A nurse in a public health department is caring for a client.
Which of the following data in the client’s medical record should cause the nurse to suspect the client is infected with the plague? Select all that apply.
Temperature
Client’s statement about “bites”
Travel history
Lymph node assessment
Body aches
New onset of weakness
Headache and chills
Pruritic lesions on the right leg
Clear lungs to auscultation bilaterally
Correct Answer : A,B,C,D,E,F,G,H
Choice A rationale: The client’s persistent fever is a common symptom of the plague and many other infections.
Choice B rationale: The client’s statement about getting flea bites during their trip is significant because the plague is often transmitted through the bite of an infected flea.
Choice C rationale: The client’s recent travel to South Asia could have exposed them to areas where plague is endemic or there are ongoing outbreaks.
Choice D rationale: The presence of tender, inguinal lymphadenitis (swollen lymph nodes in the groin area) is a classic sign of bubonic plague.
Choice E rationale: Body aches can be a symptom of the systemic infection caused by the plague.
Choice F rationale: New onset of weakness can be a symptom of the systemic infection caused by the plague.
Choice G rationale: Headache and chills are common symptoms of the plague and many other infections.
Choice H rationale: Pruritic (itchy) lesions on the right leg could be the site of the flea bites that transmitted the plague bacteria.
Choice I rationale: Clear lungs to auscultation bilaterally does not necessarily rule out the plague. While pneumonic plague does affect the lungs, bubonic plague (the most common form) primarily causes lymphadenitis and does not typically present with respiratory symptoms in the early stages.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
While performing tuberculosis screenings throughout the community can be beneficial in identifying new cases, it is not the most effective action to prevent the spread of tuberculosis from a known active case.
Choice B rationale
Reporting the active case to a public health department is important for surveillance and public health tracking. However, it does not directly ensure that the specific client’s tuberculosis is being effectively managed to prevent further spread.
Choice C rationale
Ensuring client adherence to the medication regimen is the most effective action the nurse can take to prevent the spread of tuberculosis within the community. Effective treatment of tuberculosis involves a long-term medication regimen that, when adhered to, can render the disease non-infectious.
Choice D rationale
Providing education to the community about the manifestations of tuberculosis can increase awareness and potentially lead to earlier identification of new cases. However, it does not directly prevent the spread of the disease from a known active case.
Correct Answer is B
Explanation
The correct answer is Choice B
Choice A rationale: Turning the patient every 4 hours may prevent pressure ulcers, but it can cause discomfort for a near-death patient. Less frequent repositioning might be more suitable for maintaining comfort during the end-of-life stage.
Choice B rationale: Elevating the head of the patient's bed can help ease breathing difficulties by reducing the pressure on the diaphragm and enhancing lung expansion. This position promotes comfort and reduces the work of breathing, which is beneficial for near-death patients.
Choice C rationale: Offering the patient ice chips can provide temporary relief from dry mouth, but it may not be the most effective measure for ensuring comfort. Adequate hydration and regular oral care are generally more beneficial for maintaining patient comfort.
Choice D rationale: Providing oral care every 6 hours might not be frequent enough to ensure comfort. More frequent oral care, such as every 2 hours, helps maintain moisture in the mouth, reduces discomfort, and prevents infections, enhancing the patient's overall comfort
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