NSG 201H -Infectious Respiratory Disorders

NSG 201H -Infectious Respiratory Disorders

NSG 201H -Infectious Respiratory Disorders

Chapter 24: Coordinating Care for Patients With Infectious Respiratory Disorders

Multiple Choice

Identify the choice that best completes the statement or answers the question.

 

____     1.   The nurse is assessing several patients at a community clinic. Which patient should not receive an annual influenza vaccination?

1)	A 65-year-old woman
2)	A 3-year-old with cystic fibrosis
3)	A 35-year-old man with a severe allergy to eggs
4)	A 25-year-old pregnant woman at 20 weeks’ gestation

 

____     2.   A patient with the flu is experiencing tachypnea. What intervention is inappropriate to address in the nursing diagnosis of Ineffective Breathing Pattern related to the flu?

1)	Maintain adequate hydration
2)	Keep the head of the bed elevated
3)	Teach the patient coughing, deep breathing, and hydration
4)	Prepare the patient for the possibility of a tracheostomy tube.

 

____     3.   The nurse makes a home visit to a patient recovering from complications related to influenza. Which patient statement indicates the need for further intervention by the nurse?

1)	“I went back to work.”
2)	“I’m eating healthy foods now.”
3)	“I continue to wake up coughing at night.”
4)	“I have not had chills since I left the hospital.”

 

NSG 201H -Infectious Respiratory Disorders

____     4.   The nurse is reviewing diagnostic and laboratory studies performed for an older adult patient with influenza. Which result should the nurse recognize as being consistent with influenza?

1)	Increased BUN
2)	Decreased sodium level
3)	Fluid-filled lungs on chest x-ray
4)	Decreased white blood cell count

 

____     5.   The nurse is planning care for a patient diagnosed with influenza. Which intervention should the nurse include when planning this patient’s care?

1)	Placing a ventilator in the room
2)	Notifying other departments of the diagnosis
3)	Placing the patient in a negative air flow room
4)	Placing droplet and contact precaution signs on the patient room door

 

____     6.   An older adult patient is admitted with pneumonia. Which manifestation is unexpected during the nurse’s initial assessment?

1)	Lethargy
2)	Hemoptysis
3)	Increased appetite
4)	Increased respirations

 

____     7.   A nurse is caring for an older adult patient admitted to the hospital with pneumonia. The patient asks the nurse what can be done to decrease the risk for developing pneumonia in the future. Which response by the nurse is inappropriate?

1)	“You should avoid alcohol.”
2)	“You can start by not smoking.”
3)	“You can get the pneumonia vaccination, which may help to decrease your risk in the future.”
4)	“You should drink a yogurt drink once a day that is supplemented with L. casei immunitas cultures.”

 

____     8.   The nurse is caring for an older adult patient who is hospitalized with a second episode of pneumonia in the past 18 months. The patient has expressed frustration to the nurse and states, “I never got sick when I was younger. Why is this happening?” Which response by the nurse is most appropriate?

1)	“As you grow older, your immune system just quits working.”
2)	“As you grow older, there is a decrease in the immune response, which puts you at greater risk for developing an infection.”
3)	“As you grow older, there in an overall increase in the speed and strength of your immune response.”
4)	“As you grow older, there is an increase in the number of B cells in the circulation, which hinders the immune response.”

 

NSG 201H -Infectious Respiratory Disorders

____     9.   The nurse determines that the diagnosis of Ineffective Airway Clearance is appropriate for a patient with pneumonia who is experiencing copious amounts of respiratory secretions. Which intervention should the nurse include in this patient’s plan of care?

1)	Perform chest percussion every four hours and prn
2)	Administer the pneumococcal vaccine prior to discharge
3)	Limit fluid intake to 1,000 mL per day
4)	Provide the patient with smoking cessation education

 

____   10.   The nurse is providing discharge teaching to a patient recovering from pneumonia. Which patient statement indicates that additional teaching is needed?

1)	“I can’t get the influenza vaccine due to my allergy to eggs.”
2)	“I will get the influenza vaccine every year.”
3)	“I will get the pneumococcal vaccine every fall.”
4)	“I will get the pneumococcal vaccine as soon as I recover from this pneumonia.”

 

____   11.   The nurse is providing care to a patient with pneumonia and has a fever. Which intervention should the nurse implement to attain the goal of normal body temperature?

1)	Increase the temperature of the room environment to prevent shivering
2)	Administer antipyretic medications
3)	Restrict fluids during periods of hyperthermia because of the risk of electrolyte imbalance
4)	Use ice packs and a tepid bath every two hours

 

____   12.   The nurse is preparing to assess an older adult patient admitted with tuberculosis. Which manifestations does the nurse anticipate for this patient?

1)	Night sweats
2)	Swollen lymph nodes
3)	Cough
4)	Hemoptysis

 

____   13.   An adolescent patient is brought to the emergency department (ED) with fatigue, weight loss, a dry cough, and night sweats. The family just recently immigrated to the United States. Based on this data, for which potential risk should the nurse include when planning care for this patient?

1)	Pneumothorax
2)	Pneumonia
3)	Renal failure
4)	Septicemia

 

____   14.   The nurse in an inner city clinic is providing a health screening for a homeless patient with a history of drug abuse. The patient has a chronic nonproductive cough. For which should the nurse expect to screen this patient?

1)	Herpes zoster
2)	Sickle cell disease
3)	Sick sinus syndrome
4)	Tuberculosis

 

____   15.   The nurse is planning care for an older adult patient recently diagnosed with tuberculosis (TB). The patient lives alone in an apartment and will continue treatment at home. Which nursing diagnosis is a priority for this patient?

