Infection Quiz Questions

The nurse suspects the client is developing postoperative pneumonia. Which clinical manifestation would support the nurse's conclusion? Select all that apply. Wheezes Chills Crackles Afebrile Tachypnea

Chills Crackles Tachypnea

A client is admitted to the facility with a productive cough, night sweats, and a fever. Which action is most important in the initial care plan? Assessing the client's temperature every 8 hours Placing the client in respiratory isolation Monitoring the client's fluid intake and output Wearing gloves during all client contact

Placing the client in respiratory isolation

The nurse understands that a client with diabetes mellitus is at greater risk for developing which of the following complications? Low blood pressure Urinary tract infections Lifelong obesity Elevated triglycerides

Urinary tract infections

The nurse is caring for an older adult client suspected of having a urinary tract infection. The nurse should assess for what finding specifically associated with the development of this condition in the older adult? Dysuria Nausea Acute confusion High fever

Acute confusion

A nurse is performing a respiratory assessment on a client with pneumonia. She asks the client to say "ninety-nine" several times. Through her stethoscope, she hears the words clearly over his left lower lobe. What term should the nurse use to document this finding? Bronchophony Tactile fremitus Crepitation Egophony

Bronchophony

An 87-year-old client has been hospitalized with pneumonia. Which nursing action would be a priority in this client's plan of care? Nasogastric intubation Administration of probiotic supplements Bed rest Cautious hydration

Cautious hydration

The nurse at the diabetes clinic is instructing a client who is struggling with compliance to the diabetic diet. When discussing disease progression, which manifestation of the disease process on the urinary system is most notable? Clients have frequent urinary tract infections. Clients develop a neurogenic bladder. Clients have urinary frequency. Clients have chronic renal failure.

Clients have chronic renal failure.

The nurse is caring for an older client whose chart reveals that the client has a reversible cause of urinary incontinence. The nurse creates a plan of care for which condition? Asthma Bladder cancer Constipation Decreased progesterone levels

Constipation

Which is a reversible cause of urinary incontinence in the older adult? Increased fluid intake Age Constipation Decreased progesterone levels in menopausal women

Constipation

A client who is septic has started shivering violently. Which nursing intervention is necessary to care for this client? Control the shivering. Place the client on a warming blanket. Keep the client dry and covered. Maintain the client in a supine position with legs elevated 12 inches.

Control the shivering.

A nurse is evaluating education provided to various clients being discharged to home. The nurse assesses that client most likely to be nonadherent with treatment is the one who Has tuberculosis and is taking multiple antitubercular medications Has pneumonia and is prescribed an oral antibiotic Had abdominal surgery and will be changing the dressing daily Has a duodenal ulcer and is prescribed a histamine-2 receptor blocker

Has tuberculosis and is taking multiple antitubercular medications

The intensive care unit nurse is caring for a client with sepsis whose tissue perfusion is declining. What sign would indicate to the nurse that end-organ damage may be occurring? Urinary output increases Skin becomes warm and dry Adventitious lung sounds occur in the upper airway Heart and respiratory rates are elevated

Heart and respiratory rates are elevated

An older adult patient is in the hospital being treated for sepsis related to a urinary tract infection. The patient has started to have an altered sense of awareness, profound dehydration, and hypotension. What does the nurse suspect the patient is experiencing? Systemic inflammatory response syndrome Hyperglycemic hyperosmolar syndrome Multiple-organ dysfunction syndrome Diabetic ketoacidosis

Hyperglycemic hyperosmolar syndrome

A nurse is caring for a client who has arrived at the emergency department in shock. The nurse intervenes based on the knowledge that which of the following is the most common cause of shock? Anaphylaxis Sepsis Hypovolemia Cardiac dysfunction

Hypovolemia

A nurse is preparing an education program about renal disease. Which risk factor should the nurse include when teaching? Select all that apply. Hypotension Immobility Spinal cord injury Sickle-cell anemia Seizures

Immobility Spinal cord injury Sickle-cell anemia

A nurse is caring for a client who was admitted with pneumonia, has a history of falls, and has skin lesions resulting from scratching. The priority nursing diagnosis for this client should be: Risk for falls. Ineffective breathing pattern. Impaired tissue integrity. Ineffective airway clearance.

Ineffective airway clearance.

