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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.
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A nurse admits a client from the emergency department. Client data are listed below: History: 70 years of age, history of diabetes, on insulin twice a day. Physical Assessment: Crackles and rhonchi heard throughout the lungs, dullness to percussion LLL, afebrile, productive cough, oriented to person only. What action by the nurse is the priority?
- A. Administer oxygen at 2 liters per nasal cannula.
- B. Begin broad-spectrum antibiotics.
- C. Collect a sputum sample for a culture.
- D. Start an IV of normal saline at 50 mL/hr.
Correct Answer: A
Rationale: All actions are appropriate for this client who has manifestations of pneumonia. However, airway and breathing come first, so beginning oxygen administration to maintain saturation greater than 95% is the priority.
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.
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 nurse has educated a client on isoniazid (INH). What statement by the client indicates teaching has been effective?
- A. I need to take extra vitamin C while on INH.
- B. I should take this medicine with milk or juice.
- C. I should take this medication on an empty stomach.
- D. My contact lenses will be permanently stained.
Correct Answer: C
Rationale: INH needs to be taken on an empty stomach, either 1 hour before or 2 hours after meals. This statement indicates the client understands the correct administration of the medication.
A client is being discharged on long-term therapy for tuberculosis (TB). What referral by the nurse is most appropriate?
- A. Community social worker for Meals on Wheels.
- B. Occupational therapy for job retraining.
- C. Physical therapy for homebound therapy.
- D. Visiting Nurses for directly observed therapy.
Correct Answer: D
Rationale: Directly observed therapy is often utilized for managing clients with TB in the community to ensure adherence to the treatment regimen, which is critical for successful treatment.