Nokea
A hospital nurse is participating in a drill during which many clients with inhalation anthrax are being admitted. What drugs should the nurse anticipate administering? (Select all that apply.)
- A. Amoxicillin (Amoxil)
- B. Ciprofloxacin (Cipro)
- C. Doxycycline
- D. Ethambutol (Myambutol)
- E. Sulfamethoxazole-trimethoprim (Septra)
Correct Answer: A,B,C
Rationale: Amoxicillin, ciprofloxacin, and doxycycline are all possible treatments for inhalation anthrax. Ethambutol is used for tuberculosis, and SMX-TMP is commonly used for urinary tract infections.
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A nurse in a family practice clinic is preparing discharge instructions for a client reporting facial pain that is worse when bending over, tenderness across the cheeks, and postnasal discharge. What instruction will be most helpful?
- A. Ice packs may help with the facial pain.
- B. Limit fluids to dry out your sinuses.
- C. Try warm, moist heat packs on your face.
- D. We will schedule you for a computed tomography scan this week.
Correct Answer: C
Rationale: This client has rhinosinusitis. Comfort measures for this condition include breathing in warm steam, hot packs, nasal saline irrigation, sleeping with the head elevated, increased fluids, and avoiding cigarette smoke. Warm, moist heat packs are particularly effective for relieving facial pain.
A nurse is caring for several older clients in the hospital that the nurse identifies as being at high risk for healthcare-associated pneumonia. To reduce this risk, what activity should the nurse delegate to the unlicensed assistive personnel (UAP)?
- A. Encourage between-meal snacks.
- B. Monitor temperature every 4 hours.
- C. Provide oral care every 4 hours.
- D. Report any new onset of cough.
Correct Answer: C
Rationale: Oral colonization by gram-negative bacteria is a risk factor for healthcare-associated pneumonia. Good, frequent oral care can help prevent this from developing and is a task that can be delegated to the UAP.
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.
A client is in the family medicine clinic reporting a dry, sore throat. The provider asks the nurse to assess for odynophagia. What assessment technique is most appropriate?
- A. Ask the client what foods cause trouble swallowing.
- B. Observe the client's throat for redness.
- C. Perform a throat culture immediately.
- D. Check the client's temperature.
Correct Answer: A
Rationale: Odynophagia refers to painful swallowing. Asking the client what foods cause trouble swallowing is the most direct way to assess for this condition.
A client has been taking isoniazid (INH) for tuberculosis for 3 weeks. What laboratory results need to be reported to the health care provider immediately?
- A. Albumin: 5.1 g/dL.
- B. Alanine aminotransferase (ALT): 180 U/L.
- C. Red blood cell (RBC) count: 5.2 million/mm³.
- D. White blood cell (WBC) count: 12,500/mm³.
Correct Answer: B
Rationale: INH can cause liver damage, especially if the client drinks alcohol. The ALT (one of the liver enzymes) is extremely high and needs to be reported immediately, as it indicates potential liver toxicity.