admitted to the emergency department (ED) with a possible diagnosis of avian influenza ("bird flu"). Which of these actions included in the hospital protocol for avian influenza should the nurse take first? 1 Place the patient in a negative air pressure room. 2 Ensure that ED staff members receive oseltamivir. 3 Start an IV line and administer rehydration therapy. 4 Obtain specimens for the H5 polymerase chain reaction test.

1

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? 1 "You will be treated for 5 to 7 days." 2 "You must be afebrile for 24 hours." 3 "You will complete 6 days of therapy." 4 "You will require antibiotics for 7 to 10 days."

1

A patient is being discharged home with active tuberculosis. Which information does the nurse include in the discharge teaching plan? 1 "You will need to have your household undergo TB testing." 2 "You will have to take these medications for at least 1 year." 3 "You are not contagious unless you stop taking your medication." 4 "Your sputum may turn a rust color as your condition gets better."

1

A patient taking antibiotics to treat rhinosinusitis reports facial pain over the affected sinuses. Which comfort measure does the nurse suggest in addition to the antibiotic therapy? 1 Moist heat packs over the affected sinuses 2 Tilting the head forward to relieve discomfort 3 Anticoagulant medications to reduce pressure 4 Frequent nose-blowing to clear sinus passages

1

A patient tells the nurse that after 3 weeks of multidrug therapy to treat tuberculosis (TB), the symptoms seem to have resolved. What does the nurse tell this patient? 1 "You will need to continue therapy for at least 6 months." 2 "Directly observed therapy will be necessary in your case." 3 "If a TB skin test is negative, you may stop taking the drugs." 4 "The provider may reduce the number of drugs you are taking."

1

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? 1 Normal drug side effects of rifampin 2 Hemolysis and a potential for anemia 3 Drug resistance with spread of infection 4 Hepatotoxicity caused by drinking alcohol

1

A patient who is taking isoniazid and rifampin to treat tuberculosis reports reddish-orange urine. Which action should the nurse take? 1 Reassure the patient that this is an expected drug side effect. 2 Encourage the patient to increase fluids to 2 L or more per day. 3 Request an order to change the isoniazid to another anti-tubercular drug. 4 Notify the provider and request an order for a complete blood count and creatinine clearance. 00:00:04 Question Answer Confidence ButtonsJust a guessPretty sureNailed it

1

A patient with active tuberculosis is ordered to take isoniazid (INH), pyrazinamide (PZA), and rifampin (RIF) and asks the nurse why it is necessary to take three antibiotics. What is the nurse's best answer? 1 "Three antibiotics help prevent bacterial drug resistance." 2 "You will have fewer drug side effects with multidrug therapy." 3 "The dose of each drug can be reduced with multidrug therapy." 4 "Taking three drugs has a synergistic effect in eradicating the organism."

1

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? 1 Encourage an intake of 2 liters of fluid per day. 2 Help the patient to ambulate several times daily. 3 Give intravenous antibiotics as ordered by the provider. 4 Administer pain medications on schedule to provide comfort.

1

An older patient is diagnosed with pneumonia. To assist with comfort during the admission interview, what does the nurse do? 1 Allows the patient to rest at frequent intervals 2 Gets the interview completed as quickly as possible 3 Places the patient in the bed immediately after arrival 4 Performs the physical assessment quickly and efficiently

1

Which statement is true about community-acquired pneumonia (CAP) as compared to health care-associated pneumonia (HAP)? 1 HAPs are more likely to be resistant to some antibiotics. 2 In CAP, the fibrin and edema of inflammation stiffen the lung. 3 In CAP, capillary leak spreads the infection to areas of the lung. 4 CAPs are more difficult to treat due to their resistance to antibiotics.

1

Which symptom of pneumonia may present differently in the older adult than in the younger adult? 1 Fever 2 Headache 3 Wheezing 4 Crackles on auscultation

1

Which upper respiratory infection is often triggered by a hypersensitivity reaction to airborne allergens? 1 Rhinitis 2 Sinusitis 3 Tonsillitis 4 Pharyngitis

1

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. 1 Fever 2 Fatigue 3 Mild chest pain 4 Upper respiratory infection 5 Sudden onset of breathlessness

1, 2, 3

Which statements about anthrax infection are correct? Select all that apply. 1 Although rarely occurring naturally, inhalation anthrax is nearly 100% fatal without treatment. 2 Toxins produced by the organisms in the lungs create massive edema, suppressing neutrophil action. 3 Dyspnea, diaphoresis, and sudden onset of breathlessness are common in late stages of the diseases. 4 Early on it is commonly accompanied by upper respiratory manifestations of sore throat or rhinitis. 5 As macrophages in the lungs engulf the anthrax spores, the organism leaves its capsule and replicates.

