A patient is admitted to a respiratory unit with a diagnosis of bacterial pneumonia. Findings include a fever and a weak, congested-sounding cough with moist crackles throughout the lung fields. How should the nurse prioritize care?

Difficulty with breathing

Inability to clear the airway

Confusion from fever

Inadequate oxygen level

Answer and Explanation

The Correct Answer is B

B. The inability to clear the airway is a critical issue. This patient has a weak, congested-sounding cough and moist crackles, indicating that secretions are present and not being effectively cleared. This can lead to airway obstruction, decreased oxygenation, and further respiratory complications. Clearing the airway is a top priority to ensure the patient can breathe properly and prevent further deterioration.
A. Difficulty breathing (dyspnea) is a serious concern as it can indicate respiratory distress or failure. However, it is often a symptom rather than a primary issue, and its underlying causes (such as an inability to clear the airway or inadequate oxygen levels) must be addressed first.
C. Confusion can result from high fever, infection, or hypoxia. While it is important to address the fever and its underlying cause, confusion itself is usually a secondary issue. Addressing the primary respiratory issues will often improve the patient's mental status as well.
D. Hypoxia can result from severe pneumonia, and resolving it involves ensuring the patient has a clear airway and adequate ventilation. Measuring and correcting oxygen levels (e.g., with supplemental oxygen) is crucial, but the underlying cause (such as airway obstruction) must also be managed.

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Correct Answer is A

Explanation

A. Oatmeal is a good source of fiber, which can help manage blood sugar levels. Whole-grain toast provides complex carbohydrates and fiber, and using an artificial sweetener in oatmeal reduces sugar intake. Tea is a good beverage choice as it does not contain sugar or calories if not sweetened.
B. This option is less appropriate for a patient with diabetes. While eggs are a good source of protein, bacon is high in saturated fat and sodium, which is not ideal for cardiovascular health. Orange juice contains a high amount of natural sugar and can cause a rapid increase in blood glucose levels. Coffee is fine if consumed without sugar or high-fat creamers.
C. Whole-grain toast with peanut butter provides fiber, protein, and healthy fats, which are beneficial. Skim milk is a good source of calcium and protein. However, the inclusion of orange juice is problematic due to its high sugar content, which can spike blood sugar levels.

D. While grapefruit is a low-sugar fruit, cranberry juice often contains added sugars and can increase blood glucose levels. A bagel, even with sugar-free jelly, is high in refined carbohydrates, which can cause a rapid rise in blood sugar.

A. A 50-year-old with COPD and a Spo2 of 90% B. A 72-year-old with pneumonia who needs his antibiotic C. A 37-year-old with asthma who reported that he is still having shortness of breath after using his inhaler D. A68-year-old on a CPAP who needs a sputum specimen sent to the lab

Correct Answer is C

Explanation

C. Persistent shortness of breath after using an inhaler could indicate an inadequate response to treatment or worsening asthma exacerbation. The nurse should therefore see this patient first.
A. In COPD patients pulse oximetry oxygen saturations of more than 90% are acceptable. In the treatment of exacerbations of chronic obstructive pulmonary disease (COPD), oxygen should be titrated to achieve a target oxygen saturation range of 88-92%. This results in a greater than twofold reduction in mortality, compared with the routine administration of high-concentration oxygen therapy.
B. Administering antibiotics can be prioritized, but it may not require immediate attention compared to addressing acute respiratory distress or hypoxemia.
D. Collecting a sputum specimen for laboratory analysis is important for diagnosing and managing respiratory infections, but it may not be as time-sensitive as addressing acute respiratory distress or hypoxemia.

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A patient is admitted to a respiratory unit with a diagnosis of bacterial pneumonia. Findings include a fever and a weak, congested-sounding cough with moist crackles throughout the lung fields. How should the nurse prioritize care?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which breakfast menu is most appropriate for a patient with diabetes?

Correct Answer is A

Explanation

After change of shift, the nurse has the following patients on her assignment. Which one should she see first?

Correct Answer is C

Explanation

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