A nurse is caring for a client.
Exhibit 1 Nurses' Notes Day 1: Exhibit 2 Exhibit 3 Client reports fatigue, weight loss, night sweats, and a persistent cough.
Performed a purified protein derivative test on the client and obtained a QuantiFERON-TB Gold blood test as prescribed.
Bilateral breath sounds with crackles and scattered wheezes throughout.
Cough productive for yellow, purulent sputum.
What are the first two actions the nurse should take?
Administer antibiotics and bronchodilators.
Initiate airborne precautions and isolation.
Start the client on cough suppressants and antihistamines.
Obtain sputum culture and chest X-ray.
The Correct Answer is D
The first two actions the nurse should take are to obtain a sputum culture and a chest X-ray.
These tests can help diagnose the cause of the client’s symptoms and guide treatment.
Choice A is wrong because administering antibiotics and bronchodilators should only be done after a diagnosis has been made.
Choice B is wrong because airborne precautions and isolation may not be necessary depending on the cause of the client’s symptoms.
Choice C is wrong because cough suppressants and antihistamines may not be appropriate treatments depending on the cause of the client’s symptoms.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
This statement indicates that the nurse should take steps to ensure effective communication with the client by recommending an interpreter who is the same gender as the client.
This can help to facilitate understanding and comfort during the informed consent process.
Choice A is wrong because nodding alone is not sufficient to indicate understanding.
Choice C is wrong because using medical terminology can be confusing and may not facilitate understanding.
Choice D is wrong because questions should be addressed directly to the client, with the interpreter facilitating communication.
Correct Answer is A
Explanation
A. This is appropriate and necessary prior to the procedure. Bowel prep may include laxatives or enemas the evening before and possibly the morning of the procedure.
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