1, 2, 3, 5

The nurse is performing health assessments at an ambulatory walk-in clinic. Which patients would the nurse consider at risk for tuberculosis? Select all that apply. 1 The patient who abuses alcohol 2 The patient who has congestive heart failure 3 The patient who recently emigrated from Spain 4 The patient who doesn't have a permanent residence 5 The patient recently released from a corrective facility

1, 4, 5

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. 1 A 34-year-old with HIV infection 2 A 55-year-old who recently had abdominal surgery 3 A 14-year-old who is recovering from a broken femur 4 A 75-year-old who is recovering from a hip replacement 5 A 7-year-old who is undergoing chemotherapy for leukemia

1, 4, 5

A nurse is caring for a patient who appears cachectic and pale but appears in no acute distress. The patient tells the nurse that he has had a chronic cough for months and produces a large amount of foul-smelling sputum. He also states that he occasionally suffers from a stabbing pain when taking a deep breath. When reviewing the patient's history, the nurse notes that the patient has a recent history of influenza. Breath sounds reveal decreased sound with rhonchi to the right lower lobe and percussion to the right lower lobe is dull. What procedure does the nurse anticipate preparing for? 1 Administration of a bronchodilator 2 Insertion of a thoracentesis needle and drainage 3 Intubation and initiation of mechanical ventilation 4 Placement of a nasogastric tube and tube feedings

2

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? 1 Cough 2 Joint pain 3 Chest pain 4 Night sweats

2

A patient reports severe coughing for the last few weeks. The patient reports coughing long and hard with vomiting. What disease does the nurse suspect that this patient may have? 1 Anthrax 2 Pertussis 3 Pneumonia 4 Coccidioidomycosis

2

A patient with asthma reports diarrhea and vomiting. Which drug should be used with caution? 1 Ribavirin 2 Zanamivir 3 Amantadine 4 Rimantadine

2

A patient with pneumonia is producing a smaller volume of thicker secretions than the day before. The patient is receiving intravenous antibiotics. What action does the nurse take? 1 Monitor peak flow levels every 4 hours. 2 Encourage the patient to drink more fluids. 3 Request an order to switch to an oral antibiotic. 4 Reassure the patient that the infection is improving.

2

A patient with pulmonary tuberculosis is being started on combination therapy. What does the nurse explain to the patient as the purpose of combination therapy? 1 To allow for missed doses 2 To shorten therapy by 6 months 3 To treat highly resistant cases of tuberculosis 4 To improve the patient's ability to tolerate medications

2

An older patient presents to the emergency department (ED) with a 2-day history of cough, pain on inspiration, shortness of breath, and dyspnea. The patient never had a pneumococcal vaccine. The patient's chest x-ray shows density in both bases. The patient has wheezing upon auscultation of both lungs. Would a bronchodilator be beneficial for this patient? 1 It would not be beneficial for this patient. 2 It would help decrease the bronchospasm. 3 It would decrease the patient's pain on inspiration. 4 It would clear up the density in the bases of the patient's lungs.

2

Stroke patients are at high risk for pneumonia related to what condition? 1 Helminths 2 Aspiration 3 Inhalation 4 Mycoplasmas

2

The nurse is caring for a patient who has just been diagnosed with pulmonary tuberculosis and will be discharged with a prescription for isoniazid 300 mg orally each day. At what time should the nurse teach this patient to take this medication? 1 An hour before bedtime 2 An hour before breakfast 3 Immediately after breakfast 4 Immediately before breakfast

2

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? 1 Side-lying 2 Sitting in tripod position 3 Prone with head of bed at 30° angle 4 Supine with head of bed at 45° angle

2

The nurse is caring for a patient with low-grade fever, fatigue, mild chest pain, and a dry cough. The patient does not have a sore throat or rhinitis. When asked about travel history, the patient tells the nurse about a recent trip to volunteer at a livestock farm. What is the nurse's priority action? 1 Ordering sputum cultures 2 Beginning antibiotic therapy 3 Ordering PCR laboratory testing 4 Prescribing an antifungal agent

2

The nurse is instructing a nursing student on how to prevent pneumonia in an older adult who is receiving mechanical ventilation. Which statement by the student indicates a need for further teaching? 1 "I will suction subglottic secretions every 2 hours and as needed." 2 "I will provide meticulous oral care every 24 hours and as needed." 3 "I should not wear hand jewelry while providing care to this patient." 4 "I should keep the head of the bed elevated at least 30 degrees at all times."

2

The nurse is preparing to admit an adult patient with pertussis. Which symptom does the nurse anticipate finding in this patient? 1 Hemoptysis 2 Post-cough emesis 3 Mild cold-like symptoms 4 "Whooping" after a cough

2

The nurse is providing health education to a patient regarding ways to prevent influenza. Which statement made by the patient shows effective learning? 1 "I will refrain from taking drugs for at least 2 weeks." 2 "I will refrain from attending public meetings if I feel I am getting sick." 3 "I will refrain from giving non-perishable food for at least 2 weeks to all the family members." 4 "I will refrain from paying attention to public health announcements for disease outbreaks."

2

The nurse is teaching a patient newly diagnosed with tuberculosis (TB) about the medication and treatment regimen for this disease. What information does the nurse include when teaching this patient? 1 Most people can be effectively treated with one or two medications. 2 Avoid alcohol while taking the medications unless the provider says otherwise. 3 Do not participate in even nonstrenuous exercise while taking these medications. 4 Have the skin test repeated periodically to evaluate the drug therapy's effectiveness.

2

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? 1 Viral 2 Lobar 3 Bronchial 4 Bacterial

2

Which of these patients should the charge nurse assign to the LPN/LVN working on the medical-surgical unit? 1 Patient with group A beta-hemolytic streptococcal pharyngitis who has stridor 2 Patient with pulmonary tuberculosis who is receiving multiple medications 3 Patient with sinusitis who has just arrived after having endoscopic sinus surgery 4 Patient with tonsillitis who has a thick-sounding voice and difficulty swallowing

2

he community health nurse is planning tuberculosis treatment for a patient who is homeless and heroin-addicted. Which action will be most effective in ensuring that the patient completes treatment? 1 Have the patient repeat medication names and side effects. 2 Arrange for a health care worker to watch the patient take the medication. 3 Give the patient written instructions about how to take prescribed medications. 4 Instruct the patient about the possible consequences of nonadherence.

