The nurse is teaching an elderly client the risks of infection for older adults. Which of the following factors would the nurse include in the education? (Select all that apply.)

Show expected changes in white blood cell counts.

Skin tests for tuberculosis may be falsely negative.

Should receive influenza, pneumococcal, and shingles vaccinations.

Higher risk for respiratory tract and genitourinary infections.

Booster vaccinations are not likely needed as one ages.

May not have a fever with severe infection.

Answer and Explanation

Correct Answer : B,C,D,F

A.   Aging can lead to changes in immune function, including alterations in white blood cell counts. While absolute counts may not be drastically lower, the immune response may be less effective. This is important information as it helps the patient understand their altered immune status and potential infection risks.
B.   Older adults may have a diminished immune response, which can lead to false-negative results in tuberculosis skin tests (e.g., PPD test). This is crucial information, as it can affect diagnosis and treatment decisions, highlighting the need for alternative screening methods.
C.   Vaccinations are critical for older adults to help prevent infections. Influenza, pneumococcal, and shingles vaccines can significantly reduce the risk of these infections, which are more severe in the elderly. This is an essential component of their health maintenance.
D.   Older adults are at increased risk for respiratory tract infections (like pneumonia) and genitourinary infections (like urinary tract infections) due to factors such as comorbidities and changes in immune function. Educating clients about these risks helps them recognize symptoms and seek timely care.
E.   Older adults often require booster vaccinations to maintain immunity, as their immune response may diminish over time. This misinformation could lead to increased susceptibility to vaccine-preventable diseases.
F.   It is common for elderly individuals to present with atypical signs of infection, including the absence of fever even in severe cases. This is important for both the patient and caregivers to understand, as it may lead to delayed recognition and treatment of infections.

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Correct Answer is B

Explanation

A. Osteoarthritis (OA) typically presents with joint pain and stiffness, but it is usually unilateral and does not cause the same types of deformities seen in RA. OA also tends to develop over time without the systemic symptoms associated with RA.
B. The combination of bilateral pain and morning stiffness in the hands, along with the presence of large nodules (likely rheumatoid nodules), swan-neck deformities, and ulnar deviation, is characteristic of rheumatoid arthritis (RA). RA is an autoimmune disorder that affects joints symmetrically and commonly leads to these specific deformities.
C. Lupus arthritis can cause joint pain and swelling, but it is often accompanied by other systemic symptoms like skin rashes (butterfly rash), fatigue, and organ involvement. The specific deformities noted (swan-neck and ulnar deviation) are more closely aligned with RA than lupus.
D. Gout is characterized by sudden, severe attacks of pain, often in the big toe or foot, and is caused by the deposition of urate crystals in the joints. It does not typically present with the deformities or patterns seen in the described patient.

A. Leukocytosis B. Left shift C. Erythrocytosis D. Neutropenia

Correct Answer is A

Explanation

A. Leukocytosis refers to an elevated white blood cell (WBC) count, typically above the normal range (approximately 4,000 to 10,000 WBCs per microliter of blood). A count of 22,000 indicates leukocytosis, which may be due to infection, inflammation, stress, or other conditions.
B. A left shift refers to an increase in immature white blood cells, particularly neutrophil precursors, in the bloodstream. It often indicates an acute infection or inflammatory response. While the WBC count of 22,000 may suggest a left shift, it does not confirm it without further analysis of the differential count of the WBCs.
C. Erythrocytosis is an increase in red blood cells (RBCs), not white blood cells. Therefore, this option is incorrect. A high WBC count does not indicate changes in red blood cell levels.
D. Neutropenia refers to a decreased number of neutrophils, which are a type of white blood cell. Given the WBC count of 22,000, neutropenia is not applicable and is therefore incorrect.

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The nurse is teaching an elderly client the risks of infection for older adults. Which of the following factors would the nurse include in the education? (Select all that apply.)

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Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

A nurse is caring for a client who has a WBC count of 22,000. The nurse should conclude that the client has which of the following?

Correct Answer is A

Explanation

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