An 80-year-old client is diagnosed with pneumonia. Which of the following symptoms may appear first?

Altered mental status and dehydration

Hemoptysis and dyspnea

Pleuritic chest pain and hypertension

Fever and chills

Answer and Explanation

The Correct Answer is D

A.   While altered mental status can occur in older adults with pneumonia, especially due to hypoxia or infection, it is often a result of more advanced disease or complications rather than an early symptom. Dehydration can also occur but is not a direct symptom of pneumonia.
B.   Hemoptysis (coughing up blood) is not a common early symptom of pneumonia, especially in older adults. Dyspnea (difficulty breathing) may occur, but it generally arises as the pneumonia worsens. These symptoms might not be the first to present.
C.   Pleuritic chest pain (pain upon breathing) can be associated with pneumonia but is not necessarily an early symptom, especially in the elderly. Hypertension may be present but is not a hallmark of pneumonia and can vary widely among patients.
D.   Fever and chills are common initial symptoms of pneumonia and are part of the body’s response to infection. In elderly patients, fever may sometimes be less pronounced or atypical, but it is still one of the first signs of pneumonia.

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Correct Answer is D

Explanation

A. While it may be important to inform the parents later, this is not the immediate priority. The first step should be to assess and manage the current situation before involving the parents.
B. This is a reasonable action to help soothe the itching and irritation caused by contact dermatitis. However, before applying compresses, it’s crucial to ensure that the area is clean and that there is no potential for worsening the condition.
C. This may be necessary if the reaction is severe or worsening, but in this case, the student is exhibiting signs consistent with contact dermatitis, which can often be managed effectively at school without immediate medical intervention.
D. Washing the affected area with soap and water helps remove any potential irritants or allergens that may be causing the dermatitis. This action can help prevent the condition from worsening and relieve some of the symptoms.

A. Allow the client to verbalize feelings about having the white patches. B. Explain the patches will go away on their own in about 2 weeks. C. Instruct to rinse the mouth with diluted hydrogen peroxide and water daily. D. Notify the health care provider to obtain an antifungal medication.

Correct Answer is D

Explanation

A. While it's important for clients to express their feelings and concerns, this intervention does not directly address the issue of the white patches or the potential infection. It may provide emotional support, but it does not contribute to resolving the clinical problem.
B. While some mild cases may resolve on their own, oral thrush often requires antifungal treatment, especially in immunocompromised patients or those on prolonged antibiotic therapy. Telling the patient that it will go away without treatment could lead to worsening symptoms and complications.
C. While oral hygiene is important, rinsing with diluted hydrogen peroxide is not the standard treatment for oral thrush. This method could cause irritation and may not effectively eliminate the fungal infection. Other rinses (like saline) might be more appropriate for general oral care but would not address the underlying candidiasis.
D. White, cheesy patches in the mouth suggest oral thrush, which is commonly treated with antifungal medications (such as fluconazole or nystatin).

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An 80-year-old client is diagnosed with pneumonia. Which of the following symptoms may appear first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

A client with pneumonia receiving antibiotic therapy reports white, cheesy patches in the mouth. Which intervention should the nurse implement?

Correct Answer is D

Explanation

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