Deck 33: Care of Patients With Infectious Respiratory Problems

Question 1

A client is worried about contracting influenza.What is the nurse's best response to the client?

A) "Flu is no longer a prevalent problem."
B) "Did you receive a flu vaccine this year?"
C) "Current flu strains are generally mild."
D) "If you develop symptoms, antibiotics will cure you."

Answer 1

"Did you receive a flu vaccine this year?"

Question 2

The newly employed nurse received a bacillus Calmette-Guérin (BCG)vaccine before moving to the United States.The nurse needs to receive a tuberculin (TB)test as part of the pre-employment physical.What does the nurse do?

A) The nurse should not receive the tuberculin test.
B) The nurse will need a two-step TB test.
C) The nurse will need a chest x-ray instead.
D)A physician should examine the nurse before the TB test is given.

Answer 2

The nurse will need a chest x-ray instead.

Question 3

What is the priority nursing intervention when caring for a client with severe acute respiratory syndrome (SARS)?

A) Maintaining Standard Precautions
B) Administering antibiotics
C) Assessing oxygenation
D) Making sure the client stays hydrated

Answer 3

Assessing oxygenation

Question 4

A client is admitted with suspected avian influenza.The family asks the nurse what kind of care the client will get.Which statement by the nurse is correct?

A) "He will be given standard antibiotic agents and will be placed in contact isolation."
B) "He will be placed on airborne and contact isolation."
C) "Oseltamivir (Tamiflu) will reduce complications of this infection."
D) "All family members should be tested for evidence of the same disease."

Question 5

The nurse has determined that a client has an acute sore throat.What is the nurse's best action?

A) Assess whether the client can speak.
B) Call an ear-nose-throat specialist.
C) Administer an antibiotic.
D) Give the client ice chips.

Question 6

A client who has had acute tonsillitis develops drooling and reports severe throat pain.What is the nurse's priority intervention?

A) Assess the throat for deviation of the uvula.
B) Prepare the client for surgery.
C) Teach the client about antibiotic therapy.
D) Prepare the client for percutaneous needle aspiration.

Question 7

The nurse is caring for a client with recurrent bacterial pharyngitis.Which is the nurse's highest priority intervention?

A) Assess for symptoms of human immune deficiency virus (HIV).
B) Ask about exposure to allergens.
C) Perform nasal cultures.
D) Teach the client about antibiotic therapy.

Question 8

The nurse is caring for several clients on a respiratory floor.The nurse should place the client with which condition in isolation?

A) Fever and weight loss
B) Negative QuantiFERON TB gold test
C) Negative acid-fast bacillus (AFB) stain
D) Positive nucleic acid amplification test (NAAT)

Question 9

The nurse is worried that a client who is not entirely reliable is being discharged home on therapy for multidrug-resistant tuberculosis.What strategy is the best to use for this client?

A) Directly observed therapy
B) IV drug administration
C) Remaining in the hospital
D) Isolation

Question 10

Which is the highest priority goal to set for a client with pneumonia?

A) Absence of cyanosis
B) Maintenance of SaO₂ of 95%
C) Walking 20 feet three times daily
D) Absence of confusion

Question 11

Which client does the nurse caution to avoid taking over-the-counter decongestants for manifestations of a cold or flu?

A) Young man with a latex allergy
B) Middle-aged woman with hypertension
C) Teenage woman who is taking oral contraceptives
D) Older man who has had type 1 diabetes mellitus for 20 years

Question 12

The nurse assesses a client with pneumonia and notes decreased lung sounds on the left side and decreased lung expansion.What is the nurse's best action?

A) Have the client cough and deep breathe.
B) Check oxygen saturation and notify the health care provider.
C) Perform an arterial blood gas analysis.
D) Increase oxygen flow to 10 L/min.

Question 13

The nurse is teaching a client with pneumonia ways to clear secretions.Which intervention is the most effective?

A) Administering an antitussive medication
B) Administering an antiemetic medication
C) Increasing fluids to 2 L/day if tolerated
D) Having the client cough and deep breathe hourly

Question 14

A client who is immune compromised develops muscle aches and fever.The client is admitted to the hospital for several days and is diagnosed with influenza.At discharge,the client asks when he can go back to work.What is the nurse's best response?

A) "You should be able to return to work in 5 days."
B) "You can return to work as soon as you feel ready."
C) "You cannot return to work for several weeks."
D) "You will need to have cultures performed before returning to work."

Question 15

A client who works in a day care facility is admitted to the emergency department.The client is diagnosed with pneumonia,and a sputum culture is taken.Infection with Streptococcus pneumoniae is confirmed.What is the nurse's primary action?

A) Have emergency intubation equipment nearby.
B) Teach the client about the treatment.
C) Isolate the client.
D) Perform chest physiotherapy.

Question 16

An older adult is admitted to the emergency department with respiratory symptoms.Which client symptom requires the nurse to intervene immediately?

A) Confusion
B) Scattered wheezing
C) Crackles
D) Flushed cheeks

Question 17

A client has acute rhinitis.What is the most important intervention for the nurse to perform?

A) Assess for symptoms of infection.
B) Ascertain whether the client has allergies.
C) Question the client on the use of nasal sprays.
D) Do blood and urine screenings for drug use.

Question 18

It is suspected that a client has bacterial pharyngitis.What is the best intervention?

A) Administer a broad-spectrum antibiotic.
B) Have the client produce a sputum specimen.
C) Obtain samples for culture and sensitivity.
D) Assess a rapid antigen test (RAT).

Question 19

A client has pharyngitis.Which symptom helps the nurse determine whether the infection is bacterial versus viral?

