A nurse is assisting with the care of a 15-year-old adolescent who has Streptococcus pneumonia.

Exhibits

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

Answer and Explanation

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.

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Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A,B"},"C":{"answers":"A,B"},"D":{"answers":"A"}}

Explanation

Acute Laryngotracheobronchitis (Croup): This condition typically presents with a barking, seal-like cough and inspiratory stridor due to inflammation of the upper airway, often caused by a viral infection such as parainfluenza virus.

Pneumonia: While irritability and fever can be present in both conditions, the presence of stridor (especially inspiratory) is more characteristic of Acute Laryngotracheobronchitis. Pneumonia typically presents with a productive cough, fever, and signs of lower respiratory tract involvement such as crackles or decreased breath sounds on auscultation.

A. Draw a blood culture. B. Collect a stool specimen for occult blood. C. Obtain a stool specimen for culture. D. Conduct a tape test.

Correct Answer is C

Explanation

A. Drawing a blood culture is not indicated for suspected Clostridium difficile, as it is a gastrointestinal infection.
B. A stool specimen for occult blood is not specific for diagnosing Clostridium difficile.
C. Obtaining a stool specimen for culture is the appropriate action to diagnose Clostridium difficile, as it will identify the presence of the bacteria.
D. A tape test is used to detect pinworms, not Clostridium difficile.

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Naxlex Comprehensive Predictor Exams

A nurse in a clinic is assisting with the care of a 3-year-old toddler. Exhibits The nurse is reviewing the collected data. For each finding, click to specify if the finding is consistent with acute laryngotracheobronchitis or pneumonia. Each finding may support more than 1 disease process.

Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A,B"},"C":{"answers":"A,B"},"D":{"answers":"A"}}

Explanation

A nurse is caring for a toddler whose guardian reports multiple episodes of diarrhea. The provider suspects Clostridium difficile. Which of the following actions should the nurse take?

Correct Answer is C

Explanation

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