An older adult client presents with dyspnea on exertion, cough with green sputum, fever, and fatigue. The nurse notes thick rhonchi/coarse crackles upon lung auscultation and the patient's chest X-ray shows bilateral consolidation. The nurse anticipates which of the following interventions?

Western Blot test

Initiation of broad-spectrum antibiotics

Initiation of Isoniazid and Rifampin

Antiretroviral therapy.

Answer and Explanation

The Correct Answer is B

A) "Western Blot test":
. The Western Blot test is typically used to confirm HIV infection after a positive enzyme-linked immunosorbent assay (ELISA). This test is not relevant for diagnosing pneumonia, which is the most likely cause of this patient's symptoms. The patient's presentation — including dyspnea on exertion, cough with green sputum, fever, fatigue, and bilateral consolidation on the chest X-ray — points to a respiratory infection (likely pneumonia) rather than an HIV-related issue.

B) "Initiation of broad-spectrum antibiotics":
. The patient's symptoms, including dyspnea, cough with green sputum, fever, fatigue, and bilateral consolidation on chest X-ray, strongly suggest community-acquired pneumonia (CAP) or hospital-acquired pneumonia (HAP). In either case, broad-spectrum antibiotics are indicated to cover a wide range of potential bacterial pathogens, especially in older adults or those with comorbidities who may be at risk for more severe infections. Immediate treatment with antibiotics is necessary to prevent complications such as respiratory failure or sepsis. Once cultures and sensitivities are obtained, the antibiotics may be adjusted based on the specific pathogen.

C) "Initiation of Isoniazid and Rifampin":
. Isoniazid and Rifampin are used to treat tuberculosis (TB), but this patient’s symptoms do not indicate TB. The patient is experiencing acute respiratory symptoms, including fever, cough with sputum production, and consolidation on chest X-ray, which are more indicative of pneumonia than of tuberculosis. Although TB could present similarly, additional testing such as a TB skin test (TST) or sputum culture for acid-fast bacilli (AFB) would be necessary before initiating antitubercular therapy. The priority intervention here is antibiotic treatment for bacterial pneumonia.

D) "Antiretroviral therapy":
. Antiretroviral therapy (ART) is used to treat HIV, but there is no indication that this patient has HIV. The symptoms presented — dyspnea, productive cough, fever, and bilateral consolidation on chest X-ray — are more consistent with an acute bacterial infection such as pneumonia rather than an HIV-related complication. ART would only be appropriate if the patient were known to have HIV and developed an opportunistic infection; however, this patient's presentation suggests a primary respiratory infection, not an HIV-related issue.

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Correct Answer is A

Explanation

The client is showing signs of fluid overload due to heart failure exacerbation, including:

Progressive shortness of breath (fluid in the lungs)
Jugular venous distention (JVD) (increased central venous pressure)
Crackles in the lung bases (pulmonary congestion/edema)
Bounding pulse (increased circulating volume)

IV diuretics (e.g., Furosemide/Lasix) are the first-line treatment to rapidly reduce fluid overload by promoting diuresis and decreasing pulmonary congestion.

A. Aim to keep your HDL cholesterol as low as possible B. Controlling your diabetes is an important factor C. Exercising and achieving your goal weight are recommended D. Increase saturated fat intake and limit unsaturated fats E. It is important to keep your blood pressure within normal limits

Correct Answer is ["B","C","E"]

Explanation

A) Aim to keep your HDL cholesterol as low as possible:
High-density lipoprotein (HDL) cholesterol is often referred to as "good" cholesterol because it helps remove excess cholesterol from the bloodstream, thereby reducing the risk of atherosclerosis and coronary artery disease. The goal should be to raise HDL cholesterol levels, not lower them. Higher levels of HDL are associated with a lower risk of heart disease.

B) Controlling your diabetes is an important factor:
Diabetes is a major risk factor for coronary artery disease (CAD). Uncontrolled blood sugar levels can lead to damage of the blood vessels, increase the risk of atherosclerosis, and raise the likelihood of heart disease. Proper management of diabetes through diet, medication, and lifestyle changes is essential to reduce the risk of CAD.

C) Exercising and achieving your goal weight are recommended:
Regular exercise and maintaining a healthy weight are crucial for reducing the risk of coronary artery disease. Exercise helps improve cardiovascular health, lowers blood pressure, increases HDL cholesterol, and helps control body weight and blood sugar. Achieving and maintaining a healthy weight reduces the strain on the heart and lowers the risk of developing CAD.

D) Increase saturated fat intake and limit unsaturated fats:
Saturated fats can raise low-density lipoprotein (LDL) cholesterol, also known as "bad" cholesterol, which contributes to plaque buildup in the arteries and increases the risk of heart disease. Unsaturated fats, found in foods like olive oil, avocados, and fatty fish, are healthier and can help reduce cholesterol levels and improve heart health. The goal should be to limit saturated fats and increase the intake of unsaturated fats.

E) It is important to keep your blood pressure within normal limits:
High blood pressure is a significant risk factor for coronary artery disease. It can lead to the hardening and narrowing of the arteries, increasing the risk of heart attacks, strokes, and other cardiovascular events. Keeping blood pressure within normal limits through lifestyle changes, such as reducing salt intake, managing stress, exercising, and taking medications if needed, is essential for heart health.

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An older adult client presents with dyspnea on exertion, cough with green sputum, fever, and fatigue. The nurse notes thick rhonchi/coarse crackles upon lung auscultation and the patient's chest X-ray shows bilateral consolidation. The nurse anticipates which of the following interventions?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is A

Explanation

A nurse is providing patient education for reducing the risk of coronary artery disease. Which of the following statements should the nurse make? (Select all that apply.)

Correct Answer is ["B","C","E"]

Explanation

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