The nurse is caring for an 86-year-old client who is reporting inability to concentrate, uneasiness, lightheadedness, weakness, and muscle and joint discomfort. The client also has an elevated pulse, elevated respirations, and a normal temperature. Which of the following statements would be accurate?

Without an elevated temperature, infection is not present.

The client's symptoms are typical of an older adult client.

An infection was present and has dissipated.

An older adult can have an infection without a fever.

Answer and Explanation

The Correct Answer is D

A.   It is possible for an infection to be present without an elevated temperature, especially in older adults.
B.   While some symptoms may be common in older adults, the presence of symptoms alone does not exclude the possibility of infection.
C.   The resolution of infection cannot be determined solely based on the absence of fever.
D.   Older adults may have a blunted fever response to infection, leading to a lack of fever despite the presence of other symptoms.

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Naxlex Comprehensive Predictor Exams

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Correct Answer is ["B","D","E","F","H","J"]

Explanation

A. While encouraging fluid intake is generally beneficial, this action alone may not adequately address the client's respiratory distress.
B. Obtaining the client's vital signs and noting changes from previous readings is essential for assessing the client's condition and response to interventions.
C. Administering antitussive medication may not be appropriate as the client is able to expectorate secretions, and suppressing the cough may hinder clearance of secretions.
D. Positioning the client in a high-Fowler position helps improve lung expansion, aiding in respiratory effort.
E. Increasing the supplemental oxygen flow can help alleviate respiratory distress by improving oxygenation.
F. Calling the respiratory therapist for a nebulizer treatment is appropriate, especially since the client reported previous relief with this intervention.
G. Increasing IV fluids may not directly address the client's respiratory distress and should be based on fluid status and other clinical indications.
H. Documenting findings and actions taken ensures proper communication and continuity of care.
I. Contacting the Rapid Response Team may not be necessary as the client is alert and oriented and not in immediate distress.
J. Listening to the client's breath sounds allows the nurse to compare with previous findings and evaluate respiratory status.

A. White blood cell count of 1,500 mm3 B. Hematocrit level at 35% C. Hemoglobin of 16 g/dL D. Platelet count of 150,000 per microliter

Correct Answer is A

Explanation

A. Neutropenic precautions are implemented when the white blood cell count is significantly decreased, typically below 1,000/mm3, to protect the client from potential infections due to compromised immunity.
B. Hematocrit level and hemoglobin levels are indicators of red blood cell function and oxygen-carrying capacity and are not directly related to neutropenia.

C. Hemoglobin levels are an indicator of oxygen-carrying capacity and are not directly related to neutropenia.
D. Platelet count is related to clotting function and is not directly related to neutropenia.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is ["B","D","E","F","H","J"]

Explanation

The client is being admitted to the oncology unit and is being placed on neutropenic precautions. Which lab value would indicate the need for this type of precaution?

Correct Answer is A

Explanation

A nurse is attending a continuing education course about communicable diseases. During which phase does the client develop non-specific symptoms such as malaise, fever, and body aches?

The nurse is caring for several clients on a hospital's surgical unit. Which of the following clients are at greatest risk for developing an infection?

A nurse is preparing to administer dexamethasone 3 mg PO. Available is dexamethasone 1.5 mg tablets. How many tablets should the nurse administer? (Round the answer to the nearest whole number and label your answer).

A nurse who uses meticulous sterile technique when performing wound care procedures is attempting to control which link in the chain of infection?

A nurse is completing a head-to-toe assessment on a client who is 3 days post-operative from a right mastectomy. Which of the following should the nurse recognize as a sign of possible infection? Select all that apply.

A newly hired nurse is completing their health evaluation and physical for their new employment. The laboratory technician draws a titer for rubella. The laboratory results are negative. What would be the next action?