The nurse reviews the healthcare provider’s orders for a client with bacterial pneumonia. Which of the following should the nurse carry out first?
Obtain a sputum culture specimen.
Administer azithromycin 500mg IVPB.
Encourage coughing and deep breathing.
Offer clear liquids for the client to drink.
The Correct Answer is A
The nurse should obtain a sputum culture specimen before administering any antibiotics to the client with bacterial pneumonia.
This is because the sputum culture can help identify the causative organism and the appropriate antibiotic therapy.
Administering antibiotics before obtaining the sputum culture can alter the results and lead to ineffective treatment.
Choice B is wrong because azithromycin is an antibiotic that should be given after obtaining the sputum culture.
Choice C is wrong because coughing and deep breathing are important interventions to promote airway clearance and gas exchange, but they are not the priority actions for this client.
Choice D is wrong because offering clear liquids can help prevent dehydration and thin secretions, but they are not the most urgent action for this client.
Normal ranges for blood urea nitrogen (BUN) are 7 to 20 mg/dL and for creatinine are 0.6 to
1.2 mg/dL.
Elevated levels of these substances can indicate renal impairment, which can be a complication of bacterial pneumonia.
The nurse should monitor these levels and report any abnormalities to the health care provider.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A two-day postoperative client who has a large abdominal incision and says, “Something feels like it just popped open after I practiced my coughing”. This client may have a dehiscence or separation of the surgical wound, which is a serious complication that requires immediate attention.
The nurse should evaluate this client first and notify the surgeon.
Choice B is wrong because bile-colored fluid draining from a nasogastric tube is an expected finding after abdominal surgery and does not indicate an urgent problem.
The nurse should monitor the client’s fluid and electrolyte balance and provide antiemetics as needed.
Choice C is wrong because a three-day postoperative client who has an ileostomy and reports the need to have a bowel movement may have a paralytic ileus or a temporary cessation of bowel motility. This is a common postoperative complication that usually resolves within 72 hours.
The nurse should assess the client’s bowel sounds, abdominal distension, and ostomy output and encourage early mobilization and oral intake as tolerated.
Choice D is wrong because a three-day postoperative client who is receiving intravenous antibiotics for a wound infection may have a surgical site infection or an infection that occurs within 30 days of surgery. This is a preventable complication that can be managed with antibiotics, wound care, and infection control measures.
The nurse should monitor the client’s vital signs, wound appearance, and laboratory values and educate the client on signs and symptoms of infection.
Correct Answer is B
Explanation
According to the Addiction Nursing Competencies, antisocial personality traits are one of the risk factors for developing addictive behaviors.
Antisocial personality disorder is characterized by a disregard for the rights and feelings of others, impulsivity, deceitfulness, and lack of remorse.
Choice A is wrong because high self-esteem is not associated with addictive behaviors. On the contrary, low self-esteem, passivity, and inability to relax or defer gratification are some of the personality factors that can predispose a person to substance use disorders.
Choice C is wrong because good communication skills are not related to addictive
behaviors. In fact, poor communication skills, social isolation, and lack of support are some of the psychosocial factors that can contribute to substance use disorders.
Choice D is wrong because aggressive behaviors are not a specific indicator of addictive behaviors.
Aggression can be a result of various factors, such as frustration, anger, stress, or mental illness. Aggression can also be influenced by the type and amount of substance used.
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