PCC- PrepU: Exam 3 topics

What factors may prompt such a change in tuberculosis (TB) treatment to include second-line anti-TB drugs? Select all that apply.

-resistance to 1st-line drugs -unable to tolerate 1st-line drugs

The nurse is collecting data on a client with a urinary tract infection (UTI). Which statements should the nurse expect the client to make? Select all that apply.

-urinate frequently -burning -urinate urgently

A male patient has been prescribed methotrexate. The nurse should caution the patient against using which over-the-counter medication?

ASA

Acute pyelonephritis is a result of:

bacterial infection

A nurse is preparing an in-service presentation for a group of nurses about antitubercular drugs. The nurse would identify which drug as a secondary drug to treat tuberculosis?

ciprofloxacin

When preparing to take a client's blood pressure, the nurse notes that the sphygmomanometer is visibly soiled. What is the correct action by the nurse?

cleanse & disinfect

A nurse is caring for a client with a warm and painful toe from gout. What medication will the nurse administer?

colchicine

A nurse should expect to administer which medication to a client with gout?

colchicine

A client with osteoarthritis asks for information concerning activity and exercise. When assisting the client, which concept should be included?

delaying exercise for at least 1 hour after awakening allows the client to participate in exercise after some of the morning-related stiffness has subsided

A client diagnosed with arthritis doesn't want to take medications. Physical therapy and occupational therapy have been consulted for nonpharmacologic measures to control pain. What might physical and occupational therapy include in the care plan to help control this client's pain?

exercise routine including ROM

A nurse who provides weekly care in a homeless shelter has unknowingly inhaled airborne Mycobacterium tuberculosis (TB) and has subsequently developed latent tuberculosis infection. Which statement is accurate regarding this nurse?

likely asymptomatic

Which nursing observation is an appropriate outcome to indicate effective anti-infective therapy for a urinary tract infection?

negative UA

A client presented to the emergency department of the hospital with a swollen, reddened, painful leg wound and has been diagnosed with methicillin-resistant Staphylococcus aureus (MRSA) cellulitis. The client's physician has ordered a complete blood count and white cell differential. Which blood component would the physician most likely anticipate to be elevated?

neutrophils

A client, diagnosed with tuberculosis, will soon begin first-line drug treatment. How will rifampin most likely be administered to this client?

PO, empty stomach

Which client is at greatest risk for developing balanoposthitis?

uncircumcised penis

Fluconazole is the prototype for antifungals. Which are characteristics of fluconazole? (Select all that apply.)

-bind to sterols in fungal cell membrane -tx of oropharyngeal, esophageal, & vaginal candidiasis -metabolized in liver & excreted in urine

A client receiving isoniazid (INH) and rifampin has a decreased urinary output and decreased sensation in the great toes. Which laboratory values should be assessed?

ALT & AST

Which nursing diagnosis would be most appropriate for a client being treated with an antifungal?

acute pain r/t GI, CNS & local effects of the drug

Given the fact that acute pancreatitis can result in severe, life-threatening complications, the nurse should be assessing the client for which complication?

acute tubular necrosis

Since older adults do not always have a fever with an infection, the extended-care facility personnel should observe client for:

agitation

A nurse is reviewing the admission assessment data of a client diagnosed with acute gastritis. The nurse determines that the condition most likely occurred as a result of:

arthritis tx with high levels of NSAIDs

A client suffers from bloody diarrhea after eating contaminated food at a local restaurant. The client has been infected with a(an):

bacteria

The parents of a 4-month-old diagnosed with sepsis tell the nurse that the physician explained sepsis to them but they don't really understand it. The parents state, "Could you please explain it to us?" What is the best response by the nurse?

causes release of toxins into system, which causes impaired function in lungs, liver & kidneys

After teaching a group of students about carbapenems, the instructor determines the need for additional teaching when the students identify what as an example?

cefuroxime

The clinic nurse is caring for a client with acute bronchitis. The client asks what may have caused the infection. What may induce acute bronchitis?

chemical irritation

A nurse evaluates a client and suspects pericarditis. What indicator is considered the most characteristic symptom of pericarditis?

chest pain

A client is given theophylline to treat acute asthma symptoms. Which food should the client avoid?

chocolate

A female client is admitted to the critical care unit with sepsis related to a contaminated central line. The health care provider orders intravenous beta-lactam antimicrobials. The client's current laboratory report reflects renal impairment. What would the nurse expect the provider to do?