The assessment of a client admitted with increased ascites related to cirrhosis reveals the following: pulse 86 beats per minute and weak, respirations 28 breaths per minute, blood pressure 130/88 mm Hg, and pulse oximetry 90%. Which nursing diagnosis should receive top priority? Fatigue Excess fluid volume Ineffective breathing pattern Imbalanced nutrition: less than body requirements

Ineffective breathing pattern

The clinic nurse is doing a preoperative assessment of a client who will be undergoing outpatient cataract surgery with lens implantation in 1 week. While taking the client's medical history, the nurse notes that this client had a kidney transplant 8 years ago and that the client is taking immunosuppressive drugs. For what is this client at increased risk when having surgery? Rejection of the kidney Rejection of the implanted lens Infection Adrenal storm

Infection

A nurse who provides care in a long-term care facility is aware of the high incidence and prevalence of urinary tract infections among older adults. What action has the greatest potential to prevent UTIs in this population? Administer prophylactic antibiotics as prescribed. Limit the use of indwelling urinary catheters. Encourage frequent mobility and repositioning. Toilet residents who are immobile on a scheduled basis.

Limit the use of indwelling urinary catheters.

The nurse is caring for a client newly diagnosed with sepsis. The client has a serum lactate concentration of 6 mmol/L and fluid resuscitation has been initiated. Which value indicates that the client has received adequate fluid resuscitation? Central venous pressure of 6 mm Hg Mean arterial pressure of 70 mm Hg Urine output of 0.2 mL/kg/hr ScvO2 of 60%

Mean arterial pressure of 70 mm Hg

The nurse is caring for a client with a cystoscopy tube draining urine from the bladder. When reviewing the client's history prior to administering care, which is of most concern? Diagnostic studies reporting bladder stones Crusted drainage around the cystoscopy tube A white blood count of 12,000 cells/mm3 New diagnosis of urosepsis

New diagnosis of urosepsis

Sepsis can cause massive vasodilation. Fluid leaves the vasculature and goes into the interstitial space (third space). Since fluid is sitting in the interstitial space instead of the vessels, the tissues have poor perfusion. So, we give the patient rather a large amount of isotonic IV fluid such as: D5 1/2 NS D5LR Normal saline 0.45% NS

Normal saline

A gerontologic nurse is teaching a group of medical nurses about the high incidence and mortality of pneumonia in older adults. What is a contributing factor to this that the nurse should describe? Older adults have less compliant lung tissue than younger adults. Older adults are not normally candidates for pneumococcal vaccination. Older adults often lack the classic signs and symptoms of pneumonia. Older adults often cannot tolerate the most common antibiotics used to treat pneumonia.

Older adults often lack the classic signs and symptoms of pneumonia.

A critical care nurse is aware of the high incidence of ventilator-associated pneumonia (VAP) in clients who are being treated for shock. What intervention should be specified in the client's plan of care while the client is ventilated? Performing frequent oral care Maintaining the client in a supine position Suctioning the client every 15 minutes unless contraindicated Administering prophylactic antibiotics, as prescribed

Performing frequent oral care

The nurse is caring for a client who has been admitted for the treatment of AIDS. In the morning, the client tells the nurse that he experienced night sweats and recently "coughed up some blood." What is the nurse's most appropriate action? Assess the client for additional signs and symptoms of Kaposi sarcoma. Review the client's most recent viral load and CD4+ count. Place the client on respiratory isolation and inform the physician. Perform oral suctioning to reduce the client's risk for aspiration.

Place the client on respiratory isolation and inform the physician.

During a preadmission assessment, the nurse finds increased tactile fremitus. She knows this sign is consistent with which of the following diagnoses? Bronchitis Emphysema Atelectasis Pneumonia

Pneumonia

Nursing students are reviewing the changing patterns of disease. The students demonstrate a need for additional review when they identify which condition as being on the rise? Acquired immunodeficiency syndrome Tuberculosis Pneumonia Sexually transmitted infections

Pneumonia

The nurse is reviewing the electronic health record of a client with an empyema. What health problem in the client's history is most likely to have caused the empyema? Smoking Asbestosis Pneumonia Lung cancer

Pneumonia

The nurse reviews the results of a client's ventilation-perfusion (V/Q) scan. For which condition will the nurse plan care when the ventilation-perfusion ratio is less than 0.80? Pneumonia Cardiogenic shock Pulmonary emboli Pulmonary infarction

