Patient Data shows that on Day 1, there were no active processes.
On Day 2, there were small bilateral lower lobes pulmonary infiltrates with the right lower lobe showing increased involvement compared to the left side.
What is the likely diagnosis?
Pneumonia
Tuberculosis
Bronchitis
Pulmonary Embolism
The Correct Answer is A
Choice A rationale:
Pneumonia is the most likely diagnosis given the rapid development of pulmonary infiltrates within a 24-hour period. Pneumonia is an infection of the lungs that can be caused by bacteria, viruses, or fungi. It typically presents with symptoms such as fever, cough, shortness of breath, and chest pain. The presence of pulmonary infiltrates on imaging studies, such as a chest X-ray, is a key diagnostic feature of pneumonia.
The distribution of the infiltrates, involving the lower lobes with a predominance on the right side, is also consistent with pneumonia. This is because the lower lobes are more susceptible to pneumonia due to their anatomy and gravity.
The absence of active processes on Day 1 makes other diagnoses less likely. For example, tuberculosis typically develops more slowly over weeks or months, and bronchitis usually does not cause pulmonary infiltrates.
Pulmonary embolism can cause pulmonary infiltrates, but it would typically be associated with other symptoms such as sudden onset of shortness of breath, chest pain, and tachycardia.
Choice B rationale:
Tuberculosis is a chronic infection that typically develops slowly over weeks or months. It is less likely to cause rapid development of pulmonary infiltrates as seen in this case.
Tuberculosis often involves the upper lobes of the lungs, and it may be associated with other symptoms such as fever, night sweats, and weight loss.
Choice C rationale:
Bronchitis is an inflammation of the bronchi, the large airways that carry air to the lungs. It typically causes a cough, but it does not usually cause pulmonary infiltrates.
Bronchitis is often caused by a virus, and it usually resolves on its own within a few weeks.
Choice D rationale:
Pulmonary embolism is a blockage of a pulmonary artery, one of the blood vessels that carries blood to the lungs. It can cause pulmonary infiltrates, but it would typically be associated with other symptoms such as sudden onset of shortness of breath, chest pain, and tachycardia.
Pulmonary embolism is often caused by a blood clot that travels from a vein in the leg to the lungs.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["38"]
Explanation
Here are the steps to calculate the IV flow rate:
Step 1: Calculate the volume to be infused per minute.
75 mL ÷ 30 minutes = 2.5 mL/minute
Step 2: Multiply the volume per minute by the drop factor to determine the drops per minute.
2.5 mL/minute × 15 gtt/mL = 37.5 gtt/minute
Step 3: Round the answer to the nearest whole number. The nurse should regulate the IV to deliver 38 gtt/minute.
Correct Answer is D
Explanation
The correct answer is choice D. Reported history of alcoholism.
Choice A rationale:
Employment as a construction worker is not directly relevant to the administration of terbinafine HCL. While it may affect the client’s overall health and risk of injury, it does not impact the medication’s safety or efficacy.
Choice B rationale:
A white blood cell count of 8,500/mm³ (8.5 x 10³/L) is within the normal range and does not indicate any immediate concern that would affect the administration of terbinafine HCL.
Choice C rationale:
Thick and yellow toenails are typical symptoms of a fungal toenail infection and are the reason for prescribing terbinafine HCL. This finding confirms the diagnosis but does not present a contraindication to the medication.
Choice D rationale:
A reported history of alcoholism is crucial to address because terbinafine HCL can cause liver toxicity. Clients with a history of alcoholism are at higher risk for liver damage, and this must be carefully evaluated before starting the medication.
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