decrease drug dose

A client is being discharged following an allergic reaction after ingesting aspirin. When providing client education about the allergy, the nurse would provide the client with what information?

do not take any NSAIDs

A child is being seen in the emergency department (ED) after ingesting crayons with lead in them. He is disoriented and having seizures. The provider suspects he has which of the following?

encephalitis

Which of the following are considered primary drugs to treat TB? Select all that apply:

ethambutol (Myambutol) isoniazid (Nydrazid) rifampin (Rifadin)

Which action is the best precaution against transmission of infection?

eye prophylaxis w/ABT for neonate whose mom has gonorrhea infection

A nurse assesses a client in the health care provider's office. Which assessment findings support a suspicion of systemic lupus erythematosus (SLE)?

facial erythema, pericarditis, pleuritis, fever & weight loss

The nurse is instructing a client with cancer who is receiving chemotherapy about reporting signs of infection. Which is the most reliable early indicator of infection in a client who is neutropenic?

fever

A client with rheumatoid arthritis arrives at the clinic for a checkup. Which statement by the client refers to the most overt clinical manifestation of rheumatoid arthritis?

finger joints oddly shaped

The nurse is caring for a client with gout that is taking colchicine. In addition to the administration of this medication, what education can the nurse provide to help with the prevention of future episodes of gout?

follow low purine diet

A newborn is diagnosed with ophthalmia neonatorum. The nurse understands that this newborn was exposed to which infection?

gonorrhea

A young woman comes to the walk-in clinic seeking treatment for chronic chlamydia trachomatis. Which finding is most likely because it often correlates with this diagnosis?

gonorrhea

An 80-year-old client is diagnosed with latent tuberculosis infection. What is a risk for the elderly population when being treated with INH?

hepatotoxicity

A client arrives in the orthopedic clinic with complaints of twisting the right ankle while playing softball. The nurse collects data including complaints of pain and swelling in the right ankle. What intervention will the nurse provide that will decrease vasodilation and reduce localized swelling?

ice

How does rifampin achieve a therapeutic action against both intracellular and extracellular tuberculosis organisms?

inhibits synthesis of RNA

A client has been diagnosed with syphilis and will be treated with penicillin. The client's medication will achieve a therapeutic effect through:

interference w/cell wall synthesis

A client is prescribed isoniazid (INH) for a diagnosis of tuberculosis. Which adverse effect will result in discontinuation of the medication?

jaundice

A client is receiving rifampin and isoniazid in combination for treatment of tuberculosis. What would the nurse need to monitor closely?

liver function studies

The nurse is providing care to a client who has had surgery as treatment for breast cancer. The nurse would be alert for the development of which complication?

lymphedema

An male client presents with urethral itching, burning, pain, and a creamy, yellow discharge following unprotected sex with a new partner 3 days ago. The nurse anticipates the client to be diagnosed with which sexually transmitted infection?

n. gonorrhoeae

A nurse recognizes that a client with tuberculosis needs further teaching when the client states:

necessary for people i work with to take meds

A client is admitted to the hospital with an elevated temperature and flank pain. When reviewing the complete blood count (CBC), which level is the most important for the nurse to communicate to the health care provider?

neutrophils 85%

The female client has been taking a fluoroquinolone and calls the health care provider's office to report that she is experiencing redness and is excoriated in her groin area. What is the nurse's best response?

notify HCP

While speaking to a senior citizen club about osteoarthritis (OA), which facts are accurate to share?

obesity in women correlated to having OA in knees

What would be the best response to the mother of two teens who have been diagnosed with scabies?

one of children probably had direct contact w/infected person

A client has been admitted to the emergency department with severe mid-epigastric, upper quadrant abdominal pain. Based on the signs and symptoms and laboratory data documented in the chart, the nurse would anticipate preparing for which diagnosis?

pancreatitis

Which term is used to describe edema of the optic nerve?

papilledema

What intervention is a priority for a client diagnosed with osteoarthritis?

physical therapy & exercise

A young woman presents with signs and symptoms of urinary tract infection (UTI). The nurse notes that this is the fifth UTI in as many months. What would this information lead the nurse to believe?

possible obstruction in urinary tract

A nurse is examining the abdomen of a client with suspected peritonitis. How does the nurse elicit rebound tenderness?