Pneumonia

A 75-year-old client had surgery for a left hip fracture yesterday. When completing the plan of care, the nurse should include assessment for which complications? Select all that apply. Pneumonia Necrosis of the humerus Skin breakdown Sepsis Delirium

Pneumonia Skin breakdown Sepsis Delirium

An older adult reports urinary incontinence that has been occurring for years. On which areas will the nurse focus when assessing this client's concern? Select all that apply. Polyuria Infection Dizziness Dehydration Respiratory rate

Polyuria Infection Dehydration

Regarding pneumonia, the most common bacterial causative agent (which happens to also be in the pneumonia vaccine) is: Streptococcus pneumonia Clostridium difficile Escherichia coli salmonella

Streptococcus pneumonia

A client is suspected of sepsis from a postsurgical incision infection. What characteristic of sepsis would the nurse recognize? Select all that apply. Temperature of 102F Heart rate of 120 beats/minute Respiratory rate of 24 breaths/minute PaCO2 of 42 mm Hg Blood pressure of 120/80 mm Hg

Temperature of 102F Heart rate of 120 beats/minute Respiratory rate of 24 breaths/minute

A client has been admitted in the emergency care unit with conditions of respiratory distress and pneumonia. The client's condition worsens and requires mechanical ventilation. While visiting this client in the hospital, the family observes members of the health care team washing their hands upon entering and leaving the room. By implementing recommended hand hygiene measures, which organization's goals is the health care team supporting? The Joint Commission The National Council of State Boards of Nursing (NCSBN) Institute of Medicine (IOM) Agency for Healthcare Research and Quality (AHRQ)

The Joint Commission

A client has been admitted for an outpatient cystoscopy because of a suspected interstitial cystitis. Which statement best describes the pathology of this disorder? The bladder wall contains multiple pinpoint hemorrhagic areas that join and form larger hemorrhagic areas that may progress to fissuring and scarring of the bladder mucosa. It is caused by infection with Chlamydia trachomatis. It is caused by bacterial infection. The surface of the bladder becomes edematous and reddened, and ulcerations may develop. The bladder can contract without warning, fail to accommodate adequate volumes of urine, or fail to empty completely.

The bladder wall contains multiple pinpoint hemorrhagic areas that join and form larger hemorrhagic areas that may progress to fissuring and scarring of the bladder mucosa.

The nurse is caring for a client with respiratory distress caused by pneumonia who recently became homeless after losing his job. He also tells the nurse that the stress of losing both his job and his home has caused his wife to move in with one of their adult children. The nurse hears him say, "I just don't know what to do. I wish I were a better human being. I've never really done anything right." The nurse will attend to this client's needs in what order? The client's respiratory distress The client's homelessness The client's estrangement from his wife The client's feeling about himself The client knowing what to do

The client's respiratory distress The client's homelessness The client's estrangement from his wife The client's feeling about himself The client knowing what to do

A perioperative nurse is conducting an in-service education program about maintaining surgical asepsis during the intraoperative period. Which of the following would the nurse emphasize? The edges of a sterile package, once opened, are considered unsterile. A distance of 3 feet must be maintained when moving around a sterile field. If a tear occurs in a sterile drape, a new sterile drape is applied on top of it. Circulating nurses may come in contact with the sterile field without contaminating it.

The edges of a sterile package, once opened, are considered unsterile.

A patient has been paralyzed from the chest down for 7 years and is diagnosed with pneumonia. The nurse realizes that the patient will need additional support to cope with the infection for what reason? Coping measures become less effective with advancing age. The patient's available coping resources are already being used to manage the problems of immobility. An acute infectious process requires more adaptive mechanisms than a chronic stressor does. This additional physical stressor places unmanageable demands on the patient's internal and external resources.

The patient's available coping resources are already being used to manage the problems of immobility.

The nurse is teaching a health class of older adults about urinary tract infections (UTI)s. What characteristic of UTIs should the nurse cite? Men over age 65 are equally prone to UTIs as women, but are more often asymptomatic. The prevalence of UTIs in older men approaches that of women in the same age group. Men of all ages are less prone to UTIs, but typically experience more severe symptoms. The prevalence of UTIs in men cannot be reliably measured, as men generally do not report UTIs.

