A nurse is assisting with the care of a 15-year-old adolescent who has Streptococcus pneumonia.
The nurse is collecting data on the adolescent 24 hr later. How should the nurse interpret the findings?
For each finding, click to specify whether the finding is unrelated to the admitting diagnosis, an indication of potential improvement, or an indication of potential worsening condition.
WBC count 17,000/mm3
Steatorrhea
Oxygen saturation 95% on 1 L oxygen via nasal cannula
Barrel chest
Hemoptysis 300 ML
Respiratory rate 32/min
The Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"A"},"E":{"answers":"C"},"F":{"answers":"B"}}
WBC count 17,000/mm3: Indication of Potential Improvement. The initial WBC count was 22,000/mm3, and 24 hours later, it has decreased to 17,000/mm3, indicating improvement.
Steatorrhea: Unrelated to Diagnosis. This symptom is typically associated with cystic fibrosis rather than pneumonia.
Oxygen saturation 95% on 1 L oxygen via nasal cannula: Indication of Potential Improvement. The decrease in oxygen requirement from 2 L to 1 L suggests the adolescent's respiratory status may be improving.
Barrel chest: Unrelated to Diagnosis. This physical finding is more indicative of chronic conditions such as cystic fibrosis rather than an acute pneumonia presentation.
Hemoptysis 300 mL: Indication of Potential Worsening Condition. The presence of significant hemoptysis indicates a worsening condition, possibly due to progression or complications of pneumonia.
Respiratory rate 32/min: Indication of Potential Improvement. The decrease in respiratory rate from 36/min to 32/min suggests a possible improvement in respiratory status.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. A slight fever is not typically expected after a lumbar puncture and could indicate an infection or other complication that needs to be addressed.
B. It is important to keep the child's head flat for several hours after the procedure to prevent post-lumbar puncture headaches and other complications.
C. Increasing fluid intake is encouraged after a lumbar puncture to help prevent headaches and promote recovery. Fluid restriction is not indicated.
D. Numbness in the legs is not a common side effect of a lumbar puncture. Any numbness or neurological changes should be reported immediately as they could indicate a complication.
Correct Answer is B
Explanation
A. Giving the infant a bottle immediately before bedtime is not recommended as it can increase the likelihood of reflux symptoms during sleep. It is better to have some time between feeding and sleeping to allow for digestion.
B. Keeping the infant at a 30° angle for 1 hr following each feeding helps to reduce the risk of reflux by using gravity to keep the stomach contents down. This position can aid in preventing the backflow of stomach contents into the esophagus.
C. Changing to a soy-based formula is not universally recommended for gastroesophageal reflux without a specific indication, such as a confirmed cow's milk protein allergy. It is important to follow a healthcare provider's specific recommendations regarding formula.
D. Limiting feedings to every 6 hours is not appropriate for a 2-month-old infant, who typically requires more frequent feedings to meet nutritional needs and maintain growth.
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
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.