A pneumonia that occurs 48 hours or more after admission to the hospital is considered:
Hospital-acquired pneumonia
Immunocompromised pneumonia
Community-acquired pneumonia
Viral pneumonia
The Correct Answer is A
A. Hospital-acquired pneumonia: Pneumonia that develops 48 hours or more after hospital admission is classified as hospital-acquired pneumonia (HAP). It is caused by pathogens acquired in the hospital setting, often involving multidrug-resistant organisms such as Pseudomonas aeruginosa, Staphylococcus aureus (including MRSA), and Klebsiella pneumoniae. Patients who are intubated, have prolonged hospital stays, or have weakened immune defenses are at higher risk.
B. Immunocompromised pneumonia: Pneumonia in immunocompromised patients occurs due to weakened host defenses, such as in individuals with HIV/AIDS, those undergoing chemotherapy, or transplant recipients on immunosuppressive therapy. While these patients can develop HAP, pneumonia due to opportunistic infections like Pneumocystis jirovecii or fungal infections is categorized separately.
C. Community-acquired pneumonia: Pneumonia acquired outside the hospital or within the first 48 hours of admission is classified as community-acquired pneumonia (CAP). Typical pathogens include Streptococcus pneumoniae, Haemophilus influenzae, and Mycoplasma pneumoniae. CAP is usually less resistant to antibiotics compared to HAP.
D. Viral pneumonia: Pneumonia caused by viral pathogens such as influenza, respiratory syncytial virus (RSV), or SARS-CoV-2 is classified based on the causative agent rather than the setting in which it was acquired. Although viruses can cause both CAP and HAP, the classification of pneumonia is determined by the timing of onset and exposure risks.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Antibody production against the offending fungi is delayed by the patient's age and the virulence of the organism: In older adults, the immune response may be slower or less effective due to age-related changes in the immune system. The virulence of Histoplasma capsulatum can also contribute to the severity of the infection, making it more difficult for the immune system to mount an effective response quickly, which explains the symptoms of fever, nausea, and vomiting.
B. Macrophages are able to remove the offending fungi from the bloodstream but can't destroy them: While macrophages play a crucial role in the immune response to fungi, in the case of histoplasmosis, they often engulf the fungi but may struggle to completely eradicate them, especially in immunocompromised individuals or the elderly. However, this option does not fully explain the delayed symptoms associated with the patient's age and the organism's virulence.
C. Spore inhalation initiates an autoimmune response that produces the associated symptoms: Histoplasmosis is caused by inhaling spores of Histoplasma capsulatum, but the symptoms are not the result of an autoimmune response. Instead, the immune system's attempt to combat the infection leads to the clinical manifestations, not an autoimmune process.
D. Toxin production by Histoplasma capsulatum is triggering an immune response: Histoplasma capsulatum does not produce toxins that directly trigger an immune response. Instead, the immune response is primarily due to the presence of the fungi themselves and the inflammatory response they provoke, which leads to the associated symptoms of the infection.
Correct Answer is D
Explanation
A. Shortness of breath and need for oxygen supplementation: These symptoms are more indicative of respiratory or cardiac conditions rather than Peripheral Artery Disease (PAD). While patients with PAD may experience discomfort during exertion, shortness of breath is not a primary symptom associated with PAD.
B. Tachycardia and hypotension: Tachycardia and hypotension are generally signs of acute distress, shock, or severe cardiovascular issues. These symptoms do not specifically indicate PAD, which is characterized by issues related to blood flow in the peripheral arteries.
C. Decreased alertness and slurred speech: These symptoms suggest possible neurological issues, such as a stroke or transient ischemic attack, rather than PAD. PAD primarily affects blood flow to the extremities and does not typically present with neurological symptoms.
D. Diminished pulses and pain with walking or exercise: Diminished pulses in the legs and claudication, or pain with walking or exercise, are classic symptoms of Peripheral Artery Disease. These symptoms occur due to reduced blood flow to the muscles in the legs, particularly during physical activity, and are indicative of arterial blockages.
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