Nokea
Which statement is correct regarding mycobacterium tuberculosis?
- A. This bacterium is an anaerobic type of bacteria.
- B. It is an alkali bacterium that stains bright red during an acidfast smear test.
- C. It is known as being an aerobic type of bacteria.
- D. It's an acid-fact bacterium that stains bright green during an acid-fast smear test.
Correct Answer: C
Rationale: Mycobacterium tuberculosis is an aerobic bacterium. It is acid-fast and stains red (not green) during an acid-fast smear due to its mycolic acid-rich cell wall. It is not anaerobic or alkali.
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The post-anesthesia care nurse is caring for the client diagnosed with lung cancer who had a thoracotomy and is experiencing frequent premature ventricular contractions (PVCs). Which intervention should the nurse implement first?
- A. Request STAT arterial blood gases.
- B. Administer lidocaine intravenous push.
- C. Assess for possible causes.
- D. Request a STAT electrocardiogram.
Correct Answer: C
Rationale: Frequent PVCs post-thoracotomy may stem from hypoxia, electrolyte imbalances, or pain. Assessing for causes (C) is the first step to identify and address the underlying issue. ABGs (A) or ECG (D) may follow based on findings. Lidocaine (B) is premature without identifying the cause.
A 72 year-old male patient who is diagnosed with bilateral lower lobe pneumonia is admitted to your unit. The patient has a history of systolic heart failure and arthritis. On assessment, you note the patient has a respiratory rate of 21 , oxygen saturation $93 \%$ on $2 \mathrm{~L}$ nasal cannula, is alert & oriented, and has a productive cough with green/yellowish sputum. Which of the following nursing interventions will you provide to this patient based on your assessment findings and the patient's diagnosis? Select-all-that-apply:
- A. Keep head-of-the-bed less than 30 degrees at all times.
- B. Collect sputum cultures.
- C. Encourage 3L of fluids a day to keep secretions thin.
- D. Encourage incentive spirometer usage
- E. Provide education about receiving the Pneumovax vaccine annually.
Correct Answer: B,D
Rationale: Sputum cultures identify the causative organism, and incentive spirometer use promotes lung expansion. Head-of-bed <30 degrees increases aspiration risk, 3L fluids may overload heart failure patients, and Pneumovax is not annual.
Which of the following patients are MOST at risk for developing pneumonia? Select-all-that-apply:
- A. A 53 year old female recovering from abdominal surgery.
- B. A 69 year old patient who recently received the pneumococcal conjugate vaccine.
- C. A 42 year old male with COPD and is on continuous oxygen via nasal cannula.
- D. A 8 month old with RSV (respiratory syncytial virus) infection.
Correct Answer: A,C,D
Rationale: Patients recovering from surgery are at risk due to immobility and impaired cough reflex, those with COPD have chronic lung disease increasing susceptibility, and infants with RSV are prone to secondary bacterial pneumonia. The vaccinated patient has reduced risk due to immunity.
The nurse is preparing to administer warfarin (Coumadin), an oral anticoagulant, to a client diagnosed with a pulmonary embolus. Which data would cause the nurse to question administering the medication?
- A. The client's partial thromboplastin time (PTT) is 38.
- B. The client's international normalized ratio (INR) is 5.
- C. The client's prothrombin time (PT) is 22.
- D. The client's erythrocyte sedimentation rate (ESR) is 10.
Correct Answer: B
Rationale: An INR of 5 (B) is above the therapeutic range (2–3 for pulmonary embolus), indicating excessive anticoagulation and bleeding risk, so warfarin should be questioned. PTT (A) is for heparin, not warfarin. PT (C) alone is not standardized. ESR (D) is irrelevant to anticoagulation.
Which agents should the nurse suspect as being the cause of the victims' symptoms? Select all that apply.
- A. Anthrax
- B. Sarin gas
- C. Smallpox
- D. Radiation
- E. Cyanide
- F. Ebola virus
Correct Answer: B, E
Rationale: Sarin gas and cyanide are chemical agents that can cause rapid onset of dyspnea, weakness, and nausea, consistent with the symptoms described.