The prevalence of UTIs in older men approaches that of women in the same age group.

Which of the following is the procedure of choice for men with recurrent or complicated urinary tract infections (UTIs)? Transrectal ultrasonography IV urogram Computed tomography (CT) scan Magnetic resonance imaging (MRI)

Transrectal ultrasonography

A client has just died following urosepsis that progressed to septic shock. The client's spouse says, "I knew this was coming, but I feel so numb and hollow inside." The nurse should know that these statements are characteristic of what phase? Complicated grief and mourning Uncomplicated grief and mourning Depression stage of dying Acceptance stage of dying

Uncomplicated grief and mourning

A client who is being treated in the hospital for a spinal cord injury is advocating for the removal of his urinary catheter, stating that he wants to try to resume normal elimination. What principle should guide the care team's decision regarding this intervention? Urinary catheters often lead to urinary tract infections. Urinary function is permanently lost following an SCI. Urinary catheters should not remain in place for more than 7 days. Overuse of urinary catheters can exacerbate nerve damage.

Urinary catheters often lead to urinary tract infections.

A client with sepsis is experiencing disseminated intravascular coagulation (DIC). The client is bleeding from mucous membranes, venipuncture sites, and the rectum. Blood is present in the urine. The nurse establishes the nursing diagnosis of Risk for deficient fluid volume related to bleeding. The most appropriate and measurable outcome for this client is that the client exhibits Urine output greater than or equal to 30 mL/hour Decreased bleeding Stable level of consciousness Systolic blood pressure greater than 70 mm Hg

Urine output greater than or equal to 30 mL/hour

A nurse is caring for a client who is at high risk for developing pneumonia. Which intervention should the nurse include on the client's care plan? Keeping the head of the bed at 15 degrees or less Turning the client every 4 hours to prevent fatigue Using strict hand hygiene Providing oral hygiene daily

Using strict hand hygiene

The nurse is caring for a client who has ventilator associated pneumonia. The spouse asks the nurse how their spouse developed this type of pneumonia. The response that is most accurate is: Ventilator associated pneumonia develops when a person cannot swallow adequately. Ventilator associated pneumonia develops due to artificial airways and being on a ventilator. Ventilator associated pneumonia develops from upper respiratory infections, not getting the vaccine and being around others with Upper respiratory infections. Ventilator associated pneumonia develops from being cared for in the hospital and getting a common microorganism, MRSA.

Ventilator associated pneumonia develops due to artificial airways and being on a ventilator.

A nurse practitioner is assessing a 55-year-old male client who reports perineal discomfort, burning, urgency, and frequency with urination. The client states that he has pain with ejaculation. The nurse knows that the client is exhibiting symptoms of: varicocele. epididymitis. prostatitis. hydrocele.

prostatitis.

A nurse is caring for a female client reporting dysuria for several days. Which question should the nurse exclude when establishing a baseline for interventions? Select all that apply. "Do you strain to urinate or have to go to the bathroom frequently?" "Is there anything that you do that makes the pain worst or better when you urinate?" "Have you recently increased your alcohol consumption in the last month?" "Have you had a fever or felt overheated in the last week?" "Have you noticed any blood or change in color of your urine recently?"

"Have you recently increased your alcohol consumption in the last month?"

After undergoing a total cystectomy and urinary diversion, a client has a Kock pouch (continent internal reservoir) in place. Which statement by the client indicates a need for further teaching? "I'll have to wear an external collection pouch for the rest of my life." "I should eat foods from all the food groups." "I'll need to drink at least eight glasses of water a day." "I'll have to catheterize my pouch every 2 hours."

"I'll have to wear an external collection pouch for the rest of my life."

A client at risk for pneumonia has been ordered an influenza vaccine. Which statement from the nurse best explains the rationale for this vaccine? "Getting the flu can complicate pneumonia." "Influenza vaccine will prevent typical pneumonias." "Influenza is the major cause of death in the United States." "Viruses like influenza are the most common cause of pneumonia."

"Viruses like influenza are the most common cause of pneumonia."