1)	Ineffective Therapeutic Regimen Management
2)	Deficient Knowledge
3)	Ineffective Breathing Pattern
4)	Risk for Injury

 

NSG 201H -Infectious Respiratory Disorders

____   16.   An occupational health nurse is screening a new employee in a long-term care facility for tuberculosis (TB). The employee questions why purified protein derivative (PPD) testing is done twice. Which is the most appropriate response by the nurse?

1)	“Different medication is used in the second PPD.”
2)	“The treatment for TB is six months of medication, and we want to make sure the first results of the first PPD were accurate.”
3)	“The first PPD was not interpreted in the correct time frame of 48-72 hours.”
4)	“There is an increased risk for a false-negative response for people who work in long-term care facilities. The two-step is recommended to accurately screen for TB.”

 

____   17.   The nurse is caring for a patient who is receiving multiple drugs for treatment of tuberculosis. The nurse teaches the patient the rationale for the multiple-drug treatment and evaluates learning as effective when the patient makes which statement?

1)	“Multiple drugs are necessary to develop immunity to tuberculosis.”
2)	“Multiple drugs are necessary because I became infected from an immigrant.”
3)	“Multiple drugs will be required as long as I am contagious.”
4)	“Multiple drugs are necessary because of the risk of resistance.”

 

____   18.   The nurse is caring for a patient who is admitted to the unit with tuberculosis (TB). The patient is placed in isolation. To protect the caregivers and other patients on the unit, which type of isolation room is most appropriate?

1)	Single-door room with positive air flow (air flows out of the room.)
2)	Isolation room with an anteroom and negative air flow (air flows into the room.)
3)	Isolation room with an anteroom and normal airflow
4)	Single-door room with normal airflow

 

____   19.   The charge nurse for a medical-surgical unit is notified that a patient with tuberculosis (TB) is being transported to the unit. Which nursing action for infection prevention is the most appropriate in this circumstance?

1)	Stock the patient’s supply cart at the beginning of each shift
2)	Wear a respirator mask and gown when caring for the patient
3)	Perform hand hygiene only after leaving the room
4)	Test all staff members for TB immediately

 

____   20.   A nurse is caring for a patient with tuberculosis (TB) who is taking Rifampin for treatment of the disease. Which nursing intervention is most appropriate for this patient?

1)	Administer the medication with meals to reduce gastrointestinal side effects
2)	Record a baseline visual examination before initiating therapy
3)	Administer the medication on an empty stomach
4)	Administer the medication by deep intramuscular injection into a large muscle mass

 

____   21.   The nurse is assessing a patient who is diagnosed with tuberculosis. Which assessment finding supports this diagnosis?

1)	Wheezing
2)	Hemoptysis
3)	Grey sputum
4)	Slightly whitish sputum

 

NSG 201H -Infectious Respiratory Disorders

____   22.   During the respiratory assessment, the nurse notes coarse crackles upon auscultation of the lung fields. Which diagnosis presents with this assessment finding?

1)	Pneumonia
2)	Cystic fibrosis
3)	Bronchospasm
4)	Interstitial edema

 

____   23.   The nurse is providing care to a patient who is diagnosed with pneumonia. The patient admits to smoking one pack of cigarettes per day. Which respiratory defense mechanism may have failed to cause the patient’s diagnosis?

1)	Cough reflex
2)	Filtration of air
3)	Alveolar macrophages
4)	Mucociliary clearance system

 

____   24.   The nurse receives a phone call from the parent of a child who is prescribed rifampin (Rimactane) for treatment of tuberculosis because she saw that the child’s urine was orange. Which response by the nurse is accurate?

1)	“Encourage your child to drink cranberry juice.”
2)	“An orange discoloration of urine is expected while your child is on this medication.”
3)	“Bring your child to the clinic for a urinalysis.”
4)	“Bring your child to the clinic for a radiograph of the kidneys.”

 

NSG 201H -Infectious Respiratory Disorders

Multiple Response

Identify one or more choices that best complete the statement or answer the question.

 

____   25.   The nurse caring for a homeless patient at risk for tuberculosis (TB) will include which symptoms of the disease when educating the patient? Select all that apply.

1)	Fatigue
2)	Low-grade morning fever
3)	Productive cough that later turns to a dry, hacking cough
4)	Weight loss
5)	Night sweats

 

____   26.   The nurse is assessing a patient with acute malaise and muscle aches. Which questions should the nurse ask to determine whether the patient is experiencing influenza? Select all that apply.

1)	“Have you had a flu shot this year?”
2)	“Is your cough productive?”
3)	“Have you been exposed to anyone with the flu?”
4)	“Are you having any trouble urinating?”
5)	“Do you have dizziness?”

 

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____   27.   The school nurse is planning a teaching session with the parents of students to reduce the spread of the influenza virus throughout the school. What should the nurse include when teaching the parents of a diverse population about infection-control techniques? Select all that apply.

1)	“Cover your cough” education
2)	Appropriate hand hygiene
3)	Safe food preparation and storage
4)	Sanitizing high-touch items to kill pathogens
5)	Withholding immunizations for children with compromised immune systems

 

____   28.   The nurse is caring for a patient who develops a fever and productive cough after having an appendectomy. Which prescriptions should the nurse expect from the health-care provider for this health problem? Select all that apply.

1)	Sputum cultures
2)	Antibiotics
3)	Chest physiotherapy
4)	Bronchial washing for culture
5)	Isolation precautions