press affected area firmly w/1 hand, release pressure quickly & note any increased tenderness on release

A nursing student studying pharmacology is focusing on drugs used to treat tuberculosis (TB). This student correctly identifies the classifications of antitubercular drugs as which of the following?

primary and secondary

A nurse is preparing the medical history report of a patient with a urinary tract infection. Which of the following conditions should the nurse identify as one in which the use of cephalosporins is restricted?

renal disease

The nurse completes an assessment of a client admitted with pericarditis. What client symptom will the nurse correlate with the diagnosis of pericarditis?

reports of constant chest pain

A group of students are reviewing information about drugs used to treat tuberculosis. The students demonstrate understanding of the material when they identify which drug as a first-line treatment option?

rifampin

Which client requires immediate nursing intervention? The client who:

rigid, board-like abdomen

When developing a plan of care for the client receiving a glucocorticoid, what nursing diagnosis should be of highest priority?

risk for infection r/t immunosuppression

A middle-aged patient has been prescribed tetracycline as part of his Prevpac for the treatment of H. pylori. The patient has a history of atrial fibrillation which is being treated with digitalis drugs. Given his history and current medications, the patient is at risk for which of the following conditions?

risk of toxicity

The nurse caring for a client with syphilis notes the Venereal Disease Research Laboratory (VDRL) test result is elevated. Which stage of syphilis is this client likely experiencing?

secondary

A 40-year-old woman with gray, runny vaginal discharge that has a foul, fishy odor has been told that she most likely has vaginosis. Which phenomenon most likely contributed to her present condition?

sharp reduction in number of lactobacilli in vaginal flora

The most diagnostic clinical symptom of pleurisy is:

stabbing pain during respiratory movements

A nurse is assigned to a client with acquired immunodeficiency syndrome (AIDS). The nurse takes what precautions?

standard/same as everyone

A 12-year-old boy taken to the emergency department after a soccer injury cries out, "Look, my leg is bigger now!" How will the nurse respond to the boy?

swelling is normal response from body to prepare for healing

A client is receiving chemotherapy through a central venous catheter into the right subclavian vein. The client is reporting pain in the chest and shoulder. The nurse observes that the client is dyspneic and cyanotic and the blood pressure has dropped to 86/48 mm Hg. The client's pulse is weak and rapid, and the client has a fever. What complication would the nurse suspect?

systemic infection

A patient has been prescribed oral tetracycline for the treatment of acne. Which of the following must the nurse include in the patient teaching plan?

take on empty stomach

A nurse is giving discharge instructions to a client who came to the emergency department following an ankle sprain. The client asks "Why does this hurt so much?" Which response would be most appropriate from the nurse?

the nerves are being stimulated by pressure from swelling at area of sprain

When educating a college student who lives in a crowded apartment and was recently diagnosed with tuberculosis, the school nurse will emphasize which treatment plan?

to destroy must strictly adhere to long-term regimen of several meds

The nurse is collecting data on a 2-year-old child admitted with a diagnosis of gastroenteritis. When interviewing the caregivers, which question is most important for the nurse to ask?

types of stools child has been having

What is the most common client site for development of healthcare-associated infections (HAI)?

urinary tract

The nurse is providing teaching on ways to maintain skin integrity and prevent infection for the parents of a boy with atopic dermatitis. Which response indicates a need for further teaching?

we should avoid using petroleum jelly

A 66-year-old woman has experienced a significant decline in her quality of life as a result of worsening rheumatoid arthritis. Her physician has prescribed etanercept and the nurse is responsible for facilitating this new aspect of the patient's drug regimen. This will involve the administration of:

weekly, SQ inject

A patient taking isoniazid (INH) therapy for tuberculosis demonstrates understanding when making which statement?

-it is alright if I have grilled cheese sandwich w/american cheese

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?

15-mm induration

A client diagnosed with tuberculosis (TB) is taking medication for the treatment of TB. The nurse should instruct the client that they will be safe from infecting others approximately how long after initiation of the medication therapy?

2-3wk after initiation

After diagnosing a client with pulmonary tuberculosis, the physician tells family members that they must receive isoniazid (INH) as prophylaxis against tuberculosis. The client's family asks the nurse how long the drug must be taken. What is the usual duration of prophylactic isoniazid therapy?

