A 51-year-old male client with pneumonia has undergone several days of antibiotic and respiratory treatment. Given the following assessment findings, mark whether they indicate that the treatment was effective or ineffective:

PaCO2 55 mm Hg on a blood gas

Rhonchi in the right lung

Oxygen saturation greater than 94%

Client ambulates without shortness of breath

Answer and Explanation

Correct Answer : C,D

Choice A rationale:

PaCO2 55 mm Hg on a blood gas indicates ineffective treatment. Normal PaCO2 levels range from 35-45 mm Hg.

Elevated PaCO2 (hypercapnia) suggests that the lungs are not effectively removing carbon dioxide from the body. This can be due to various factors, including:

Incomplete resolution of pneumonia Airway obstruction

Impaired respiratory muscle function

Choice B rationale:

Rhonchi in the right lung indicates ineffective treatment.

Rhonchi are coarse, rattling sounds heard in the lungs during auscultation.

They are often associated with mucus accumulation in the airways, which can occur in pneumonia.

The presence of rhonchi suggests that inflammation and mucus production persist, despite antibiotic and respiratory therapy.

Choice C rationale:

Oxygen saturation greater than 94% indicates effective treatment. Normal oxygen saturation levels are typically 95% or higher.

A saturation of 94% or above suggests that the lungs are able to effectively oxygenate the blood. This is a positive sign that the pneumonia is responding to treatment.

Choice D rationale:

Client ambulates without shortness of breath indicates effective treatment. Shortness of breath (dyspnea) is a common symptom of pneumonia.

It occurs when the lungs are unable to provide enough oxygen to the body, leading to a feeling of breathlessness.

The ability to ambulate without shortness of breath suggests that the pneumonia has improved and that the lungs are functioning more effectively.

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Correct Answer is B

Explanation

Choice A rationale:

Hemoccult test on sputum collected from hemoptysis is not a diagnostic test for TB. It is a test for blood in the stool, which can be a symptom of TB but is not specific to TB.

Hemoptysis, or coughing up blood, can occur in various conditions, including bronchitis, pneumonia, lung cancer, and TB. The Hemoccult test cannot differentiate between these causes, making it an unreliable test for diagnosing TB.

Choice B rationale:

Sputum culture positive for Mycobacterium tuberculosis is the definitive diagnostic test for TB.

It involves collecting a sample of sputum, which is the mucus coughed up from the lungs, and culturing it in a laboratory to see if Mycobacterium tuberculosis, the bacteria that causes TB, grows.

This test is highly specific for TB, meaning that a positive result is almost always indicative of TB infection. It is also sensitive, meaning that it can detect TB infection even when there are few bacteria present.

Choice C rationale:

Positive purified protein derivative (PPD) skin test indicates exposure to TB but does not confirm active infection.

The PPD skin test involves injecting a small amount of tuberculin, a protein derived from Mycobacterium tuberculosis, into the skin.

If a person has been exposed to TB, their immune system will react to the tuberculin, causing a raised red bump to appear at the injection site.

However, a positive PPD skin test does not necessarily mean that a person has active TB infection.

It could also mean that they have been exposed to TB in the past but have successfully fought off the infection. Further testing, such as a sputum culture, is needed to confirm the diagnosis of TB.

Choice D rationale:

Chest X-ray or computed tomography (CT) can show abnormalities in the lungs that are suggestive of TB, but they cannot definitively diagnose TB.

These imaging tests can reveal changes in the lungs, such as nodules, inflammation, or fluid buildup, which can be caused by TB or other conditions.

Therefore, a chest X-ray or CT scan alone is not sufficient to diagnose TB. A sputum culture is still needed to confirm the diagnosis.

A. Dysrhythmia B. Toxicity C. Anemia D. Pneumonia

Correct Answer is D

Explanation

Rationale for Choice A: Dysrhythmia

There is no information in the question stem to suggest that the patient is experiencing a dysrhythmia.

Dysrhythmias are abnormal heart rhythms that can be caused by a variety of factors, including heart disease, electrolyte imbalances, and medications.

While it is possible that the patient could develop a dysrhythmia as a complication of pneumonia, there is no evidence to support this in the given information.

Additionally, enalapril, which the patient is taking for hypertension, is not typically associated with an increased risk of dysrhythmias.

Rationale for Choice B: Toxicity

There is no information in the question stem to suggest that the patient is experiencing toxicity.

Toxicity can be caused by a variety of substances, including medications, drugs, and environmental toxins.

While it is possible that the patient could develop toxicity as a complication of pneumonia, there is no evidence to support this in the given information.

Additionally, the patient's medication regimen of enalapril and a multivitamin is not typically associated with an increased risk of toxicity.

Rationale for Choice C: Anemia

There is no information in the question stem to suggest that the patient is anemic.

Anemia is a condition in which there is a decreased number of red blood cells or hemoglobin in the blood.

While it is possible that the patient could develop anemia as a complication of pneumonia, there is no evidence to support this in the given information.

Additionally, the patient's surgical history of adenoid removal and a fractured tibia is not typically associated with an increased risk of anemia.

Rationale for Choice D: Pneumonia

The patient is a 51-year-old male with a diagnosis of pneumonia.

Pneumonia is an infection of the lungs that can be caused by bacteria, viruses, or fungi.

The patient's symptoms, such as cough, fever, and difficulty breathing, are all consistent with a diagnosis of pneumonia.

Additionally, the patient's medical history of hypertension does not rule out pneumonia, and in fact, some studies have shown that hypertension may be a risk factor for developing pneumonia.

Therefore, pneumonia is the most likely condition that the patient has based on the information provided.

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A 51-year-old male client with pneumonia has undergone several days of antibiotic and respiratory treatment. Given the following assessment findings, mark whether they indicate that the treatment was effective or ineffective:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

Correct Answer is D

Explanation

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