Nokea
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.
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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 has the diagnosis of valley fever accompanied by myalgias and arthralgias. What treatment should the nurse educate the client on?
- A. Intravenous amphotericin B.
- B. Long-term anti-inflammatories.
- C. No specific treatment.
- D. Oral fluconazole (Diflucan).
Correct Answer: D
Rationale: Valley fever, or coccidioidomycosis, is a fungal infection. The presence of joint and muscle pain indicates a moderate infection that needs treatment with antifungal medications like oral fluconazole.
A nurse working in a geriatric clinic sees clients with cold symptoms and rhinitis. Which drug would be appropriate to teach these clients to take for their symptoms?
- A. Chlorphenamine (Chlor-Trimeton)
- B. Diphenhydramine (Benadryl)
- C. Fexofenadine (Allegra)
- D. Hydroxyzine (Vistaril)
Correct Answer: C
Rationale: First-generation antihistamines are not appropriate for use in the older population. These drugs include chlorphenamine, diphenhydramine, and hydroxyzine. Fexofenadine is a second-generation antihistamine, which is safer and more suitable for older adults.
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 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.