6-12mos

After birth, an infant experiences meconium aspiration. What does the nurse anticipate the primary care provider prescribing prophylactically to prevent pneumonia?

ABT

SARS is caused by which virus?

Coronavirus

A nurse is assessing a client and obtains the following findings: abdominal discomfort, mild diarrhea, blood pressure of 100/80 mm Hg, pulse rate of 88 beats/minute, respiratory rate of 20 breaths/minute, temperature 100° F (37.8° C). What diagnosis will the nurse suspect for this client?

IBD

A client is diagnosed with latent tuberculosis infection. The nurse expects that the treatment plan will include which drug?

INH

A client has just been diagnosed with tuberculosis (TB). The nurse can expect to start the client on which drug for the initial phase of treatment?

INH, rifampin, pyrazinamide, ethambutol

A client comes to an urgent care center. The nurse notes that the client has a fever of 103.2°F (39.5°C), pleuritic pain with each breath, and enlarged lymph nodes in the neck and axilla area. The client also has a productive cough. The nurse should consider tuberculosis if the client's history includes:

IV drug use & living on streets

A client with hepatitis C is scheduled to begin a new therapy that would block the progression of the virus by interfering with its genetic replication. What type of therapy is this client beginning?

RNA interference

Which description of symptoms would the nurse expect to obtain from a client with exacerbation of sarcoidosis?

SOB, non-productive cough & chest pain

The client reports cough, low-grade fever, anorexia, and night sweats. The client has also been coughing up blood at times. What disease does this client most likely have?

TB

A client is evaluated for severe pain in the right upper abdominal quadrant, which is accompanied by nausea and vomiting. The physician diagnoses acute cholecystitis and cholelithiasis. For this client, which nursing diagnosis takes top priority?

acute pain r/t biliary spasm

Which drug classification is used to treat superinfections?

antifungals

An older adult client presents with loose mucus-filled stools. The nurse suspects the client has Clostridium difficile. What is a priority assessment for the nurse?

ask about ABT use

One method of reducing bronchoconstriction is removing excessive secretions from the respiratory tract. Patients can take several actions on their own to help manage secretions. Which will not help manage secretions?

ask physician to prescribe inhaled corticosteroids

A client has a fiberglass cast on the right arm which was placed after internal fixation 1 week ago. The nurse notes a warm area on the cast. What priority action should the nurse take?

assess temperature & interview about pain at site

A nurse is attempting to culture a lesion to determine if a client has genital herpes. What is the nurse's best action?

attempt to culture as soon as develops

When teaching a client with rheumatoid arthritis (RA), which factor does the nurse explain is an underlying cause of this disease?

autologous antibodies

An individual who is homeless was screened for tuberculosis (TB), and the results indicate latent TB. The community health nurse would anticipate inclusion of what intervention into the client's plan of care?

being treated for TB using 1st-line

A client is admitted with a possible diagnosis of osteomyelitis. Based on the documentation, which laboratory result is the priority for the nurse to report to the physician?

blood culture

A client with a long-standing diagnosis of asthma is prescribed a beta-blocker for the treatment of angina. The nurse should consequently prioritize assessment for what health problem?

bronchospasm

A 30-year-old female client received an insect bite that has progressed to cellulitis over the past several days. What client characteristic should the nurse prioritize when administering anti-infectives?

client in 2nd trimester of pregnancy

A client admitted with tuberculosis reports concerns about paying for needed medications. The nurse should:

collab w/social worker for funds

A woman asks "Why do I have to tell my sexual partner about chlamydia? I thought this was a "female" disease." What is the nurse's best response?

condition is transmittable to men & may cause infertility

A client is admitted for a relapse for sarcoidosis. Knowing this is usually caused by an inflammatory process, the nurse can anticipate administering:

corticosteroid

When a nurse assesses a client with scleroderma (systemic sclerosis), which manifestation does the nurse recognize is part of the CREST variant syndrome rather than the systemic type of this disorder?

dermal thickening proximal to wrists

A client is diagnosed as having serous otitis media. When describing this condition to the client, which of the following would be most accurate?

fluid collected in middle ear but no infection

Which condition is the cause of thickening of the nail

fungal infection

An adult client with a tentative diagnosis of infective endocarditis is admitted to an acute care facility. The medical history reveals diabetes mellitus, hypertension, and pernicious anemia. The client underwent an appendectomy 20 years earlier and an aortic valve replacement 2 years before this admission. What history finding is a major risk factor for infective endocarditis?

