A nurse is assessing a patient who has a history of human immunodeficiency virus (HIV) and has been admitted with pneumonia. Which intervention will the nurse perform to ensure the patient exhibits clear breath sounds?

Monitors the patient's temperature, heart rate, respiratory rate and blood pressure.

Educates the patient to avoid handling pet excreta or cleaning litter boxes, birdcages, or aquariums.

C Encourages the patient to perform cough, deep breathing, postural drainage every 2 to 4 hours.

Provides nutritional support if patient is unable to take sufficient amounts by mouth.

Answer and Explanation

The Correct Answer is C

A. Monitors the patient's temperature, heart rate, respiratory rate, and blood pressure:
Monitoring vital signs is crucial for assessing the patient's overall condition, including respiratory status. However, while changes in vital signs may indicate respiratory distress, they do not directly address the need to ensure clear breath sounds. This intervention alone does not actively promote airway clearance or improve breath sounds.

B. Educates the patient to avoid handling pet excreta or cleaning litter boxes, birdcages, or aquariums:
This intervention focuses on reducing the risk of exposure to potential pathogens that could worsen the patient's respiratory condition. While important for infection control, it does not directly address the need to ensure clear breath sounds. Environmental precautions, although necessary, do not actively promote airway clearance or improve breath sounds.

C. Encourages the patient to perform cough, deep breathing, and postural drainage every 2 to 4 hours:
This intervention directly targets promoting airway clearance and improving breath sounds in a patient with pneumonia. Coughing helps mobilize secretions, deep breathing promotes lung expansion and ventilation, and postural drainage assists in the drainage of secretions from different lung segments. Regular performance of these interventions prevents secretion accumulation, thereby improving breath sounds and respiratory function.

D. Provides nutritional support if the patient is unable to take sufficient amounts by mouth:
While nutritional support is important for overall patient care, especially during illness or compromised nutritional intake, it does not directly address the need to ensure clear breath sounds in a patient with pneumonia. Although adequate nutrition supports immune function and overall recovery, it does not directly impact respiratory clearance or breath sounds.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is C

Explanation

A. Following proper handwashing and use of masks: While handwashing and wearing masks are important infection control measures, they are not specific to preventing hepatitis B virus (HBV) infection. While HBV can be present in blood and certain body fluids, such as semen and vaginal fluids, the primary modes of transmission are through activities that involve percutaneous or mucosal exposure to infected blood or body fluids, such as unprotected sex, sharing needles, or accidental needlesticks. While hand hygiene and mask use are crucial in healthcare settings to prevent the transmission of various infections, including HBV, they may not offer sufficient protection against HBV transmission in all situations.

B. Avoiding chemicals that are toxic and polluted air: While avoiding toxic chemicals and polluted air is important for overall health and may support liver health indirectly, it is not directly related to preventing HBV infection. HBV is primarily transmitted through exposure to infected blood or body fluids rather than environmental factors such as air pollution or exposure to toxic chemicals.

C. Public health education and vaccination: This is the most appropriate measure for preventing HBV infection. Public health education plays a crucial role in raising awareness about the risks of HBV transmission and promoting behaviors that reduce the risk of exposure, such as safe sex practices, avoiding sharing needles, and seeking medical care for potential exposures. Additionally, vaccination against HBV is highly effective in preventing infection and is recommended for all individuals, particularly those at increased risk of exposure, such as healthcare workers, people with multiple sexual partners, and individuals who inject drugs. Vaccination not only protects vaccinated individuals but also contributes to herd immunity, reducing the overall prevalence of HBV in the population.

D. Limiting alcohol intake of red and white wine: While limiting alcohol intake is important for liver health, particularly in individuals with liver disease, it is not specifically aimed at preventing HBV infection. Excessive alcohol consumption can contribute to liver damage and may exacerbate liver disease in individuals infected with HBV. However, it does not directly address the risk of HBV transmission.

