Nokea
The client diagnosed with community-acquired pneumonia is admitted to the medical unit. Which health-care provider order should the nurse implement first?
- A. Start IV with 1,000 mL 0.9% saline.
- B. Ceftriaxone 1 gm IVPB every 12 hours.
- C. Obtain sputum and blood cultures.
- D. CBC and basic metabolic panel.
Correct Answer: C
Rationale: Sputum/blood cultures (C) must be obtained before antibiotics to identify pathogens, a priority. IV fluids (A), antibiotics (B), and labs (D) follow.
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The nurse advises the client to make sure to take the entire antibiotic prescription because an untreated or undertreated streptococcal infection can lead to which of the following conditions?
- A. Glomerulonephritis
- B. Chickenpox
- C. Shingles
- D. Whooping cough
Correct Answer: A
Rationale: Untreated group A streptococcal infections can lead to complications like glomerulonephritis, a condition affecting the kidneys, due to an immune response.
The nurse is assessing a patient, who has many risk factors for the development of a DVT, for signs and symptoms of a deep vein thrombosis. What signs and symptoms below would possibly indicate a deep vein thrombosis is present?
- A. Cool extremity
- B. Decreases pulses
- C. Redness
- D. Pain
- E. Warm extremity
- F. Swelling
- G. Cyanosis
Correct Answer: C,D,E,F
Rationale: Signs and symptoms of a DVT include: redness, swelling, warm extremity, pain, positive Homan's Sign, and swelling (which can be unilateral...meaning there is more swelling in one extremity compared to the other).
When the client asks the nurse about why the physician has prescribed two drugs, which response is most accurate?
- A. One medication diminishes the side effects of the other.
- B. One medication kills the live organism; the other, its spores.
- C. Using combined medications can reduce the dosages of both drugs.
- D. Using two or more drugs lowers the potential for bacterial resistance.
Correct Answer: D
Rationale: Combination therapy (rifampin and isoniazid) reduces the risk of bacterial resistance, ensuring effective tuberculosis treatment.
Which clinical manifestation indicates to the nurse the child has cystic fibrosis?
- A. Wheezing with a productive cough.
- B. Excessive salty sweat secretions.
- C. Multiple vitamin deficiencies.
- D. Clubbing of all fingers.
Correct Answer: B
Rationale: Excessive salty sweat (B) is a hallmark of cystic fibrosis due to defective chloride transport, detectable via sweat chloride testing. Wheezing/cough (A) is non-specific. Vitamin deficiencies (C) and clubbing (D) occur later but are not diagnostic.
A 62-year-old man is admitted with emphysema and acute upper respiratory infection. Oxygen is ordered at 2 L/min. The reason for low-flow oxygen is to:
- A. prevent excessive drying of secretions.
- B. facilitate oxygen diffusion of the blood.
- C. prevent depression of the respiratory drive.
- D. compensate for increased airway resistance.
Correct Answer: C
Rationale: In COPD, low oxygen levels drive respiration. Low-flow oxygen prevents suppression of the respiratory drive, which could occur with high-flow oxygen.