hx of aortic valve replacement

The defense mechanism involving lymphoid cells, inflammatory cells, and hematopoietic cells stimulates production of antibodies and activated lymphocytes to destroy mutant body cells and pathogens is known as:

immune response

Within an infected wound bed, many cell types are involved in protecting the host and eliminating the "foreign invaders" to promote wound healing. How does the identification of body tissues from foreign substances occur?

immune system

When educating a client with a wound that is not healing, the nurse should stress which dietary modifications to ward off some of the negative manifestations that can occur with inflammation?

increase your intake of oily fish and fish oil so that you will increase absorption of omega-3 polyunsaturated fatty acids

A nurse is teaching a new mother diagnosed with HIV about the transfer of the infection to her newborn. The mother begins to cry and states, "It's too late, the lab tests on my baby are already positive for HIV." How should the nurse respond?

just because test is + for HIV does not mean baby is infected

A nurse is caring for a client with ankylosing spondylitis. For which associated symptom does the nurse assess?

kyphosis

A woman comes to the emergency department reporting vaginal discharge and pelvic pain that increases with urination. The client also reports nausea and vomiting, headache, and anorexia. A pelvic examination reveals cervical motion tenderness. The client is diagnosed with acute pelvic inflammatory disease (PID) and is admitted. Which of the following would be most appropriate to include in this client's plan of care?

maintain bedrest in semi-fowler's position

Which condition is a risk factor for the development of pelvic inflammatory disease (PID)?

multiple sex partners

A client, being treated for latent tuberculosis (TB) on an out-client basis, tells the nurse, "I've been feeling pretty good lately, so I haven't actually been all that consistent with taking my drugs." Subsequent health education by the nurse should focus on what subject?

need to consistently take prescribed meds to cure TB

When reviewing the history of a patient, which would the nurse identify as a contraindication for the use of progestins?

pelvic inflammatory disease

The nurse is conducting a community education class on gastritis. The nurse includes that chronic gastritis caused by Helicobacter pylori is implicated in which disease/condition?

peptic ulcers

An older adult client presents with a perforation of a peptic ulcer. The nurse will monitor for signs and symptoms of which priority complication?

peritonitis

After teaching a class to a group of nursing students about reporting infectious diseases to the Centers for Disease Control and Prevention, the instructor determines a need for additional discussion when the students identify which infection as being reportable:

pinworm

A client is being seen in the dermatologist clinic for psoriasis. What term should the nurse select in the electronic health record (EHR) to describe the client's lesions associated with psoriasis?

plaques

The nurse is attempting to control the infectious process while caring for a client. The nurse changes the client's wound dressing when the dressing becomes soiled. Which link of the chain of infection is the nurse interrupting with this intervention?

reservoir

A client recovered from influenza 2 days ago and informs the nurse that she is feeling better but now has a fever, chills, pain when breathing, and a productive cough. What complication does the nurse anticipate the client will be treated for?

secondary bacterial pneumonia

A girl has a urinary tract infection (UTI). Which statement by the parent demonstrates understanding of preventing future UTIs?

shouldn't allow bubble baths

When talking to a group of homeless women living in a shelter, the nurse should educate about risk for developing tuberculosis. The nurse should emphasize which lab/diagnostic test as considered to be the "gold" standard for diagnosing tuberculosis?

sputum or bronchial cultures

A 62-year-old client has been prescribed an antihistamine to alleviate vasomotor rhinitis. The client reports gastric irritation after taking the tablet. Which instructions should the nurse provide to help alleviate the client's condition?

take w/food

A healthcare provider prescribes an antibiotic for a 6-year-old client with an upper respiratory tract infection. For what prescribed antibiotic will the nurse seek clarification from the healthcare provider?

tetracycline

A woman comes to the clinic reporting intense pruritus and a thick curd-like vaginal discharge. On examination, white plaques are observed on the vaginal wall. The nurse suspects which condition?

vulvovaginal candidiasis

The nurse conducting a hand hygiene in-service determines that the participants need additional education when they state that the use of an alcohol-based hand rub is appropriate in which situation?

when hands are visibly soiled

A client has been diagnosed with bacterial conjunctivitis. This type of infection is usually characterized by large amounts of what color drainage?

yellow-green