A) Redness in the back of the throat
B) Enlarged lymph glands in the neck
C) Nasal discharge
D) Skin rash

Question 20

A client has multidrug-resistant tuberculosis (TB).What is the most important fact for the nurse to teach the client?

A) "You will need to take medications longer than clients with other strains."
B) "You will need to remain in the hospital until cultures are negative."
C) "You will need to wear a mask when you go out in public."
D) "You will need to have drug cultures done weekly."

Question 21

An older client reports having a cold and a "full bladder." What does the nurse obtain for or from the client?

A) Order for a Foley catheter
B) Order for a one-time catheterization
C) Urine specimen
D) History focusing on current medications

Question 22

The nurse is caring for a client who has inhalation anthrax.What nursing actions are of the highest priority?

A) Placing the client in an isolation room
B) Teaching the client how to use a mask
C) Teaching the client about long-term antibiotic therapy
D) Using handwashing and other Standard Precautions
E) Reporting suspected cases to the proper authorities

Question 23

A client who previously had a bacillus Calmette-Guérin (BCG)vaccine has a positive tuberculosis (TB)test.What symptoms assist in determining that the client has active disease?

A) Nausea
B) Weight loss
C) Insomnia
D) Ankle edema
E) Night sweats
F) Increased urination

Question 24

A client is admitted with left lower lung pneumonia.Which assessment finding does the nurse correlate with this condition?

A) Expiratory wheeze on the right side
B) Dullness to percussion on the lower left side
C) Crepitus of the skin around the left lung
D) Crackles heard on expiration bilaterally

Question 25

A client has a tuberculin skin test as a pre-employment physical requirement.Which statement by the nurse is best made to the client who has the test result seen in the photograph below?

A) "Your PPD is negative. No further follow-up is necessary."
B) "You will need to have a second PPD."
C) "You will need to have titers drawn."
D) "You will need further testing."

Question 26

An older adult client with heart failure asks if she should get a flu shot.Which is the nurse's best response?

A) "Yes, because of your heart failure you are at greater risk for complications."
B) "Yes, if it has been longer than 5 years since your last flu vaccination."
C) "No, your heart failure makes you too weak to get the live virus vaccine."
D) "No, the vaccine will interact with your heart medications."

Question 27

Which person is at greatest risk for developing a community-acquired pneumonia?

A) Middle-aged teacher who typically eats a diet of Asian foods
B) Older adult who smokes and has a substance abuse problem
C) Older adult with exercise-induced wheezing
D) Young adult aerobics instructor who is a vegetarian

Question 28

The nurse is caring for a client who is suspected of having severe acute respiratory syndrome (SARS).What actions by the nurse are most appropriate?

A) Wash hands when entering the client's room and use Standard Precautions.
B) Wear a gown and goggles when entering the client's room.
C) Teach the client to wear a mask at all times when someone is in the room.
D) Use a disposable particulate mask respirator when the client is coughing.
E) Keep the door to the client's room open to allow close monitoring.
F) Place the client in a negative airflow room, if available in the facility.

Question 29

Which is a priority teaching intervention for the client who is using a nicotine patch?

A) "Abruptly discontinuing this patch can cause high blood pressure."
B) "Abruptly discontinuing this patch can cause nausea and vomiting."
C) "Smoking while using this patch increases the risk for pneumonia."
D) "Smoking while using this patch increases the risk for a heart attack."

Question 30

Which is the nurse's best response to an older adult client who is hesitant to take the pneumococcal vaccination and influenza vaccine in the same year?

A) "You need both injections. A risk factor for getting pneumonia is infection with influenza."
B) "Take both injections. They will protect you against respiratory problems for this year."
C) "The flu shot may protect you against influenza but not against bacteria that cause pneumonia."
D) "You should get the pneumococcal vaccination so you won't infect other people."

Question 31

A client started on therapy for tuberculosis infection is reporting nausea.What does the nurse teach this client?

A) Eat a diet rich in protein, iron, and vitamins.
B) Do not drink fluids with medications.
C) Take medications at bedtime.
D) Space medications 12 hours apart.
E) Take medications with milk.
F) Take an antiemetic daily.

Question 32

What is the best way for the nurse to decrease the risk of ventilator-associated pneumonia (VAP)in a ventilator-dependent client?

A) Provide prophylactic antibiotics.
B) Provide frequent oral care.
C) Keep the head of the bed elevated.
D) Maintain good hand hygiene.
E) Perform chest percussion frequently.

Question 33

The nurse auscultates the following lung sound in the client with pneumonia.What is the best intervention? (Click the media button to hear the audio clip.)

A) Have the client cough and deep breathe.
B) Prepare to administer a bronchodilator.
C) Have the client use an incentive spirometer.
D) Administer IV fluids.

Question 34

A client enters the clinic with an acute sore throat and a temperature of 101.5° F (38.5° C).What diagnostic testing does the nurse educate the client about?

A) Complete blood count (CBC)
B) Throat culture
C) Monospot test
D) Arterial blood gas
E) Biopsy
F) HIV testing

Question 35

A client has a peritonsillar abscess.Which priority instruction does the nurse provide to this client?

A) "If you notice an enlarged node on the side of your neck where the abscess is, call your health care provider."
B) "Stay home from work or school until your temperature has been normal for 24 hours."
C) "You may gargle with warm water that has a teaspoon of salt in it as often as you like."
D) "Take the antibiotic for the entire time it is prescribed, not just until you feel better."

Question 36

What teaching is appropriate for a client with acute rhinitis and sinusitis?

A) Using hot packs over the sinuses
B) Fluid restriction
C) Saline irrigations
D) Staying in a dry climate
E) Taking echinacea
F) Antifungal medications