2

n older patient with pneumonia has become more confused during the initial assessment. What action should the nurse take initially? 1 Notify the Rapid Response Team. 2 Assess the patient's oxygen saturation. 3 Evaluate orientation to person, place, and time. 4 Request a nebulized bronchodilator medication.

2

A patient reports severe headache, nausea , and vomiting for one full day. Which drugs would be most effective in the patient? Select all that apply. 1 Ribavirin 2 Zanamivir 3 Oseltamivir 4 Amantadine 5 Rimantadine

2, 3

When widely distributed during a pandemic flu, which drugs reduce the severity of infection and mortality rate? Select all that apply. 1 Vepacel 2 Zanamivir 3 Oseltamivir 4 Ethambutol 5 Pyrazinamide

2, 3

What information is important to share with a patient who is being discharged after treatment for pneumonia? Select all that apply. 1 Resume regular activities 2 Get an annual influenza immunization 3 Avoid contact with all persons with colds or influenza 4 Stop or reduce any intake of tobacco and tobacco products 5 Because you have had pneumonia, you won't need a pneumococcal vaccination

2, 3, 4

What recommendations will the nurse make for a patient and his or her family about the prevention of pneumonia? Select all that apply. 1 Get plenty of exercise. 2 Avoid indoor pollutants. 3 Eat a healthy, balanced diet. 4 Drink at least 1 L of fluid a day. 5 Avoid crowded areas during flu season and holidays.

2, 3, 5

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. 1 Sore throat 2 Tachycardia 3 Nasal drainage 4 Crackles upon auscultation 5 Diminished chest expansion

2, 4, 5

n older adult patient presents with a persistent cough, fever, night sweats, and mucopurulent sputum. What should be the first line drug therapies used in treatment? Select all that apply. 1 Rifampin (RIF) 700 mg orally daily 2 Isoniazid (INH) 300 mg orally daily 3 Pyrazinamide 2500 mg twice a week 4 Pyrazinamide (PZA) 1500 mg orally daily 5 Ethambutol (EMB) 3000 mg twice a week

2, 4, 5

The nurse is providing health education to an older adult patient to prevent pneumonia. Which statements made by the patient demonstrate a need for further teaching? Select all that apply. 1 "I will refrain from smoking." 2 "I will refrain from drinking nonalcoholic fluids." 3 "I will refrain from exposure to indoor pollutants." 4 "I will refrain from going to public areas during flu season." 5 "I will refrain from obtaining the pneumococcal vaccination."

2, 5

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? 1 "You should get the pneumococcal polysaccharide vaccine." 2 "Stay away from large groups of people, especially children." 3 "See your health care provider at the first sign of respiratory infection." 4 "Ask your health care provider to prescribe prophylactic antibiotics."

1

A 75-year-old patient tells the nurse he is not planning to receive a "flu shot" this year because the shot makes him sick. What is the nurse's best response? 1 "The injectable flu vaccine is not a live virus and cannot cause influenza." 2 "If you had a 'flu shot' last year, you should still have immunity to influenza." 3 "If the shot makes you sick, your provider can order an antiviral medication." 4 "The virus in the injection is attenuated, meaning it can cause mild symptoms."

1

A nurse is caring for a patient with chronic obstructive pulmonary disease (COPD). The patient's 52-year-old caregiver asks the nurse if she should receive an annual influenza vaccination. What is the nurse's best response? 1 "Yes, you should receive the influenza vaccination by injection and should receive it every year." 2 "Yes, as long as you are healthy you can receive the intranasal spray influenza vaccine every year." 3 "No, as long as the patient has received the influenza vaccination by injection, you do not need it every year." 4 "No, as long as you are healthy you do not have an increased risk of spreading or becoming infected with influenza."

1

The nurse has been instructed to administer tuberculosis (TB) medication to a patient who has been noncompliant by directly observed therapy. Which statement by the nurse will assist the patient in understanding this therapy? 1 "You must swallow your pills in front of me." 2 "It is necessary for you to call me right after you take your medications." 3 "I will check your pill bottles every day to make sure you are taking your medications." 4 "I will meet you at the pharmacy to make sure you are picking up the correct prescriptions."

1

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? 1 The patient reports that the cough has lasted more than 3 weeks. 2 The patient states that sometimes it seems like he is wheezing when he coughs. 3 The patient states that the cough is caused by a "tickle" in the back of the throat. 4 The patient says that the cough is productive with green and yellow colored sputum.

1

The nurse is caring for a pediatric patient with pertussis who is currently in the catarrhal phase of the illness. What manifestations will the nurse most likely find on assessment of this patient? 1 Mild cough 2 Severe cough 3 Bloody sputum 4 Pneumonia on chest x-ray

1

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? 1 "People are infectious to others only when symptoms are present." 2 "As soon as drug therapy is initiated, your parent will not be contagious." 3 "Since you have had prolonged contact with your parent, you are most likely infected." 4 "You will need to begin treatment for TB since you have been exposed to your parent."

