Unit 6 - Class Activities

Question 1

An 80 year old male patient is admitted to your medical floor with Bacterial pneumonia. During the health history you learn that the patient has osteoarthritis, is vegetarian, owns 5 cats & 4 chickens and is obsessed with cleanliness. Which of the following would most likely be a predisposing factor for the diagnosis of pneumonia.

A.Age
B.Osteoarthritis
C.Vegetarian diet 
D.Daily bathing
E.Animal bacteria

Answer 1

A.Age

*Client age is a predisposing factor for pneumonia: pneumonia is more common in elderly or debilitated clients. Other predisposing factors include smoking, suppression and the presence of a chronic illness.

Question 2

A patient who has had ulcerative colitis for the past 5 years is admitted to the hospital with exacerbation of the disease. Which of the following factors was most likely of greatest significance in causing an exacerbation of ulcerative colitis ?

A.A demanding and stressful job
B.Changing to a modified vegetarian diet
C.Beginning a weight training program
D.Walking 2 miles every day

Answer 2

A.A demanding and stressful job

*Stressful and emotional events have been clearly linked to exacerbation of ulcerative colitis, although their role in the etiology/ cause of the disease had been disproved, A modified vegetarian diet or and exercise program is an unlikely cause of the exacerbation

Question 3

Acute bacterial infections and also some infections caused by viruses & fungi

Answer 3

neutrophilia

Question 4

viral infections

Answer 4

neutropenia

Question 5

Which of the following is the FIRST priority in preventing infections when providing care for a client?

A.Handwashing
B.Wearing gloves
C.Using a barrier between clients furniture and nurses bag in the home care setting
D.Wearing gowns and googles

Answer 5

A.Handwashing

*CDC: Hand hygiene is now regarded as one of the most important element of infection control activities. In the wake of the growing burden of health care associated infections (HCAIs), the increasing severity of illness and complexity of treatment, superimposed by multi-drug resistant (MDR) pathogen infections, health care practitioners (HCPs) are reversing back to the basics of infection preventions by simple measures like hand hygiene. This is because enough scientific evidence supports the observation that if properly implemented, hand hygiene alone can significantly reduce the risk of hand hygiene alone can significantly reduce the risk of cross-transmission of infection in healthcare facilitiescross-transmission of infection in healthcare facilities (HCFs)1–5.

Question 6

You are more likely to acquire pneumonia for all the following reasons, EXCEPT:

A.Smoking
B.History of chronic lung disease
C.Antibiotic use within the past 3 months
D.Living in cold environment

Answer 6

D.Living in cold environment

Question 7

Which of the following is used to diagnose pneumonia?

A.MRI
B.Chest X-ray
C.Blood tests
D.Brain CT scan

Answer 7

B.Chest X-ray

Question 8

What are precautions & teaching will you take with a person with pneumonia?

A.Advise patient against smoking
B.Advise patient against drinking water
C.Droplet precaution
D.Both A and C

Answer 8

D.Both A and C

Question 9

Pneumonia complications may include? Check all that apply

A.Bacteria in your bloodstream
B.Septic Shock
C.Fluid Accumulation and infection around your lungs
D.Lung abscess
E.Acute Respiratory Distress Syndrome (ARDS)

Answer 9

A.Bacteria in your bloodstream
B.Septic Shock
C.Fluid Accumulation and infection around your lungs
D.Lung abscess
E.Acute Respiratory Distress Syndrome (ARDS)

Question 10

Which of the following would be priority assessment data to gather from a client who has been diagnosed with pneumonia? Select all that apply

A.Auscultation of breath sounds
B.Auscultation of bowel sounds
C.Presence of chest pain
D.Presence of peripheral edema
E.Color of nail beds

Answer 10

A.Auscultation of breath sounds
C.Presence of chest pain
E.Color of nail beds

Question 11

Which of the following mental status changes may occur when a client with pneumonia is first experiencing hypoxia?

A.Coma
B.Apathy
C.Irritability
D.Depression

Answer 11

C.Irritability

*Hypoxia: irritability , restlessness, or anxiety asINITIALmental status changes and as the hypoxia becomes more severe the patient may become confused and combative. Coma is a LATE manifestation

Question 12

Which of the following would be an appropriate expected outcome for an elderly client recovering from bacterial pneumonia? Pick the BEST one!

A.A respiratory rate of 25 to 30 breaths / minute
B.The ability to perform activities of daily living without dyspnea
C.A maximum loss of 5 to 10 lb. of body weight
D.Chest pain that is minimized by splinting the rib cage

Answer 12

B.The ability to perform activities of daily living without dyspnea

*Should be no pain, no tachypnea, and no weight loss if they are recovering

Question 13

A nurse notes that a client has kyphosis and generalized muscle atrophy. Which of the following problems is a priority when the nurse develops a nursing plan of care?

A.Infection
B.Confusion
C.Ineffective coughing and deep breathing
D.Difficulty chewing solid foods

Answer 13

C.Ineffective coughing and deep breathing

*In kyphosis of the thoracic spine bends forward with convexity of the curve in a posterior direction, making effective coughing and deep breathing difficult. Although the client may develop other problems because respiratory status deteriorates when pulmonary secretions are not adequately cleared from airway and can lead to pneumonia. Ineffective coughing and deep breathing should receive priority attention

Question 14

A client with bacteria pneumonia is to be started on I.V. antibiotics . Which of the following diagnostic tests must be completed before antibiotic therapy begins?

