Nokea
A client is in the family practice clinic reporting a severe cold that started 4 days ago. On examination, the nurse notes the client also has a severe headache and muscle aches. What action by the nurse is best?
- A. Educate the client on oseltamivir (Tamiflu).
- B. Facilitate admission to the hospital.
- C. Instruct the client to have a flu vaccine.
- D. Teach the client to sneeze in the upper sleeve.
Correct Answer: D
Rationale: Sneezing and coughing into one's sleeve helps prevent the spread of upper respiratory infections. Given the client's symptoms and the need to prevent further transmission, this is the most appropriate action.
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Which teaching point is most important for the client with bacterial pharyngitis?
- A. Gargle with warm salt water.
- B. Take all antibiotics as directed.
- C. Use a humidifier in the bedroom.
- D. Wash hands frequently.
Correct Answer: B
Rationale: Any client on antibiotics must be instructed to complete the entire course of antibiotics. Not completing them can lead to complications or drug-resistant strains of bacteria. This is the most critical teaching point to prevent treatment failure.
A client in the emergency department is taking rifampin (Rifadin) for tuberculosis. The client reports yellowing of the sclera and skin and bleeding after minor trauma. What laboratory results correlate to this condition? (Select all that apply.)
- A. Blood urea nitrogen (BUN): 19 mg/dL.
- B. International normalized ratio (INR): 6.3.
- C. Prothrombin time: 35 seconds.
- D. Serum sodium: 120 mEq/L.
- E. White blood cell (WBC) count: 72,000/mm³.
Correct Answer: B,C
Rationale: Rifampin can cause liver damage, evidenced by the client's high INR and prothrombin time, which indicate coagulopathy due to liver dysfunction. The BUN, WBC count, and sodium levels are not directly related to this condition.
A nurse is providing pneumonia vaccinations in a community setting. Due to limited finances, the event organizers must limit giving the vaccination to priority groups. What clients would be considered a priority? (Select all that apply.)
- A. 22-year-old client with asthma.
- B. Client who had a cholecystectomy last year.
- C. Client with well-controlled diabetes.
- D. Healthy 72-year-old client.
- E. Client who is taking medication for hypertension.
Correct Answer: A,C,D,E
Rationale: Clients over 65 years of age and any client with a chronic health condition (e.g., asthma, diabetes, hypertension) are considered a priority for a pneumonia vaccination. A cholecystectomy does not qualify as a chronic health condition.
The emergency department (ED) manager is reviewing client charts to determine how well the staff performs when treating clients with community-acquired pneumonia. What outcome demonstrates that goals for this client type have been met?
- A. Antibiotics started before admission.
- B. Blood cultures obtained within 20 minutes.
- C. Chest x-ray was obtained within 30 minutes.
- D. Pulse oximetry obtained on all clients.
Correct Answer: A
Rationale: Goals for treatment of community-acquired pneumonia include initiating antibiotics prior to inpatient admission or within 6 hours of presentation to the ED. This is a key indicator of effective treatment.
A client has been admitted for suspected inhalation anthrax infection. What question by the nurse is most important?
- A. Are any family members also ill?
- B. Have you traveled recently?
- C. How long have you been ill?
- D. What is your occupation?
Correct Answer: D
Rationale: Inhalation anthrax is rare and is an occupational hazard among people who work with animal wool, bone meal, hides, and such, such as tanners and veterinarians. Inhalation anthrax in someone without an occupational risk is considered a bioterrorism event and must be reported to authorities immediately.