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tyeoi tyeoi
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Posts: 541
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6 years ago
An older adult is brought to the emergency department by a family member, who reports a moderate change in mental status and mild cough. The client is afebrile. The health care provider orders a chest x-ray.
 
  The family member questions why this is needed since the manifestations seem so vague. What response by the nurse is best?
  a.
  Chest x-rays are always ordered when we suspect pneumonia.
  b.
  Older people often have vague symptoms, so an x-ray is essential.
  c.
  The x-ray can be done and read before laboratory work is reported.
  d.
  We are testing for any possible source of infection in the client.

Question 2

The charge nurse on a medical unit is preparing to admit several clients who have possible pandemic flu during a preparedness drill. What action by the nurse is best?
 
  a. Admit the clients on Contact Precautions.
  b. Cohort the clients in the same area of the unit.
  c. Do not allow pregnant caregivers to care for these clients.
  d. Place the clients on enhanced Droplet Precautions.

Question 3

A client is in the family practice clinic reporting a severe cold that started 4 days ago. On examination, the nurse notes the client also has a severe headache and muscle aches. What action by the nurse is best?
 
  a. Educate the client on oseltamivir (Tamiflu).
  b. Facilitate admission to the hospital.
  c. Instruct the client to have a flu vaccine.
  d. Teach the client to sneeze in the upper sleeve.

Question 4

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.

Question 5

A nurse in a family practice clinic is preparing discharge instructions for a client reporting facial pain that is worse when bending over, tenderness across the cheeks, and postnasal discharge. What instruction will be most helpful?
 
  a. Ice packs may help with the facial pain.
  b. Limit fluids to dry out your sinuses.
  c. Try warm, moist heat packs on your face.
  d. We will schedule you for a computed tomography scan this week.

Question 6

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. Chlorpheniramine (Chlor-Trimeton)
  b. Diphenhydramine (Benadryl)
  c. Fexofenadine (Allegra)
  d. Hydroxyzine (Vistaril)

Question 7

A nurse cares for a client who is prescribed an intravenous prostacyclin agent. Which actions should the nurse take to ensure the client's safety while on this medication? (Select all that apply.)
 
  a. Keep an intravenous line dedicated strictly to the infusion.
  b. Teach the client that this medication increases pulmonary pressures.
  c. Ensure that there is always a backup drug cassette available.
  d. Start a large-bore peripheral intravenous line.
  e. Use strict aseptic technique when using the drug delivery system.
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wrote...
6 years ago
The answer to question 1

ANS: B
It is essential to obtain an early chest x-ray in older adults suspected of having pneumonia because symptoms are often vague. Waiting until definitive manifestations are present to obtain the x-ray leads to a costly delay in treatment. Stating that chest x-rays are always ordered does not give the family definitive information. The x-ray can be done while laboratory values are still pending, but this also does not provide specific information about the importance of a chest x-ray in this client. The client has manifestations of pneumonia, so the staff is not testing for any possible source of infection but rather is testing for a suspected disorder.

The answer to question 2

ANS: B
Preventing the spread of pandemic flu is equally important as caring for the clients who have it. Clients can be cohorted together in the same set of rooms on one part of the unit to use distancing to help prevent the spread of the disease. The other actions are not appropriate.

The answer to question 3

ANS: D
Sneezing and coughing into one's sleeve helps prevent the spread of upper respiratory infections. The client does have manifestations of the flu (influenza), but it is too late to start antiviral medications; to be effective, they must be started within 24 to 48 hours of symptom onset. The client does not need hospital admission. The client should be instructed to have a flu vaccination, but now that he or she has the flu, vaccination will have to wait until next year.

The answer to question 4

ANS: B
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. The other instructions are appropriate, just not the most important.

The answer to question 5

A nurse in a family practice clinic is preparing discharge instructions for a client reporting facial pain that is worse when bending over, tenderness across the cheeks, and postnasal discharge. What instruction will be most helpful?
a.
Ice packs may help with the facial pain.
b.
Limit fluids to dry out your sinuses.
c.
Try warm, moist heat packs on your face.
d.
We will schedule you for a computed tomography scan this week.

ANS: C
This client has rhinosinusitis. Comfort measures for this condition include breathing in warm steam, hot packs, nasal saline irrigations, sleeping with the head elevated, increased fluids, and avoiding cigarette smoke. The client does not need a CT scan.

The answer to question 6

ANS: C
First-generation antihistamines are not appropriate for use in the older population. These drugs include chlorpheniramine, diphenhydramine, and hydroxyzine. Fexofenadine is a second-generation antihistamine.

The answer to question 7

ANS: A, C, E
Intravenous prostacyclin agents should be administered in a central venous catheter with a dedicated intravenous line for this medication. Death has been reported when the drug delivery system is interrupted; therefore, a backup drug cassette should also be available. The nurse should use strict aseptic technique when using the drug delivery system. The nurse should teach the client that this medication decreases pulmonary pressures and increases lung blood flow.
tyeoi Author
wrote...
6 years ago
TY
wrote...
6 years ago
My pleasure
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