A nurse is assessing a newly admitted client whose chief complaint is “coughing up blood” and whose recent history includes a productive cough and night sweats. What is the nurse’s priority intervention?

Initiate droplet precautions.

Consider standard precautions to be sufficient.

Transfer the client to a positive pressure room.

Initiate airborne precautions.

Transferring the client to a positive pressure room is inappropriate. Positive pressure rooms are designed to keep contaminants out and are used for protecting immunocompromised patients from infections. For a client with suspected TB, a negative pressure room is required to prevent the spread of infectious particles to other areas.

Answer and Explanation

The Correct Answer is D

Choice A reason:

Initiating droplet precautions is not sufficient for a client presenting with symptoms such as coughing up blood, productive cough, and night sweats. These symptoms are indicative of possible tuberculosis (TB), which is an airborne disease. Droplet precautions are used for infections spread through large respiratory droplets, such as influenza or pertussis, but not for TB.

Choice B reason:

Considering standard precautions to be sufficient is incorrect. Standard precautions are the basic level of infection control that should be used in the care of all patients to prevent the spread of infections. However, for a client with symptoms suggestive of TB, additional airborne precautions are necessary to prevent the spread of the disease.

Choice C reason:

Choice D reason:

Initiating airborne precautions is the correct intervention. Airborne precautions are necessary for diseases that are transmitted through smaller respiratory droplets that can remain suspended in the air and be inhaled by others. Tuberculosis is one such disease, and initiating airborne precautions helps to prevent the spread of the infection to healthcare workers and other patients.

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Correct Answer is ["0.5"]

Explanation

Step 1: Convert the prescribed dose from mcg to mg.

235 mcg ÷ 1000 = 0.235 mg

Step 2: Determine the strength of the available tablet.

Available strength = 0.5 mg per tablet

Step 3: Calculate the number of tablets needed.

Number of tablets = 0.235 mg ÷ 0.5 mg/tablet

Step 4: Perform the division.

0.235 ÷ 0.5 = 0.47

Step 5: Round the answer to the nearest tenth.

0.47 rounded to the nearest tenth = 0.5

A. Increase in cellular size of the bronchi and bronchioles. B. Overexpansion of the diaphragm. C. A decreased ability to inhale. D. Destruction of alveolar walls and loss of lung elasticity.

Correct Answer is D

Explanation

Choice A reason:

An increase in cellular size of the bronchi and bronchioles is not the primary issue in emphysema. Emphysema primarily affects the alveoli, the tiny air sacs in the lungs, rather than the bronchi and bronchioles.

Choice B reason:

Overexpansion of the diaphragm is not a primary problem in emphysema. While the diaphragm may become flattened due to hyperinflation of the lungs, this is a secondary effect rather than the primary issue.

Choice C reason:

A decreased ability to inhale is not the main problem in emphysema. The primary issue is difficulty exhaling due to the loss of elasticity in the alveolar walls, which leads to air trapping and hyperinflation

Choice D reason:

Destruction of alveolar walls and loss of lung elasticity is the primary physiologic problem in emphysema. This destruction leads to reduced surface area for gas exchange and impaired lung function. The loss of elasticity makes it difficult for the lungs to expel air, leading to air trapping and hyperinflation.

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A nurse is assessing a newly admitted client whose chief complaint is “coughing up blood” and whose recent history includes a productive cough and night sweats. What is the nurse’s priority intervention?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client prescribed drug N 235 mcg PO daily. Available is drug N PO 0.5 mg per 1 scored tablet. How many tablets should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

Correct Answer is ["0.5"]

Explanation

The nurse recognizes that the primary physiologic problem affecting clients with emphysema is:

Correct Answer is D

Explanation

The nurse recognizes that the client is manifesting early signs of hypoxia with findings of:

A nurse is caring for a client who has active pulmonary tuberculosis (TB) and a new prescription for IV rifampin. The nurse should instruct the client that they should expect to experience which of the following manifestations while taking this medication?

A nurse is assessing a newly admitted client whose chief complaint is “coughing up blood” and whose recent history includes a productive cough and night sweats. What is the nurse’s priority intervention?

The nurse is caring for a client recently diagnosed with emphysema. What information, regarding health maintenance, would the nurse include in teaching sessions? (SELECT ALL THAT APPLY)

The nurse has applied a client problem of ineffective gas exchange for a client diagnosed with chronic bronchitis. Which intervention would the nurse include in the plan of care?

Which of the following is a characteristic of a Venturi mask?

The client with right lower lobe pneumonia has been treated with intravenous antibiotics for three days. Which assessment data obtained by the nurse indicates that the treatment has been effective?