When providing preoperative care for a client with an abdominal aneurysm, changes in which assessment finding are most important for the practical nurse (PN) to report to the registered nurse (RN)?

Choice A reason: Sputum is the most appropriate specimen to collect prior to the initiation of antibiotic therapy in a client with suspected pneumonia. Sputum cultures can help identify the specific bacteria or other pathogens causing the infection, allowing for targeted antibiotic therapy. Collecting the sputum sample before starting antibiotics ensures that the culture results are not influenced by the medication, leading to more accurate identification of the causative agent and more effective treatment.
Choice B reason: Urine is not the appropriate specimen to collect for diagnosing pneumonia. While urine cultures can be useful for diagnosing urinary tract infections or detecting certain pathogens through urine antigen tests, they are not relevant to identifying the etiology of a respiratory infection like pneumonia. The focus should be on obtaining samples directly from the respiratory system.
Choice C reason: A throat smear can be useful for diagnosing upper respiratory tract infections, such as strep throat, caused by Group A Streptococcus. However, it is not the most relevant test for diagnosing pneumonia, which affects the lower respiratory tract. A sputum sample is more appropriate for identifying the pathogens responsible for pneumonia.
Choice D reason: Blood cultures can be useful for detecting bacteremia or septicemia, especially in severe cases of pneumonia where the infection has spread to the bloodstream. However, they are not the primary method for identifying the specific cause of pneumonia. Blood cultures are typically used in conjunction with other tests, such as sputum cultures, to provide a comprehensive diagnosis.

Choice A reason: Initiating contact isolation precautions is not necessary for psoriasis. Psoriasis is a non-infectious and non-contagious chronic skin condition, so isolating the client would not be appropriate. The main focus should be on managing the symptoms and providing the client with strategies to alleviate their discomfort and improve their quality of life.
Choice B reason: Explaining the need to keep the affected areas dry is not suitable for managing psoriasis. In fact, keeping the skin hydrated is crucial in managing psoriasis symptoms. Dry skin can exacerbate the condition, leading to increased flaking, itching, and discomfort. The practical nurse should educate the client on proper skin care, including using moisturizers to keep the skin hydrated and avoiding harsh soaps and hot water.
Choice C reason: Preparing the client for allergen testing is not relevant in the context of psoriasis. Psoriasis is an autoimmune condition, not an allergic reaction, so allergen testing would not provide useful information for managing the condition. The focus should be on identifying and managing triggers that can exacerbate psoriasis, such as stress, infections, and certain medications.
Choice D reason: Reviewing stress reduction strategies with the client is the most appropriate action. Stress is a known trigger for psoriasis flare-ups, and helping the client develop effective stress management techniques can significantly improve their symptoms. Techniques such as mindfulness, relaxation exercises, and counseling can be beneficial in reducing stress and minimizing psoriasis symptoms. Educating the client on the importance of stress management and providing them with practical strategies can empower them to better manage their condition.