1

The nurse is planning care for an 80-year-old long-term care patient who takes a histamine-2 blocker and who is confused most of the time. To help prevent pulmonary infection in this patient, which nursing action is included in the plan of care? 1 Assist the patient with all oral intake. 2 Provide postural drainage every 8 hours. 3 Administer prophylactic antibiotic medications. 4 Request an order for bronchodilator medications.

1

The nurse is providing teaching to a patient who has been diagnosed with bacterial rhinosinusitis. Which instruction does the nurse include when teaching this patient about his diagnosis? 1 "Be sure to complete the full course of antibiotics." 2 "Fluid should be restricted to prevent excess mucous production." 3 "Decongestants may cause rebound rhinitis and should be avoided." 4 "Facial pain that is worse when bending forward is abnormal and should be reported to your provider."

1

The nurse is reviewing home care instructions for a patient diagnosed with acute viral rhinitis. Which medication order does the nurse question? 1 Antibiotic 2 Antipyretic 3 Decongestant 4 Antihistamine

1

The nurse notices a visitor walking into the room of a patient on airborne isolation with no protective gear. What does the nurse do? 1 Provides a mask to the visitor 2 Ensures that the patient is wearing a mask 3 Provides a particulate air respirator to the visitor 4 Tells the visitor that the patient cannot receive visitors at this time

1

What is a key difference between seasonal influenza and pandemic influenza? 1 Pandemic influenza has the potential to spread globally because of its highly infectious nature in humans. 2 Seasonal influenza is caused by viral infections; pandemic influenza is more likely to be bacterial in nature. 3 People over the age of 50 who have chronic illness should be vaccinated yearly to decrease the risk of pandemic influenza. 4 Humans have a natural resistance to viral infections found in animals and birds and do not require immunization against pandemic influenza.

1

Which disorder of the lungs may feature a distinct "whooping" sound in children that may not be present in adults? 1 Pertussis 2 Tuberculosis 3 Inhalation anthrax 4 Coccidioidomycosis

1

Which may be the most common feature of pneumonia and lung abscesses? 1 Pleuritic chest pain 2 Rust-colored sputum 3 Foul-smelling sputum 4 Mucopurulent sputum

1

Which method is the best way to prevent outbreaks of pandemic influenza? 1 Early recognition and quarantine 2 Avoiding public gatherings at all times 3 Widespread distribution of antiviral drugs 4 Vaccinating everyone with pneumonia vaccine

1

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. 1 "Take a daily multivitamin." 2 "Avoid alcoholic beverages." 3 "Do not wear contact lenses." 4 "It is important to use contraceptives." 5 "Know the signs and symptoms of gout."

1, 2

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. 1 Anorexia 2 Blood-streaked sputum 3 Menstrual irregularities 4 Sharp chest pain when coughing 5 Nighttime oral temperature greater than 101°F

1, 2, 3

A patient reports pain over the cheek radiating to the teeth and fever, swelling, fatigue, ear pressure, referred pain to the temple, and general facial pain that is worse when bending forward. Upon assessment, the nurse finds erythema and tenderness to percussion over the sinuses. Which medications does the nurse anticipate will be beneficial for the patient? Select all that apply. 1 Ibuprofen 2 Amoxicillin 3 Phenylephrine 4 Diphenhydramine 5 Chlorpheniramine

1, 2, 3

Which actions known as the "ventilator bundle" have been shown to reduce the incidence of ventilator-associated pneumonia (VAP)? Select all that apply. 1 Oral care 2 Hand hygiene 3 Head-of-bed elevation 4 Equipment decontamination 5 Careful monitoring of oxygen levels

1, 2, 3

A patient with tuberculosis (TB) who is homeless and has been living in shelters for the past 6 months asks the nurse why he must take so many medications. What information will the nurse provide in answering this question? Select all that apply. 1 Multiple drug regimens destroy organisms as quickly as possible. 2 Combination drug therapy is effective in preventing transmission. 3 Combination drug therapy is the most effective method of treating TB. 4 The use of multiple drugs reduces the emergence of drug-resistant organisms. 5 Combination drug therapy will decrease the length of required treatment to 2 months.

1, 2, 3, 4

Which nursing interventions are focused on preventing the spread of severe acute respiratory syndrome (SARS) caused by coronaviruses? Select all that apply. 1 Using strict airborne isolation techniques 2 Handwashing before and after all patient care 3 Disinfecting contaminated surfaces and equipment 4 Using Contact Precautions with people suspected to have SARS 5 Reporting the occurrence to the Centers for Disease Control and Prevention (CDC)

1, 2, 3, 4

Which statements about pulmonary tuberculosis (TB) are correct? Select all that apply. 1 Infected people are not infectious to others until manifestations of the disease occur. 2 Mycobacterium tuberculosis is transmitted from person to person via the airborne route. 3 An asymptomatic period of up to years or decades can follow the time of primary infection. 4 Foreign immigrants, especially from Mexico, the Philippines, and Vietnam, are at greatest risk. 5 Anergy is not a problem with the use of a TB skin test once a person presents with symptoms.

1, 2, 3, 4

Which pathological findings associated with pneumonia result in an increased respiratory rate and dyspnea? Select all that apply. 1 Pain 2 Anxiety 3 Alveolar consolidation 4 Stimulation of J receptors 5 Pulmonary capillary shunting

1, 2, 4

The nurse is reviewing the influenza criteria to see if a newly admitted patient meets vaccination requirements. Which findings would lead the nurse to recommend that the patient receive the vaccine? Select all that apply. 1 The patient has asthma. 2 The patient has diabetes. 3 The patient is 30 years old. 4 The patient lives in a nursing home. 5 The patient is being treated for cancer.

