Nokea
If a client is allergic to penicillin, the nurse should anticipate a hypersensitivity response to which other group of antibiotics?
- A. Aminoglycosides such as kanamycin (Kantrex)
- B. Tetracyclines such as doxycycline (Vibramycin)
- C. Cephalosporins such as ceftriaxone (Rocephin)
- D. Fluoroquinolones such as ciprofloxacin (Cipro)
Correct Answer: C
Rationale: Cephalosporins have a similar beta-lactam structure to penicillin, increasing the risk of cross-reactivity in penicillin-allergic clients.
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The nurse suspects the client admitted with a near-drowning is developing acute respiratory distress syndrome (ARDS). Which data support the nurse's suspicion?
- A. The client's arterial blood gases are within normal limits.
- B. The client appears anxious, has dyspnea, and is tachypneic.
- C. The client has intercostal retractions and is using accessory muscles.
- D. The client has bilateral lung sounds with crackles and rhonchi.
Correct Answer: C
Rationale: Intercostal retractions and accessory muscle use (C) indicate severe respiratory distress, consistent with ARDS due to increased work of breathing from reduced lung compliance. Normal ABGs (A) contradict ARDS, which involves hypoxia. Anxiety, dyspnea, and tachypnea (B) are non-specific. Crackles and rhonchi (D) may occur but are less specific than physical signs of distress.
Which assessment finding provides the best indication that the nurse needs to suction the client with a tracheostomy?
- A. Respirations are low.
- B. Pulse rate is slow.
- C. Breath sounds are wet.
- D. Blood pressure is elevated.
Correct Answer: C
Rationale: Wet breath sounds indicate mucus accumulation in the tracheostomy, necessitating suctioning to clear the airway.
Which oxygen flow rate is most appropriate for the nurse to administer for this client?
- A. 2 L/minute
- B. 5 L/minute
- C. 8 L/minute
- D. 10 L/minute
Correct Answer: A
Rationale: A low flow rate of 2 L/minute is appropriate for COPD clients to avoid suppressing the hypoxic drive while improving oxygenation.
Which nursing rationale best explains the reason for using a cuffed tracheostomy tube on the client?
- A. The cuff prevents skin breakdown.
- B. The cuff prevents aspiration.
- C. The cuff is more comfortable.
- D. The cuff reduces infection.
Correct Answer: B
Rationale: The cuff on a tracheostomy tube seals the airway, preventing aspiration of secretions or food into the lungs.
How long after administering a tuberculin skin test should the nurse inspect the client's injection site?
- A. 1 week
- B. 1 day
- C. 2 to 3 days
- D. 4 to 5 days
Correct Answer: C
Rationale: The tuberculin skin test reaction is typically read 48 to 72 hours (2 to 3 days) after administration to assess for induration.