Chapter 14: Care of Patients with Disorders of the Lower Respiratory System deWit: Medical-Surgical Nursing: Concepts & Practice, 3rd Edition

MULTIPLE CHOICE 1. The patient with acute bronchitis asks if antibiotics will be ordered for the condition. Which response is best for thenurse to make? a. “Antibiotics are the best treatment option.” b. “Antibiotics will not help a viral condition.” c. “Antibiotics will be given if the sputum culture indicates your bronchitis is caused by bacteria.” d. “Antibiotics will inhibit the inflammatory response of your body to the invasion of this infection.” ANS: C Bronchitis is treated symptomatically with humidification and cough medications. Antibiotics are only given if the sputum culture suggests it. PTS:1 DIF: Cognitive Level: Comprehension REF: 290 OBJ:1 (theory) TOP: Bronchitis: Treatment KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Pharmacological Therapies 2. The nurse is assessing the patient with influenza. The patient reports having general malaise and aching muscles over the past 2 weeks. The nurse suspects that the patient may have developed which complication of influenza? a. Bronchitis b. Bacterial pneumonia c. Urinary infection d. Encephalitis ANS: B Bacterial pneumonia is a common complication of influenza and may present with atypical symptoms of only general malaise and muscle aches, making it difficult to recognize the symptoms of pneumonia. Bronchitis, urinary infections, and encephalitis are not common complications of influenza. PTS:1 DIF: Cognitive Level: Application REF: 293 OBJ:1 (theory) TOP: Complications of Influenza: Pneumonia KEY: Nursing Process Step: Planning MSC: NCLEX: Health Promotion and Maintenance 3. What is the purpose of treatment with amantadine (Symmetrel)? a. To prevent viral pneumonia if taken regularly. b. To prevent avian flu if taken at the first signs and symptoms of disease. c. To lessen the severity of type A flu symptoms if taken within 48 hours of exposure. d. To reduce irritation of bronchitis if taken weekly. ANS: C Amantadine (Symmetrel) is an antiviral medication that may be given within 48 hours of exposure or within 48 hours of the onset of influenza symptoms. It is not a drug that is taken regularly and will not stop the spread of the avian flu. PTS:1 DIF: Cognitive Level: Knowledge REF: 291 OBJ:1 (theory) TOP: Treatment: Amantadine KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Pharmacological Therapies 4. The nurse is caring for a patient with suspected bacterial pneumonia. Which finding supports the potential diagnosis? a. Elevated white blood cell (WBC) count b. Consolidation of lung tissue c. Interstitial inflammation d. Copious exudate ANS: C Viral pneumonia causes interstitial inflammation with attendant edema. White blood cell (WBC) count will not be elevated and noexudate is consolidating the lung as with bacterial pneumonia. PTS:1 DIF: Cognitive Level: Comprehension REF: 292 OBJ:1 (theory) TOP: Pneumonia: Viral KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance 5. The 79-year-old patient with bacterial pneumonia becomes increasingly restless, confused, and agitated. The patient’stemperature is 100° F, and his pulse, blood pressure, and respirations are elevated since the last assessment 6 hours ago. What action should the nurse take first? a. Auscultate the patient’s lungs. b. Assess the patient’s oxygen saturation. c. Administer the mild sedative as ordered. d. Administer an ordered analgesic for discomfort.