1, 2, 4, 5

Which assessment findings does the nurse anticipate for the patient suspected of having pneumonia? Select all that apply. 1 Myalgia 2 Dyspnea 3 Bradypnea 4 Bradycardia 5 Hemoptysis

1, 2, 5

Which nursing interventions are critical in caring for individuals with influenza? Select all that apply. 1 Encouraging the patient to rest and increase fluid intake 2 Supporting the patient and preventing the spread of the disease 3 Avoiding the use of oxygen as it has limited benefit and will be more likely to cause toxicity 4 Placing the patient in protective isolation until the patient's immune system fully recovers 5 Monitoring pulse rate and quality and urine output during rehydration in a patient with diarrhea

1, 2, 5

A community health nurse is preparing teaching materials for an upcoming community health fair. What risk factors will the nurse include when teaching about community-acquired pneumonia? Select all that apply. 1 Increased age 2 Increased weight 3 Presence of a chronic condition 4 Administration of influenza vaccine within 3 years 5 Administration of pneumococcal vaccine within 3 years

1, 3, 4

The nurse is discussing pneumonia prevention techniques with a group of adults older than age 60. What information should this nurse tell this group? Select all that apply. 1 Receive an annual influenza vaccination. 2 Drink approximately 1 liter of fluid each day. 3 Avoid interacting with individuals who smoke. 4 Attempt to get 6 to 8 hours of sleep every night. 5 Receive an annual pneumococcal pneumonia vaccination.

1, 3, 4

Which patients should receive education about pneumococcal vaccines? Select all that apply. 1 An adult older than 65 2 A patient who is pregnant 3 A patient who is HIV-positive 4 A patient who has alcoholism 5 A patient with chronic lung disease

1, 3, 4, 5

Which points does the nurse include when educating an older patient and family about pneumonia prevention? Select all that apply. 1 Avoiding dehydration 2 Monitoring blood pressure 3 Avoiding crowded public places 4 Decreasing exposure to air pollutants 5 Receiving an annual influenza vaccine

1, 3, 4, 5

Following a bioterrorism attack with anthrax, the emergency department nurse checks the medication room for ample supply of which medications? Select all that apply. 1 Rifampin 2 Gentamicin 3 Amoxicillin 4 Vancomycin 5 Doxycycline 6 Ciprofloxacin

1, 3, 4, 5, 6

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. 1 Left lower lobe 2 Left upper lobe 3 Right lower lobe 4 Right upper lobe 5 Right middle lobe

1, 3, 5

The nurse has decided to immediately place a patient in respiratory isolation because the patient is exhibiting which signs/symptoms of the prodromal (early) stage of inhalation anthrax? Select all that apply. 1 Fever 2 Diaphoresis 3 Mild chest pain 4 Pleural effusion 5 Mediastinal "widening" (chest x-ray)

1, 3, 5

A patient has been diagnosed with community-acquired pneumonia (CAP). What risk-factors are associated with CAP? Select all that apply. 1 Use of tobacco 2 Recent aspiration 3 History of chronic lung disease 4 Pneumococcal vaccine more than 5 years ago 5 Presence of gram-negative colonization of the mouth and throat

1, 4

An older adult patient was diagnosed with influenza 1 week ago. What direction should the nurse include in the teaching plan for the patient? Select all that apply. 1 Increase fluid intake. 2 Increase daily caloric intake. 3 Humidity can worsen symptoms. 4 Avoid the use of diphenhydramine. 5 Use appropriate hand-washing techniques.

1, 4, 5

What questions should the nurse ask to determine an older adult patient's risk for developing pneumonia? Select all that apply. 1 "Do you have a habit of smoking?" 2 "Do you have a history of hypertension?" 3 "Do you have any family history of lung disease?" 4 "Have you had a pneumococcal vaccination in the last 3 years?" 5 "Have you had any symptoms of influenza in the previous months?"

1, 4, 5

What signs and symptoms does the nurse anticipate to find in a patient diagnosed with tuberculosis? Select all that apply. 1 Lethargy 2 Dyspnea 3 Weight gain 4 Night sweats 5 Low-grade fever

1, 4, 5

A nurse is caring for a patient who is orally intubated and mechanically ventilated. The nurse understands that this patient is at an increased risk for developing ventilator associated pneumonia. When planning care for this patient, what pathophysiological concepts regarding an artificial airway does the nurse recognize as a contributing factor to the development of this condition? Select all that apply. 1 It bypasses the protective airway mechanisms 2 It alters and decreases the body's immune response 3 It prevents adequate gas exchange at the cellular level 4 It causes a hyperactive reaction of the mucociliary clearance 5 It allows aspiration of secretions from the oropharynx and stomach

1, 5

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. 1 Chest x-ray 2 Mantoux test 3 Sputum culture 4 Needle biopsy of lung 5 QuantiFERON-TB Gold test

1, 5

Which groups are at greatest risk for drug-resistant Streptococcus pneumoniae? Select all that apply. 1 Individuals older than age 65 years 2 Those who have aspirated acidic stomach contents 3 People who have not received an influenza vaccine 4 People who have traveled outside the United States 5 Older adults exposed to children from a daycare environment