A nurse is assessing the injection site of a client who has received a purified protein derivative test. Which finding indicates a need for further evaluation? 5-mm induration Reddened area 15-mm induration A blister

15-mm induration

An intensive care nurse is aware of the need to identify clients who may be at risk of developing disseminated intravascular coagulation (DIC). Which ICU client most likely faces the highest risk of DIC? A client with extensive burns A client who has a diagnosis of acute respiratory distress syndrome A client who suffered multiple trauma in a workplace accident A client who is being treated for septic shock

A client who is being treated for septic shock

Which client is most at risk for developing disseminated intravascular coagulation (DIC)? A client admitted with suspected cocaine overdose A client with an amniotic fluid embolism A client with a stage IV pressure ulcer A client with heart failure and renal failure

A client with an amniotic fluid embolism

A hospital audit reveals that four clients in the hospital have current orders for restraints. The nurse knows that restraints are an intervention of last resort, and that it is inappropriate to apply restraints to which of the following clients? A postlaryngectomy client who is attempting to pull out the tracheostomy tube A client in hypovolemic shock trying to remove the dressing over a central venous catheter A client with urosepsis who is ringing the call bell incessantly to use the bedside commode A client with depression who has just tried to commit suicide and whose medications are not achieving adequate symptom control

A client with urosepsis who is ringing the call bell incessantly to use the bedside commode

The nurse is providing care for a client who has a diagnosis of pneumonia due to Streptococcus pneumonia infection. What aspect of nursing care would constitute part of the planning phase of the nursing process? Achieve SaO2 ≥92% at all times Auscultate chest q4h Administer oral fluids q1h and PRN Avoid overexertion at all times

Achieve SaO2 ≥92% at all times

The nurse is reviewing the blood gas results for a patient with pneumonia. What arterial blood gas measurement best reflects the adequacy of alveolar ventilation? PaO2 PaCO2 pH SaO2

PaCO2

A client asks a nurse a question about the Mantoux test for tuberculosis. The nurse should base her response on the fact that the: area of redness is measured in 3 days and determines whether tuberculosis is present. skin test doesn't differentiate between active and dormant tuberculosis infection. presence of a wheal at the injection site in 2 days indicates active tuberculosis. test stimulates a reddened response in some clients and requires a second test in 3 months.

skin test doesn't differentiate between active and dormant tuberculosis infection.

In a diagnosis of an upper urinary tract infection, which structures could be affected? Select all that apply. ureter kidney bladder urethra

ureter kidney

A nurse is giving a speech addressing "Communicable Diseases of Winter" to a large group of volunteer women, most of whom are older than 60 years. What preventive measures should the nurse recommend to these women, who are at the risk of pneumococcal and influenza infections? Select all that apply. vaccinations hand antisepsis incentive spirometry prescribed opioids

vaccinations hand antisepsis

The nurse is caring for a client in the early stages of sepsis. The client is not responding well to fluid resuscitation measures and has a worsening hemodynamic status. Which nursing intervention is most appropriate for the nurse to implement? Administer recombinant human activated protein C (rhAPC) as prescribed. Begin a continuous IV infusion of insulin per protocol. Initiate enteral feedings as prescribed. Administer norepinephrine as prescribed.

Administer norepinephrine as prescribed.

To prevent pneumonia and promote the integrity of the pulmonary system, an essential postoperative nursing intervention includes: Assisting with incentive spirometry every 6 hours Ambulating the client as soon as possible Positioning the client in a supine position Assessing breath sounds at least every 2 hours

Ambulating the client as soon as possible

A patient visited a health care clinic for treatment of upper respiratory tract congestion, fatigue, and sputum production that was rust-colored. Which of the following diagnoses is likely based on this history and inspection of the sputum? Bronchiectasis An infection with pneumococcal pneumonia A lung abscess Bronchitis

An infection with pneumococcal pneumonia

The nurse is caring for a client reporting chest discomfort. The client's diagnosis at admission is left lower lobe pneumonia. Which strategy will the nurse instruct the client to use to help alleviate the discomfort? Lay on the right side Assume a left side-lying position while in bed Request narcotic medication when pain is experienced Complete deep breathing exercises when chest discomfort occurs

Assume a left side-lying position while in bed

A nurse is providing care for a client who is postoperative day 2 following gastric surgery. The nurse's assessment should be planned in light of the possibility of what potential complications? Select all that apply. Malignant hyperthermia Atelectasis Pneumonia Hemorrhage Chronic gastritis

Atelectasis Pneumonia Hemorrhage

The nurse is caring for an acutely ill client. What assessment finding should prompt the nurse to inform the health care provider that the client may be exhibiting signs of acute kidney injury (AKI)? The client is unable to initiate voiding for 2 days. The urine is cloudy and has visible sediment with a foul odor. Average urine output has been 10 mL/hr for several hours. The client reports left-sided flank pain.

