Nokea
Which assessment data indicate to the nurse the client diagnosed with Legionnaires' disease is experiencing a complication?
- A. The client has an elevated body temperature.
- B. The client has less than 30 mL urine output an hour.
- C. The client has a decrease in body aches.
- D. The client has an elevated white blood cell count.
Correct Answer: B
Rationale: Oliguria (<30 mL/hr, B) indicates renal failure, a serious complication of Legionnaires' disease due to systemic infection or shock. Fever (A) and elevated WBC (D) are expected in active infection, not complications. Decreased body aches (C) suggests improvement, not a complication.
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A farmer who has had a cough for several months has noticed a lack of energy lately. He is being tested for histoplasmosis. Which factor reported by the client would be most related to the diagnosis of histoplasmosis?
- A. He drinks raw milk.
- B. He cleans chicken houses.
- C. He handles fertilizer frequently.
- D. He stepped on a rusty nail recently.
Correct Answer: B
Rationale: Cleaning chicken houses exposes the client to bird droppings, a common source of Histoplasma capsulatum, the fungus causing histoplasmosis.
The client diagnosed with tonsillitis is scheduled to have surgery in the morning. Which assessment data should the nurse notify the health-care provider about prior to surgery?
- A. The client has a hemoglobin of 12.2 g/dL and hematocrit of 36.5%.
- B. The client has an oral temperature of 100.2°F and a dry cough.
- C. There are one (1) to two (2) white blood cells (WBCs) in the urinalysis.
- D. The client's current international normalized ratio (INR) is 1.
Correct Answer: B
Rationale: Fever (100.2°F) and cough (B) suggest infection, a surgical risk requiring HCP notification. Hb/Hct (A) are near normal, WBCs in urine (C) are insignificant, and INR 1 (D) is normal.
The term 'blue bloaters' is used to describe patients with?
- A. Pulmonary hypertension
- B. Left-sided heart failure
- C. Chronic Bronchitis
- D. Emphysema
Correct Answer: C
Rationale: Blue bloaters' describes chronic bronchitis patients, who present with cyanosis ('blue') and edema ('bloating') due to hypoxemia and right heart failure. Emphysema patients are often called 'pink puffers.'
You are assessing your newly admitted patients who are all presenting with atypical signs and symptoms of a possible lung infection. The physician suspects tuberculosis. So, therefore, the patients are being monitored and tested for the disease. Select all the risk factors below that increases a patient's risk for developing tuberculosis:
- A. Diabetes
- B. Liver failure
- C. Long-term care resident
- D. Inmate
- E. IV drug user
- F. HIV
- G. U.S. resident
Correct Answer: A,C,D,E,F
Rationale: Risk factors for tuberculosis include conditions or environments that weaken the immune system or increase exposure: diabetes , long-term care residency , incarceration , IV drug use , and HIV . Liver failure is not a direct risk factor, and being a U.S. resident is not specific enough.
Aside from the characteristics of the client's cough, which other pertinent assessment finding should the nurse document?
- A. Family history of respiratory disease
- B. Current vital signs
- C. Appearance of respiratory secretions
- D. Any self-treatment measures used by the client
Correct Answer: C
Rationale: The appearance of respiratory secretions (color, consistency) provides critical information about the infection's severity and type.