1, 5

A 76-year-old patient who is recovering from influenza A reports severe dry mouth and constipation. After reviewing the patient's medication list, the nurse suspects the patient is experiencing the anticholinergic effect of which medication? 1 Oseltamivir 2 Hydroxyzine 3 Phenylephrine 4 Cephalosporin

2

A febrile patient presents to the emergency department with a headache, chills, fatigue, nausea, vomiting, and diarrhea. What illness does the nurse suspects that the patient has? 1 Influenza A 2 Influenza B 3 Influenza C 4 Influenza AB

2

A patient admitted to the hospital with an exacerbation of chronic obstructive pulmonary disease (COPD) and chronic malnutrition develops a cough, a temperature of 39°C, an oxygen saturation of 94%, and crackles in both lungs. Which action would the nurse take first? 1 Provide supplemental oxygen. 2 Request an order for a chest x-ray. 3 Monitor closely for respiratory failure. 4 Ask the provider to order a complete blood count.

2

A patient comes to the emergency department with a sore throat. Examination reveals redness and swelling of the pharyngeal mucous membranes. Which diagnostic test does the nurse expect will be requested first? 1 Chest x-ray 2 Throat culture 3 Tuberculosis (TB) skin test 4 Complete blood count (CBC)

2

A patient who has acute viral rhinitis cares for an older family member who is susceptible to respiratory infections. Which action does the nurse suggest to this patient to help prevent the spread of infection? 1 "Get an influenza vaccine immediately." 2 "Thoroughly wash hands after touching the face." 3 "Complete the full course of antibiotic medication." 4 "Wear a mask while providing care to the family member."

2

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? 1 Metronidazole, acyclovir, flunisolide, rifampin 2 Isoniazid, rifampin, pyrazinamide (PZA), ethambutol 3 Prednisone, guaifenesin, ketorolac, pyrazinamide (PZA) 4 Salmeterol, cromolyn sodium, dexamethasone, isoniazid

2

A patient with a recent diagnosis of bacterial pharyngitis caused by group A streptococcal infection calls the health care provider stating his has developed a cough, fever, chills, shortness of breath, and severe chest pain. Which complication does the nurse suspect? 1 Mastoiditis 2 Pneumonia 3 Rheumatic fever 4 Acute glomerulonephritis

2

What consideration is important for the nurse to remember when managing the care of a patient with hospital-acquired pneumonia? 1 Provide suctioning as needed. 2 Monitor for early signs of sepsis. 3 Provide stress ulcer prophylaxis. 4 Elevate the head of the bed at least 30 degrees.

2

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. 1 "Refrain from wearing soft contact lenses." 2 "Refrain from drinking alcoholic beverages." 3 "Refrain from taking the drug on an empty stomach." 4 "Drink at least 8 ounces of water when you take the medication." 5 "Report yellowing of the skin and any darkened urine immediately."

2, 5

A clinic nurse is providing teaching for a patient who has been diagnosed with a peritonsillar abscess. What does the nurse include in this patient's teaching? 1 "Gargling with warm saline may make discomfort worse." 2 "Take the prescribed antibiotics until the swelling subsides." 3 "Go to the emergency department if drooling or stridor occur." 4 "A tonsillectomy will be necessary when the acute infection is past."

3

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? 1 "The organism that causes SARS is resistant to all antibiotics." 2 "I will notify the provider to see if an antibiotic can be ordered." 3 "Antibiotics are not effective because SARS is caused by a virus." 4 "Antibiotics are usually given when the disease becomes more severe."

3

A local hunter is admitted to the intensive care unit with a diagnosis of inhalational anthrax. Which medications does the RN anticipate the health care provider will order? 1 Ceftriaxone 2 g IV every 8 hours 2 Amoxicillin 500 mg orally every 8 hours 3 Ciprofloxacin 400 mg IV every 12 hours 4 Pyrazinamide (PZA) 1000 to 2000 mg orally every day

3

A newly admitted patient with pneumonia has an oral temperature of 102°F, an oxygen saturation of 93%, diminished breath sounds bilaterally, and the patient is unable to cough effectively. The nurse has received orders for oxygen therapy, intravenous antibiotics, antipyretic medication, and sputum specimen collection. What should be the nurse's first action? 1 Provide humidified oxygen. 2 Obtain the sputum specimen. 3 Give the intravenous antibiotic. 4 Administer the antipyretic medication.

3

A nurse is diagnosed with seasonal influenza, and on the second day of treatment with oseltamivir, she asks the supervising nurse when she may return to work on a hospital unit. What does the supervising nurse tell her? 1 "You will need to remain off work for 2 weeks or longer." 2 "After initiation of antiviral therapy, you are no longer contagious." 3 "If you are feeling well and afebrile in 5 days, you may return to work." 4 "When you have a negative influenza test, you will be cleared for work."

3

A patient is admitted with a diagnosis of avian influenza (H5N1). For which symptoms specific to avian influenza does the nurse assess the patient? 1 Cough, sore throat, and fever 2 Fever, sore throat, and nasal drainage 3 Shortness of breath, diarrhea, and bleeding 4 Shortness of breath, fever, and nasal drainage

3

A patient is being treated with ciprofloxacin 500 mg PO twice daily due to possible exposure to inhalation anthrax. What is the nurse's bestanswer when the patient asks how long this medication must be taken? 1 "You will need to take the medication for 10 days." 2 "You will need to take the medication for at least a year." 3 "You will need to take the medication for about 2 months." 4 "You will need to take the medication for at least 6 months."