Average urine output has been 10 mL/hr for several hours.

The nurse is teaching about preventing pneumonia and influenza to a group of clients in a senior citizens' wellness class. The nurse includes which of the following topics in the class? Select all options that apply. Avoiding environmental smoke Participating in regular exercise Ensuring appropriate fluid intake Avoiding all sun exposure Following a high-calcium diet

Avoiding environmental smoke Participating in regular exercise Ensuring appropriate fluid intake

A patient is being treated in the intensive care unit for sepsis related to ventilator-associated pneumonia. The patient is on large doses of three different antibiotics. What severe outcome should the nurse monitor for in the lab studies? Leukocytosis Bone marrow suppression Oral thrush Rash

Bone marrow suppression

Which of the following is a major cause of relapsing urinary tract infections in men? Chronic bacterial prostatitis Urinary retention Improper hygiene Pyelonephritis

Chronic bacterial prostatitis

A client was climbing a ladder, slipped on a rung, and fell on the right side of the chest. X-ray studies reveal three rib fractures, and the client reports pain with inspiration. What is the anticipated treatment for this client? Chest strapping Mechanical ventilation Coughing and deep breathing with pillow splinting Thoracentesis

Coughing and deep breathing with pillow splinting

An elderly client is diagnosed with pulmonary tuberculosis. Upset and tearful, he asks the nurse how long he must be separated from his family. Which nursing diagnosis is most appropriate for this client? Anxiety Social isolation Deficient knowledge (disease process and treatment regimen) Impaired social interaction

Deficient knowledge (disease process and treatment regimen)

A nurse cares for a client with sepsis who had bariatric surgery two weeks ago. What is the most likely source of the sepsis? Disruption at the site of anastomosis. Perforation of the gastric contents. Bacterial infiltration at the surgical site of the skin. Colonization of bacteria in the bladder.

Disruption at the site of anastomosis.

A nurse is caring for a female client with an indwelling urinary catheter. Which action should the nurse take into consideration to reduce the client's risk of developing a urinary tract infection (UTI)? Use clean technique when inserting the catheter. Administer prophylactic antibiotics, as ordered. Ensure that the catheter is removed as soon as possible. Irrigate the catheter with sterile water once per shift.

Ensure that the catheter is removed as soon as possible.

A client with a spinal cord injury says he has difficulty recognizing the symptoms of urinary tract infection (UTI). Which symptom is an early sign of UTI in a client with a spinal cord injury? Lower back pain Burning sensation on urination Frequency of urination Fever and change in urine clarity

Fever and change in urine clarity

A client is admitted to the hospital with pneumonia. He has a history of Parkinson disease, which his family says is worsening. Which assessment should the nurse expect? Impaired speech Muscle flaccidity Pleasant and smiling demeanor Tremors in the fingers that increase with purposeful movement

Impaired speech

All prostatectomies include the risk of damage to the pudendal nerve. Therefore, postoperatively, the nurse assesses for: A urinary tract infection. Increased frequency of urination. Permanent perineal numbness. Impotence.

Impotence.

The nurse is writing a care plan for an 85-year-old client who has community-acquired pneumonia. The nurse assesses decreased breath sounds to bilateral lung bases on auscultation. What is the most appropriate nursing diagnosis for this client? Ineffective airway clearance related to tracheobronchial secretions Pneumonia related to progression of disease process Poor ventilation related to acute lung infection Immobility related to fatigue

Ineffective airway clearance related to tracheobronchial secretions

A 52-year-old client is scheduled for diagnostic testing to address prolonged signs and symptoms of genitourinary dysfunction. What signs and symptoms are particularly suggestive of urinary tract disease? Select all that apply. Petechiae Pain Gastrointestinal symptoms Changes in voiding Jaundice

Pain Gastrointestinal symptoms Changes in voiding

While performing the physical examination, the nurse determines that a patient has an area of consolidation in the lungs suggesting pneumonia. Which technique would the nurse most likely have used to obtain this finding? Inspection Palpation Percussion Auscultation

