A client who has been on a mechanical ventilator for three days develops a fever of 101 degrees Fahrenheit green sputum, and right lower lobe crackles. The nurse contacts the physician regarding possible development of which complication?

Ventilator -associated pneumonia

Pulmonary embolism

Stress ulcer

Pneumothorax

Answer and Explanation

The Correct Answer is A

A) Ventilator-associated pneumonia (VAP):
Ventilator-associated pneumonia (VAP) is a type of pneumonia that develops in patients who have been on mechanical ventilation for more than 48 hours. It is a common and serious complication in critically ill patients on ventilators. Symptoms such as fever, green sputum, and right lower lobe crackles are indicative of a respiratory infection, which, in this case, is most likely VAP. VAP typically presents with signs of infection such as elevated temperature, purulent sputum, and new infiltrates on a chest x-ray, in addition to lung crackles.

B) Pulmonary embolism (PE):
Although pulmonary embolism (PE) can cause symptoms like tachypnea, chest pain, and dyspnea, it does not typically cause a fever, green sputum, or localized crackles in the lungs. PE is usually characterized by sudden onset of respiratory distress, often accompanied by hemoptysis or chest pain, and would not typically present with the localized findings in the lower lobe (e.g., crackles).

C) Stress ulcer:
Stress ulcers can occur in critically ill patients, especially those on mechanical ventilation, due to the stress response and reduced blood flow to the stomach. However, stress ulcers typically cause gastrointestinal symptoms, such as melena (black, tarry stools) or hematemesis (vomiting blood).

D) Pneumothorax:
A pneumothorax occurs when air accumulates in the pleural space, causing a collapse of the lung. It can lead to symptoms such as sudden chest pain, dyspnea, and diminished breath sounds on one side of the chest. However, it would not typically cause fever, green sputum, or localized crackles.

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Correct Answer is C

Explanation

A) A Rhinovirus infection can cause cancer of the cervix
Rhinovirus is primarily associated with the common cold and respiratory infections, not with cervical cancer. The risk factors for cervical cancer are related to persistent infections with certain strains of the human papillomavirus (HPV), especially high-risk types like HPV-16 and HPV-18, which can lead to cervical dysplasia and, eventually, cervical cancer.

B) Eating foods high in fat and taking birth control pills are risk factors
While diet and certain medications may influence overall health, eating foods high in fat and taking birth control pills are not primary risk factors for cervical cancer. Research has shown that certain hormonal contraceptives (especially long-term use) may slightly increase the risk of cervical cancer, but the most significant and well-established risk factor is HPV infection, not fat intake or birth control use.

C) The earlier the age of sexual activity and the more partners, the greater the risk
The major risk factor for cervical cancer is persistent infection with high-risk HPV. Early initiation of sexual activity and having multiple sexual partners increase the risk of HPV infection, which is a leading cause of cervical cancer. HPV is transmitted through sexual contact, and early exposure to the virus, as well as repeated exposure to multiple partners, increases the likelihood of acquiring a high-risk strain of HPV.

D) Having yearly Pap smears will protect you from developing cancer
While Pap smears (Pap tests) are important for detecting precancerous changes (such as dysplasia) or early-stage cervical cancer, they do not prevent cancer. Pap smears can help identify abnormal cell changes that can be treated before they develop into cancer, but they do not protect against the development of cancer.

Correct Answer is ["12"]

Explanation

Given:

Ordered dose of Heparin: 20 units/kg

Patient weight: 132 lbs

Concentration of Heparin: 25,000 units/250 mL (100 units/mL)

Step 1: Convert patient weight from pounds to kilograms:

1 pound (lb) = 0.453592 kilograms (kg)

Patient weight in kg = 132 lbs x 0.453592 kg/lb = 59.87424 kg

Step 2: Calculate the total dose of Heparin:

Total dose (units) = Ordered dose (units/kg) x Patient weight (kg)

Total dose (units) = 20 units/kg x 59.87424 kg

Total dose (units) = 1197.4848 units

Step 3: Calculate the volume to be administered:

Volume (mL) = Total dose (units) / Concentration (units/mL)

Volume (mL) = 1197.4848 units / 100 units/mL

Volume (mL) = 11.974848 mL

Step 4: Round to the nearest whole number:

Volume (mL) ≈ 12 mL

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A client who has been on a mechanical ventilator for three days develops a fever of 101 degrees Fahrenheit green sputum, and right lower lobe crackles. The nurse contacts the physician regarding possible development of which complication?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client in the gynecology clinic asks the nurse, ‘’What are the risk factors for developing cervical cancer?’’ Which statement by the nurse is the best response?

Correct Answer is C

Explanation

A patient is to receive a bolus of Heparin 20 units/kg. The patient weighs 132 lbs. The medication is supplied as 25,000 units/250 mL. How many mL will the nurse give? (round to the nearest whole number)

Correct Answer is ["12"]

Explanation

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