3

A patient is taking isoniazid, rifampin, pyrazinamide, and ethambutol for tuberculosis. The patient calls to report visual changes, including blurred vision and reduced visual fields. Which medication may be causing these changes? 1 Rifampin 2 Isoniazid 3 Ethambutol 4 Pyrazinamide

3

A patient returns to the provider's office three weeks after being diagnosed with pneumonia. The nurse notes that the patient reports fatigue, weakness, and cough. The patient is concerned the pneumonia is returning. What is the best action the nurse should take? 1 Arrange for the patient to be readmitted to the hospital. 2 Assess for patient noncompliance to treatment regimen. 3 Assure the patient that recovery from pneumonia is a long process. 4 Arrange for the patient to receive another treatment of anti-infective medications.

3

A patient taking ethambutol for tuberculosis is receiving discharge teaching from the nurse. What is the most important sign or symptom of a serious adverse reaction to this medication that the nurse should teach this patient? 1 Fatigue 2 Anorexia 3 Changes in vision 4 Aching of the feet

3

A patient who has recently traveled to Vietnam comes to the emergency department with fatigue, lethargy, bloody sputum, night sweats, and a low-grade fever. What is the nurse's first action? 1 Perform a TB skin test 2 Test all family members for TB 3 Place a respiratory mask on the patient 4 Contact the health care provider for tuberculosis (TB) medications

3

A patient with a history of pain and difficulty swallowing ignored the symptoms and later developed neck swelling, muffled voice, and bad breath. What could the original symptoms have been? 1 Untreated rhinitis 2 Untreated sinusitis 3 Untreated tonsillitis 4 Untreated pharyngitis

3

A patient with pneumonia caused by aspiration after alcohol intoxication has just been admitted. The patient is febrile and agitated. Which health care provider order should the nurse implement first? 1 Administer levofloxacin 500 mg IV. 2 Give lorazepam as needed for agitation. 3 Draw aerobic and anaerobic blood cultures. 4 Refer to social worker for alcohol counselling.

3

A patient with pneumonia has a cough productive of thick green mucus, is in bed with the head of bed elevated to 30 degrees, and has an oxygen saturation of 94% with 3 L/min of oxygen via nasal cannula. The nurse notes that the patient is anxious and tense. Which is the priority nursing action for this patient? 1 Increasing the oxygen flow to 4 L/min 2 Placing the patient in an upright position 3 Using a calm, slow approach with the patient 4 Telling the patient to relax and take deep breaths

3

A public health nurse is providing education to a community about preparation for a possible influenza epidemic leading to a worldwide pandemic. What does the nurse instruct community members to do upon learning that an influenza outbreak has occurred? 1 Attend meetings to learn how to manage the outbreak. 2 Take antiviral medications to prevent developing symptoms. 3 Obtain a vaccine if not already vaccinated against influenza. 4 Stock their homes with a 2-week supply of food and medicine.

3

An older adult resident in a long-term care facility becomes confused and agitated, telling the nurse "Get out of here! You're going to kill me!" Which action should the nurse take first? 1 Give the prescribed PRN lorazepam. 2 Do a complete neurologic assessment. 3 Check the resident's oxygen saturation. 4 Notify the resident's primary care provider.

3

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? 1 Vomiting 2 Productive cough 3 Recent onset of confusion 4 Oral temperature of 101.1°F

3

The nurse is teaching a patient about isoniazid (INH) and rifampin (RIF) drug therapy for tuberculosis (TB). The nurse instructs that while on these medications, the patient should avoid consuming which food? 1 Eggs 2 Dairy 3 Alcohol 4 Red meat

3

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? 1 Tonsillitis 2 Pharyngitis 3 Peritonsillar abscess 4 Retropharyngeal abscess

3

Which combination of personal protective equipment does the nurse wear when caring for a patient with severe acute respiratory syndrome (SARS)? 1 Gloves, gown, mask 2 Gloves, mask, goggles 3 Gloves, gown, goggles, mask 4 Gloves, gown, head cover, goggles

3

Which manifestation in an older patient is the most common indicator for pneumonia? 1 Fever 2 Cough 3 Confusion 4 Increased white blood cell count

3

While performing an assessment of a patient, the nurse notes that the patient has progressive fatigue, anorexia, weight loss, irregular menses, and a low-grade fever. Which condition does the nurse suspect in the patient? 1 Pharyngitis 2 Pneumonia 3 Tuberculosis 4 Rhinosinusitis

3

A patient has recently been released from prison and has just tested positive for tuberculosis (TB). What teaching points does the community health nurse want to stress for this patient regarding medications? Select all that apply. 1 These medications may cause kidney failure. 2 These medications must be taken for 2 years. 3 The medications may cause nausea. The patient should take them at bedtime. 4 The patient is generally not contagious after 2 to 3 consecutive weeks of treatment. 5 Not taking the medication could lead to an infection that is difficult to treat or to total drug resistance.

3, 5

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? 1 Fever 2 Fatigue 3 Dry cough 4 Hypotension

4

A patient with pneumococcal pneumonia is being treated with intravenous antibiotics. On the fifth day of treatment, the nurse notes a productive cough with white mucus. Which action should the nurse take? 1 Ask the provider for an order for nebulized albuterol. 2 Report the patient's worsening condition to the provider. 3 Request an order for a stronger antibiotic to combat bacterial resistance. 4 Continue the current plan of care and reassess the patient periodically.