Percussion

The following catheterization procedures are used to treat clients with urinary retention. Which procedure would the nurse identify as carrying the greatest risk to the client? Suprapubic cystostomy tube Permanent drainage with a urethral catheter Clean intermittent catheterization Credé voiding procedure

Permanent drainage with a urethral catheter

A client with difficulty voiding and elevated BUN and creatinine values has been referred by the health care provider for further evaluation. The nurse should anticipate the use of what initial diagnostic test? Portable bladder ultrasound X-ray Computed tomography (CT) Nuclear scan

Portable bladder ultrasound

The nurse provides care for a client with pneumonia and acute respiratory distress syndrome whose oxygen saturation fluctuated between 86% and 90% over the past few days. The oxygenation saturation is consistently at 91%. Which step would the nurse take next? Provide oxygen for consistent hypoxia Encourage use of spirometry to improve oxygenation through the lungs Obtain blood for hemoglobin testing to determine oxygen transport level Continue to monitor oxygen to ensure the level does not fall below 90%

Provide oxygen for consistent hypoxia

The physician orders an alpha-adrenergic blocker for a client with benign prostatic hyperplasia. The nurse understands that this drug acts to achieve which of the following? Prevent urinary tract infections Relieve urinary symptoms Slow the prostatic enlargement Block testosterone conversion

Relieve urinary symptoms

A nurse works in a community setting that deals with a large number of homeless individuals. Which of the following would be most important for the nurse to understand? The homeless population typically seeks health care when a need first arises. The health problems faced by homeless people are often related to their living situation. The homeless population experiences high rates of trauma but lower rates for other health conditions. The nurse's approach to the care of homeless clients is the same as for any client.

The health problems faced by homeless people are often related to their living situation.

A student nurse has been assigned to provide basic care for a 58-year-old man with a diagnosis of AIDS-related pneumonia. The student tells the instructor that she is unwilling to care for this client. What key component of critical thinking is most likely missing from this student's practice? Compliance with direction Respect for authority Analyzing information and situations Withholding judgment

Withholding judgment

In a diagnosis of a lower urinary tract infection, which structures could be affected? Select all that apply. bladder kidney urethra ureter

bladder urethra

Which of the following treatments are necessary for a client that has pneumonia? Select all that apply. gradual increase of activity. fluid restriction. bed rest. oxygen therapy to keep sats at 92 and above. antibiotics.

gradual increase of activity. oxygen therapy to keep sats at 92 and above. antibiotics.

Common symptoms of pneumonia include which of the following? Select all that apply. hyperactivity gradual onset of shortness of breath fever productive cough with yellow/green sputum Vital signs within normal limits

gradual onset of shortness of breath fever productive cough with yellow/green sputum

The nurse is monitoring a client experiencing a decrease in cardiac output. What medical conditions will lead to a decrease in preload? hemorrhage, sepsis, and anaphylaxis myocardial infarction, fluid overload, and diuresis fluid overload, sepsis, and vasodilation third spacing, heart failure, and diuresis

hemorrhage, sepsis, and anaphylaxis

A client with a spinal cord injury and subsequent urine retention receives intermittent catheterization every 4 hours. The average catheterized urine volume has been 550 ml. The nurse should plan to: increase the frequency of the catheterizations. insert an indwelling urinary catheter. place the client on fluid restrictions. use a condom catheter instead of an invasive one.

increase the frequency of the catheterizations.

A client with pneumonia has a CBC drawn. Which result is most indicative of infection? increased hematocrit decreased hematocrit increased WBC decreased WBC

increased WBC

Your client with suspected sepsis has had labs drawn. Which lab shows us poor tissue perfusion? increased lactic acid decreased lactic acid

increased lactic acid

A client with suspected sepsis has come into the Emergency Department. What are signs of sepsis? Select all that apply. decreased respirations increased blood pressure increased respirations decreased blood pressure increased heart rate decreased heart rate

increased respirations decreased blood pressure increased heart rate

A client has been treated for shock and is now at risk for which secondary but life-threatening complications? Select all that apply. kidney failure disseminated intravascular coagulation acute respiratory distress syndrome hypoglycemia GERD

kidney failure disseminated intravascular coagulation acute respiratory distress syndrome

What does a positive Mantoux test indicate? active immunity to tuberculosis production of an immune response development of full-blown tuberculosis an active case of tuberculosis

production of an immune response