A nurse is caring for a client with bacterial pneumonia and has received an order for antibiotics. Which diagnostic test must be ordered before initiating antibiotic therapy to ensure appropriate treatment?

Basic metabolic panel (BMP)

Sputum culture and sensitivity

Chest radiograph

Complete blood count (CBC) with differential

Answer and Explanation

The Correct Answer is B

Choice A reason: A basic metabolic panel assesses electrolytes and renal function but does not identify the bacterial cause of pneumonia. It supports overall patient status but does not guide antibiotic selection, making it less critical than sputum culture for ensuring targeted, effective antibiotic therapy.

Choice B reason: Sputum culture and sensitivity identify the specific bacteria causing pneumonia and their antibiotic susceptibilities, ensuring targeted therapy. Inappropriate antibiotics risk treatment failure and resistance. Obtaining the culture before antibiotics prevents false-negative results, making this critical for effective treatment.

Choice C reason: A chest radiograph confirms pneumonia’s presence and extent but does not identify the causative organism or antibiotic sensitivity. It supports diagnosis but does not guide specific antibiotic therapy, making it less critical than sputum culture for ensuring appropriate treatment.

Choice D reason: A complete blood count with differential shows infection severity (e.g., elevated white cells) but does not identify specific bacteria or antibiotic sensitivity. It supports diagnosis but is secondary to sputum culture, which ensures targeted antibiotic selection for effective pneumonia treatment.

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Correct Answer is A

Explanation

Choice A reason: Measuring arm circumference quantifies swelling, a sign of complications like thrombosis or infection. Comparing both arms establishes a baseline, aiding in assessing edema severity. This objective data guides interventions, prioritizing assessment before invasive actions, ensuring accurate diagnosis and management of PICC-related issues like venous thrombosis.

Choice B reason: Notifying the provider is important but not the first step. Measuring arm circumference provides objective data to report accurately. Swelling may indicate thrombosis or infection, but without measurements, premature notification lacks specificity, potentially delaying interventions based on clinical findings and diagnostic confirmation.

Choice C reason: Removing the PICC line is premature without confirming the cause of swelling. Thrombosis, infection, or mechanical issues could cause swelling, but removal risks complications like bleeding. Assessment, like measuring arm circumference, is needed first to determine if removal or other interventions are warranted.

Choice D reason: Applying a cold pack may reduce swelling but does not address underlying causes like thrombosis or infection. Without assessing the extent and cause of swelling, this intervention is inappropriate as a first step. Objective data collection, like measuring arm circumference, guides effective treatment and prevents complications.

A. Notify the health care provider B. Ventilate the client with a bag-valve-mask C. Attempt to reinsert a new tracheostomy tube D. Cover the stoma with an occlusive dressing

Correct Answer is C

Explanation

Choice A reason: Notifying the provider delays airway restoration in a tracheostomy dislodgement. The priority is maintaining the airway, as the stoma may close rapidly in a chronic tracheostomy, risking respiratory distress, making immediate tube reinsertion critical over notification.

Choice B reason: Ventilating with a bag-valve-mask provides temporary oxygenation but does not address the dislodged tracheostomy tube. In a chronic tracheostomy, the stoma is the primary airway, and reinserting the tube prevents closure, making ventilation a secondary action.

Choice C reason: Attempting to reinsert a new tracheostomy tube is the priority, as chronic tracheostomy stomas may close rapidly, risking airway loss. Prompt reinsertion maintains patency, preventing respiratory distress or emergent surgical intervention, making this critical for client safety and breathing.

Choice D reason: Covering the stoma with an occlusive dressing risks airway obstruction in a chronic tracheostomy, where the stoma is the primary airway. This could lead to respiratory distress, as the client depends on the tracheostomy, making this incorrect compared to tube reinsertion.

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A nurse is caring for a client with bacterial pneumonia and has received an order for antibiotics. Which diagnostic test must be ordered before initiating antibiotic therapy to ensure appropriate treatment?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is C

Explanation

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