A nurse working in the emergency department (ED) is admitting a client.

Exhibits

The nurse is reviewing the client's medical record. Which of the following conditions should the nurse identify as a risk factor for pneumonia? Select all that apply.

COPD

Hypertension

Dermatitis

Smoking history

Type 2 diabetes mellitus

Hypothyroidism

Answer and Explanation

Correct Answer : A,D,E

A. COPD: Clients with chronic obstructive pulmonary disease (COPD) are at increased risk for pneumonia due to compromised lung function, chronic inflammation, and decreased mucociliary clearance, making it easier for pathogens to infect the lungs.

B. Hypertension: While hypertension is a significant cardiovascular risk factor, it does not directly increase the risk of pneumonia. Therefore, it is not a relevant factor in this case.

C. Dermatitis: Dermatitis is a skin condition and does not affect lung function or immunity in a way that would increase the risk of pneumonia.

D. Smoking history: Smoking damages the respiratory epithelium and impairs the immune defenses of the lungs, making smokers more susceptible to respiratory infections such as pneumonia.

E. Type 2 diabetes mellitus: Diabetes compromises immune function and increases the risk of infections, including pneumonia, due to hyperglycemia impairing neutrophil function and other immune responses.

F. Hypothyroidism: While hypothyroidism may cause some general symptoms such as fatigue, it does not directly compromise respiratory function or immunity in a way that increases the risk of pneumonia.

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

Explanation

Potential action	Indicated	Contraindicated
Ask the client about the content of their hallucinations.	✓
Instruct the client on expected hygiene practices.	✓
Allow the client to watch TV at a high volume.		✓
Assess the client for suicidal ideation.	✓
Place the client in a room near the activity		✓

Rationale

Ask the client about the content of their hallucinations: Indicated
- Understanding the content of hallucinations can help in assessing the severity and nature of the client's condition, and in planning appropriate interventions.
Instruct the client on expected hygiene practices: Indicated
- Encouraging and educating the client about personal hygiene is important for their overall well-being and social interactions.
Allow the client to watch TV at a high volume: Contraindicated
- High volume and excessive stimulation can exacerbate symptoms of schizophrenia, such as hallucinations and agitation.
Assess the client for suicidal ideation: Indicated
- Regular assessment for suicidal thoughts is crucial, even if the client initially denies them, as their mental state can change.
Place the client in a room near the activity: Contraindicated
- A quieter environment is generally more beneficial for clients with schizophrenia to reduce overstimulation and stress.

A. Ranitidine B. Vitamin K C. Vitamin B12 D. Metoclopramide

Correct Answer is C

Explanation

A. Ranitidine: An H2 receptor blocker, typically used to reduce stomach acid, is unnecessary since the stomach has been removed.

B. Vitamin K: Although important for clotting, vitamin K absorption is not significantly affected by total gastrectomy.

C. Vitamin B12: Clients require lifelong vitamin B12 supplementation (usually via intramuscular injections) after total gastrectomy to prevent deficiency and associated complications such as anemia and neurological impairments.

D. Metoclopramide: A prokinetic agent used to enhance gastric motility, which is not relevant after total gastrectomy.

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A nurse working in the emergency department (ED) is admitting a client. Exhibits The nurse is reviewing the client's medical record. Which of the following conditions should the nurse identify as a risk factor for pneumonia? Select all that apply.

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A nurse is caring for a client on a psychiatric unit. Exhibits For each potential action, click to specify if the action is indicated or contraindicated for the client.

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

Explanation

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Correct Answer is C

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A nurse working in the emergency department (ED) is admitting a client.

Exhibits

The nurse is reviewing the client's medical record. Which of the following conditions should the nurse identify as a risk factor for pneumonia? Select all that apply.