A. Cereals B. Citrus fruits C. Pork D. Whole milk E. Almonds

Correct Answer is ["A","B","E"]

Explanation

A. Cereals: Cereals, especially whole grains like oats, barley, and brown rice, are rich in dietary fiber, which is beneficial for managing hypertension. Dietary fiber helps regulate blood cholesterol levels and promotes satiety, which can contribute to weight management. Whole grains also contain essential nutrients such as magnesium and potassium, which have been shown to have blood pressure-lowering effects. By including cereals in the diet, particularly whole grain varieties, patients can improve their cardiovascular health and lower their risk of hypertension-related complications.

B. Citrus fruits: Citrus fruits, such as oranges, grapefruits, and lemons, are excellent sources of vitamins and minerals, including vitamin C, potassium, and fiber. Potassium is a crucial nutrient for regulating blood pressure as it helps balance sodium levels in the body. Additionally, the antioxidants found in citrus fruits may help reduce inflammation and improve blood vessel function, further supporting cardiovascular health. Including citrus fruits in the diet can provide patients with essential nutrients while contributing to lower blood pressure levels and overall heart health.

C. Pork: Pork is not typically recommended in the DASH diet due to its high saturated fat and sodium content. Diets high in saturated fat have been associated with increased cholesterol levels and a higher risk of cardiovascular disease, including hypertension. Additionally, processed pork products such as bacon and sausage often contain added sodium, which can contribute to fluid retention and elevated blood pressure. Therefore, it is advisable for patients with hypertension to limit their intake of pork and opt for leaner protein sources such as poultry, fish, beans, and legumes.

D. Whole milk: Whole milk is high in saturated fat, which is not recommended in the DASH diet for individuals with hypertension. Saturated fat can raise LDL (bad) cholesterol levels, increasing the risk of plaque buildup in the arteries and hypertension-related complications such as heart disease and stroke. To promote heart health and lower blood pressure, patients are encouraged to choose low-fat or skim milk options, which provide essential nutrients like calcium and vitamin D without the added saturated fat content.

E. Almonds: Almonds are a nutrient-dense food that can be beneficial for individuals with hypertension. They are rich in unsaturated fats, particularly monounsaturated fats, which have been associated with improved heart health and reduced risk of cardiovascular disease. Almonds also contain magnesium, potassium, and fiber, all of which play important roles in regulating blood pressure. Magnesium helps relax blood vessels, potassium helps counteract the effects of sodium, and fiber promotes satiety and digestive health. Including almonds in the diet as a source of healthy fats and nutrients can contribute to lower blood pressure and overall cardiovascular wellness.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

A nurse is assessing a patient who has a history of human immunodeficiency virus (HIV) and has been admitted with pneumonia. Which intervention will the nurse perform to ensure the patient exhibits clear breath sounds?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

During a health education session, a participant asked the nurse about the hepatitis B virus. What measure will the nurse recommend for preventing infection with this virus?

Correct Answer is C

Explanation

The nurse is reviewing dietary approaches to stop hypertension diet (DASH) with a patient who had been diagnosed with hypertension. The nurse explains that the DASH diet includes which food options? Select All That Apply

Correct Answer is ["A","B","E"]

Explanation

The nurse is assessing a patient diagnosed with hypertension several years ago. What assessment finding may indicate that target organ damage is now occurring?

A nurse is developing a discharge teaching plan for a patient diagnosed with peripheral arterial disease. Which instruction will the nurse include in the plan?

The nurse is assessing a patient who was recently switched to amlodipine. Which assessment finding indicates that the patient is experiencing side effects of the drug? Select All That Apply

The nurse is caring for a patient taking diltiazem for blood pressure management. The nurse instructs the patient to report which side effect to the provider?

A nurse is preparing to administer total parental nutrition (TPN) 1000 mL to infuse over 24 hr. The nurse should set the IV pump to deliver how many mL/hr.? (Round the answer to the nearest whole number. Use a leading zero fit applies. Do not use a trailing zero.)

A nurse is caring for a patient who is returning for a repeat blood pressure to determine if white coat syndrome occurred during the first clinical visit. Which diagnostic test will be used to confirm a diagnosis of hypertension?

A nurse is caring for a patient with peripheral arterial disease. Which factor will the nurse identify as the highest risk?

The nurse is applying standard precautions in the care of a patient who has a history of human immunodeficiency virus. What key element of standard precaution?