4

A previously infected patient with a dormant tuberculosis (TB) infection has experienced a reactivation of the disease. Which was likely a factor in this occurrence? 1 Fracture of a rib 1 week ago 2 Allergy testing 6 months ago 3 Pneumonia vaccine 2 months ago 4 Taking prednisone for the past 3 weeks

4

A young adult patient refuses an influenza vaccine, saying, "I'm healthy and won't get that sick if I get the flu." Which is the bestresponse by the nurse? 1 "If you get the flu, you can always take an antiviral medication." 2 "Not getting the vaccine increases the chances of a worldwide pandemic." 3 "If a flu pandemic begins, you should get the vaccine immediately." 4 "You may spread the disease to people who are more at risk for severe symptoms."

4

Community health nurses are tasked with providing education on the prevention of respiratory infection for diseases such as the flu. Which target audience is given the highest priority? 1 Politicians 2 Hospital staff 3 Homeless people 4 Prison staff and inmates

4

The nurse is caring for a patient with severe acute respiratory syndrome (SARS). What is the most important precaution the nurse should take when preparing to suction this patient in order to prevent contracting the infection? 1 Performing oral care after suctioning the oropharynx 2 Keeping the head of the bed elevated 30 to 45 degrees 3 Washing hands and donning gloves prior to the procedure 4 Wearing a disposable particulate mask respirator and protective eyewear

4

The nurse is caring for a pregnant patient who has a coccidioidomycosis fungal infection, which is also known as "valley fever." What medication would most likely be ordered for this patient? 1 Amoxicillin IV 2 Fluconazole PO 3 Ketoconazole PO 4 Amphotericin B IV

4

The nurse is counseling a young woman about drug therapy with isoniazid and rifampin to treat tuberculosis. Before developing the teaching plan, what must the nurse assess for first? 1 History of gout 2 Color blindness 3 Susceptibility to sunburn 4 Contraceptive methods used

4

The nurse is performing an admission assessment on a 90-year-old patient and notes confusion with poor orientation to person, place, and time. The patient's daughter tells the nurse that this isn't normal. Which initial action should the nurse take? 1 Contact the provider to request an order for an intravenous antibiotic. 2 Notify the provider and request orders for serum electrolytes and kidney function tests. 3 Reassure the daughter that confusion is common in older patients who are admitted to the hospital. 4 Perform a detailed respiratory assessment including lung sounds, pulse oximetry, and temperature.

4

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? 1 Have your antibiotics refilled if you begin to feel ill. 2 It is normal for you to feel worse before you feel better. 3 Contact the health care practitioner for mild chest pain. 4 Seek medical attention immediately if you begin to feel breathless.

4

The nurse is preparing a patient for discharge who has undergone percutaneous needle aspiration of a peritonsillar abscess. Which is most important to teach the patient about follow-up care? 1 Using warm saline gargles and irrigations 2 Taking pain medications every 4 to 6 hours 3 Completing the antibiotic medication regimen 4 Contacting the provider if the throat feels more swollen

4

The nurse is reviewing the cultures of an outpatient cancer patient with pneumonia. The nurse notes that the sputum has multidrug-resistant organisms. Based on this finding, the nurse concludes that the patient is most likely infected with what type of pneumonia? 1 Hospital acquired 2 Community acquired 3 Ventilator associated 4 Health care associated

4

Upon assessment of a patient with chest pain, the nurse finds unequal chest expansion, crackles with diminished breath sounds, tachypnea, and a fever. Which laboratory data finding would lead the nurse to believe the patient has pneumonia? 1 WBC 5,100/mm 3 2 WBC 6,500/mm 3 3 WBC 9,500/mm 3 4 WBC 12,000/mm 3

4

What education will be provided for the family of a patient being treated for tuberculosis convalescing at home? 1 Use airborne precautions. 2 Place used tissues in a trash can. 3 Cover your mouth and nose when sneezing. 4 Everyone must undergo tuberculosis testing.

4

What is the nursing priority to provide safe and effective care for the patient with pneumonia? 1 Monitoring for signs of sepsis 2 Assisting with bronchial hygiene 3 Frequently assessing breath sounds 4 Applying principles of infection control

4

Which patient is most at risk for the development of either community- or hospital-acquired pneumonia? 1 An 8-month-old born at 32 weeks gestation 2 A 59-year-old who works in the textile industry 3 A 14-year-old who developed type 1 diabetes at age 9 4 A 76-year-old who has limited mobility because of osteoarthritis

4

Which virus is a strain of the bird flu? 1 H1N7 2 H1N1 3 H1N5 4 H5N1

4

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. 1 Ribavirin 2 Zanamivir 3 Oseltamivir 4 Amantadine 5 Rimantadine

4, 5

Which statements by the patient with rhinitis indicate ineffective learning about reducing the risk of spreading colds? Select all that apply. 1 "I will rest for 10 hours each day." 2 "I will dispose of tissues immediately after use." 3 "I will wash my hands after coughing, sneezing, and nose blowing." 4 "I will stop my cough reflex when I am in a crowded place or with the family." 5 "I will have minimal contact with people who have chronic respiratory problems."

4, 5