A.Urinalysis
B.Sputum culture
C.Chest radiograph
D.Red blood cell count

Answer 14

B.Sputum culture

*A sputum culture is obtained for culture to determine the causative organism. After the organism is identified an appropriate antibiotic can be prescribed . Beginning antibiotic therapy before obtaining the sputum specimen may alter the results of the test.

Question 15

Bedrest is prescribed for a client with pneumonia during the acute phase of the illness. Bedrest serves which of the following purposes?

A.It reduces the cellular demand for oxygen
B.It decreases the episodes of coughing
C.It promotes safety
D.It promotes clearance of secretions

Answer 15

A.It reduces the cellular demand for oxygen

*Exudate in the alveoli interferes with ventilation and the diffusion of gases in clients with pneumonia . During the acute phase of the illness. It is essential to reduce the body’s need for oxygen at the cellular level, bed rest is the most effective method for doing so. Bedrest does not reduce coughing or promote clearance of secretions

Question 16

Which of the following measures would most likely be successful in reducing pleuritic chest pain. Which of the following describes pleuritic chest pain?

A.Encourage the client to breathe shallowly
B.Have the client practice abdominal breathing
C.Offer the client incentive spirometry
D.Teach the client to splint the rib cage when coughing

Answer 16

D.Teach the client to splint the rib cage when coughing

*Pleuritic pain is triggered by chest movement and is particularly severe during coughing. Splinting the chest wall will help reduce the discomfort of coughing, deep breathing is essential to prevent further atelectasis . Abdominal breathing is not effective in decreasing pleuritic pain Incentive spirometry facilitates effective deep breathing but does not decrease pleuritic chest pain

Question 17

When planning care for a patient with ulcerative colitis who is experiencing an exacerbation of symptoms, which client care activities can the nurse appropriately delegate to an unlicensed assistant? Select all that apply:

A.Assessing the clients bowel movements
B.Providing skin care following bowel movements
C.Evaluating the clients response to antidiarrheal medications
D.Maintaining intake and output records
E.Obtaining the clients weight

Answer 17

B.Providing skin care following bowel movements
D.Maintaining intake and output records
E.Obtaining the clients weight

*Assessing and evaluating can NOT be delegated

Question 18

Which goal for the clients care should take priority during the first days of hospitalization for an exacerbation of ulcerative colitis?

A.Promoting self-care and independence
B.Managing diarrhea
C.Maintaining adequate nutrition
D.Promoting rest and comfort

Answer 18

B.Managing diarrhea

*Diarrhea ( bloody many times) is the primary symptom in an exacerbation of ulcerative colitis and decreasing the frequency of stools is the first goal of treatment. The other goals are ongoing and will be best achieved by halting the exacerbation. The client may receive antidiarrheal agents, antispasmodic agents, bulk hydrophilic agents, or anti-inflammatory drugs

Question 19

A patient who has ulcerative colitis says to the nurse, “I can’t take this anymore! I’m constantly in pain, and I can’t leave my room because I need to stay by the toilet. I don’t know how to deal with this. “Based on these comments , an appropriate nursing diagnosis for this client would be:

A.Impaired physical mobility related to fatigue
B.Disturbed thought processes related to pain
C.Social Isolation related to chronic fatigue
D.Ineffective coping related to chronic abdominal pain

Answer 19

D.Ineffective coping related to chronic abdominal pain

*These patients may become apprehensive and upset about the frequency of stools and the abdominal cramping. During these exacerbations they need emotional support and encouragement to verbalize their feelings about their chronic health concerns and assistance in developing effective coping methods. The client has not expressed feeling of fatigue or isolation or demonstrated disturbed thought processes.

Question 20

A newly diagnosed patient with ulcerative colitis has been placed on steroids. They state they have heard that taking steroids can be dangerous and ask the nurse why steroids are prescribed. Which of the following statements by the nurse provides the client with accurate information about the use of steroid therapy in the treatment of ulcerative colitis?

A.“Ulcerative colitis can be cured by the use of steroids.”
B.“Steroids are used in severe flare-ups because they can decrease the incidences of bleeding.”
C.“Long-term use of steroids will prolong periods of remission.”
D.“The side effects of steroids outweigh their benefits to clients with ulcerative colitis.”

Answer 20

B.“Steroids are used in severe flare-ups because they can decrease the incidences of bleeding.”

*Steroids are effective in management of the acute symptoms of ulcerative colitis. They do NOT cure it. Long term use is not effective in prolonging the remission / assess carefully for side effects but the benefitsof short term steroid therapy usually outweigh the potential adverse effects

Question 21

Which of the following should be a priority focus of care for a client experiencing exacerbation of Crohn’s disease?

A.Encouraging regular ambulation
B.Promoting bowel rest
C.Maintaining current weight
D.Decreasing episodes of rectal bleeding

Answer 21

B.Promoting bowel rest

*Priority goal of care during an acute exacerbation of Crohn’s disease is to promote bowel rest. This is accomplished through decreasing activity encouraging rest, and initially placing client on nothing by mouth status while maintain nutritional needs parenterally. Regular ambulation is important, but the priority is bowel rest. The client will probably lose some weight during the acute phase of the illness. Diarrhea is nonbloody in Chrohn’s disease and episodes or rectal bleeding are not expected