A patient who presents with symptoms of influenza that started 24 hours ago is seen by the health care provider.
Which intervention does the nurse expect for this patient?
An order for an antiviral agent such as oseltamivir.
Instructions to rest and decrease fluid intake.
Prescription for antibiotics.
Admission to an acute care facility.
The Correct Answer is A
Choice A rationale
Oseltamivir, an antiviral neuraminidase inhibitor, is most effective when administered within 48 hours of influenza symptom onset. It works by inhibiting the viral neuraminidase enzyme, preventing the release of new virions from infected cells, thereby reducing viral spread and shortening the duration and severity of illness, if given early.
Choice B rationale
Rest is indeed important for recovery from influenza, as it conserves energy and allows the immune system to combat the infection. However, decreasing fluid intake is contraindicated; adequate hydration is crucial to prevent dehydration, especially with fever, and to help thin respiratory secretions, facilitating their clearance.
Choice C rationale
Influenza is a viral infection; therefore, antibiotics, which target bacterial pathogens, are ineffective against the influenza virus itself. Administering antibiotics would be inappropriate and could contribute to antibiotic resistance without providing therapeutic benefit for the viral illness, unless a secondary bacterial infection is suspected.
Choice D rationale
Admission to an acute care facility is generally reserved for severe cases of influenza, such as those with respiratory distress, hypoxemia, or significant comorbidities. For a patient whose symptoms started only 24 hours prior and without severe complications, outpatient management with antiviral therapy is typically sufficient.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Assessing for general allergies is a good nursing practice but is not the most immediate priority when a client presents with a firm, reddened area after a "few days ago" allergy test, especially in the context of suspected pneumonia. This finding strongly suggests a specific type IV hypersensitivity reaction, common in tuberculosis screening.
Choice B rationale
Requesting records is important for comprehensive care, but delaying immediate action based on a highly suggestive clinical finding is not the best initial response. The appearance of the "allergy test" result is a critical piece of information that warrants immediate action to protect others.
Choice C rationale
A firm, reddened area on an "allergy test" a few days prior, especially with suspected pneumonia, is highly indicative of a positive tuberculin skin test (TST), signifying a past or present *Mycobacterium tuberculosis* infection. This necessitates immediate Airborne Precautions to prevent transmission of potential active tuberculosis, given the pulmonary symptoms.
Choice D rationale
Administering intravenous antibiotics for pneumonia is appropriate if bacterial pneumonia is confirmed. However, the presence of a positive TST-like reaction shifts the immediate priority to preventing airborne transmission of tuberculosis, requiring isolation measures *before* starting broad-spectrum antibiotics for pneumonia, which may not even be the primary issue.
Correct Answer is A
Explanation
Choice A rationale
The sweat chloride test is the gold standard for diagnosing cystic fibrosis. It measures the concentration of chloride in sweat, which is significantly elevated (normal range is generally less than $40 \text{ mmol/L}$, while values greater than or equal to $60 \text{ mmol/L}$ are diagnostic) in individuals with cystic fibrosis due to a defect in the cystic fibrosis transmembrane conductance regulator (CFTR) protein, impairing chloride reabsorption.
Choice B rationale
A sputum culture identifies specific microorganisms present in the respiratory tract and their antibiotic sensitivities, which is useful for guiding treatment of respiratory infections in cystic fibrosis, but it does not confirm the underlying genetic defect characteristic of the disease. It is a diagnostic tool for secondary complications.
Choice C rationale
A stool fat content analysis assesses malabsorption, which is a common finding in cystic fibrosis due to pancreatic insufficiency. While indicative of pancreatic involvement, it does not definitively confirm the diagnosis, as other conditions can also cause fat malabsorption. The normal range for 24-hour fecal fat excretion is less than $7 \text{ g}$ in adults on a $100 \text{ g/day}$ fat diet.
Choice D rationale
Pulmonary function tests evaluate lung volumes, capacities, and flow rates. These tests are essential for assessing the severity and progression of lung disease in cystic fibrosis patients, but they do not establish the initial diagnosis. They provide information on the functional impact of the disease on the respiratory system.
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