A nurse is caring for a client who has viral pneumonia and a history of COPD. Which of the
following findings should the nurse report to the provider?
Consolidation in lower lobes by chest x-ray
Left shift in the WBC differential-shows that infection is actually bacterial rather than viral
Oxygen saturation 91%
Orthostatic hypotension
A nurse is providing care for four clients. Which of the following clients is at the greatest risk for
pneumonia?
A school-age child who has a history of allergies and asthma
A young adult client living in a college dormitory
A middle-age adult using an incentive spirometer following surgery
An older adult client transferred from a long-term care facility who has dysphagia-Has greatest
m
risk
er as
co
A nurse is caring for a client who has Hodgkin's lymphoma. Which of the following findings
eH w
should the nurse expect?
o.
rs e
Overgrowth of B-lymphocyte plasma cells- multiple myeloma
ou urc
Reed-Sternberg cells- specific to Hodgkin’s lymphoma found in lymph nodes
Epstein-Barr virus- associated w/ Burkitt’s lymphoma
Overproduction of blast phase cells- leukemia
o
A nurse is caring for a client who is receiving chemotherapy and has laboratory data revealing
aC s
bone marrow suppression. The nurse should include which of the following instructions in the
vi y re
teaching?
Take aspirin for minor aches and pains- increases risk for bleeding more than the chemo already
ed d
has
ar stu
Rinse the toothbrush with warm water after each use.
Avoid eating fresh fruit and vegetables- due to increased risk for infection, fresh fruit and
vegetables contain bacteria.
Wear clothing that will minimize sun exposure.
is
A nurse in the emergency department is assessing a newly admitted client. Which of the
Th
following places the client at increased risk for contracting hepatitis B?
Residing in an institutional setting
sh
Engaging in unprotected sexual intercourse
Working with hazardous chemical waste materials
Traveling to a foreign country
A nurse is providing discharge teaching for a client who is HIV-positive. Which of the following
instructions should the nurse include in the teaching?
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, Clean bathroom surfaces with full-strength bleach- should use a 10% bleach
Discard beverages that have been unrefrigerated for 1 hr.- because of bacterial growth
Wash laundry soiled with a body fluid in warm water- should use hot water
Work in the garden for exercise.
A nurse is planning an education program for a group of high school teachers who will be taking
students on a hike. Which of the following information should the nurse include regarding Lyme
disease?
"If bitten by a tick, you should get tested immediately."- testing should be 4-6 weeks after bite
because the reliability of testing before this time is not good.
"If you have a tick embedded in your skin, apply a lit match to remove it."
"You should wear dark-colored clothing to deter ticks from biting."
"If you develop pain and stiffness in your joints, you should see your doctor."- these would be
symptoms of stage I lyme disease. Flu-like symptoms, joint pain and stiffness, and bullseye
m
target
er as
co
eH w
A nurse is caring for a client who has neutropenia. Which of the following findings indicates a
o.
need for intervention?
rs e
ou urc
The client’s granddaughter is visiting and telling him about her first day of kindergarten – this
exposure puts the immunosuppressed pt. at risk for infection.
The client has a grilled ham and cheese sandwich, a banana, and yogurt on his lunch tray.
o
The client's family brings in a silk flower arrangement.
aC s
The client's assistive personnel places paper cups and plastic utensils in his room.
vi y re
A nurse is reviewing the daily laboratory results for a female client who has acute leukemia.
Which of the following values is an expected finding?
ed d
WBC 21,000/mm3 – typically increased from normal in leukemia
ar stu
Hgb 14 g/dL
Hct 40% (All others are typically decreased in leukemia)
3
Platelets 170,000/mm
is
A nurse is caring for a client who has an elevated prostate-specific antigen level. The nurse
Th
should anticipate that the client will undergo which of the following diagnostic tests?
Palpation of testes and lymph nodes – not a reliable test for prostate cancer
sh
Human chorionic gonadotropin level – used to test for testicular cancer
Digital rectal examination – used for differentiating prostate cancer and benign prostatic
hypertrophy
Pelvic ultrasound- not used to diagnose prostate cancer
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