NEPHRITIS
While providing care to a pediatric patient with acute glomerulonephritis, you note the urine output to be 10 mL/hr. The patient weighs 30 lbs. As the nurse, you will want to limit what type of foods from the patient’s diet?
A. Calcium-rich foods
B. Potassium-rich foods
C. Purine -rich foods
D. None of the above because the patient’s urinary output is normal based on the patient’s weight.
B
A patient recently diagnosed with cellulitis asks the nurse for clarification about what it is.
Which statement by the nurse provides an accurate description of cellulitis?
-"Cellulitis usually occurs on the torso or arms."
-"It is a bacterial infection that reflects a systemic response to an injury."
-"A diagnosis of cellulitis is made when regional lymph node involvement occurs."
-"It is an acute bacterial infection of the dermis and underlying connective tissue."
"It is an acute bacterial infection of the dermis and underlying connective tissue."
The nurse is caring for a client who was recently admitted to the hospital for complications related to Influenza A. To prevent infection transmission, which personal protective equipment (PPE) should be worn when entering the client’s room?
A. Isolation gown
B. Sterile gloves
C. N95 respirator mask
D. Face mask
D. Face mask
Rationale: The nurse should choose the correct transmission-based precautions when a client is infected or colonized with certain infectious agents. A face mask is required to prevent the transmission of Influenza A which is spread by large-particle droplets when a patient coughs, sneezes, or talks. Transmission precautions for this client include placing the client in a single room, instructing the client on respiratory hygiene/cough etiquette, and donning a mask when entering the patient’s room
A patient is presenting with mild symptoms of pneumonia. The doctor diagnoses the patient with “walking pneumonia”. From your nursing knowledge, you know this type of pneumonia is caused by what type of infectious agent?
A. Fungi
B. Streptococcus pneumoniae
C. Mycoplasma pneumoniae
D. Influenza
c
Your patient with a diagnosis of latent tuberculosis infection needs a bronchoscopy. During transport to endoscopy, the patient will need to wear?
A. N95 mask
B. Surgical mask
C. No special PPE is needed
D. Face mask with shield
The answer is C. Patients with a latent tuberculosis infection are NOT contagious. Therefore, no special PPE is needed for the patient during transport. HOWEVER, if the patient had ACTIVE tuberculosis they would need to wear a surgical mask during transport
Which patient below is at MOST RISK for developing acute glomerulonephritis?
A. A 3 year old male who has a positive ASO titer.
B. A 5 year old male who is recovering from an appendectomy.
C. An 18 year old male who is diagnosed with HIV.
D. A 6 year old female newly diagnosed with measles.
a
The nurse is providing wound care teaching to a patient with cellulitis before discharge.
Which statement by the patient would require clarification?
-"I should wash the wound with soap and water at least once daily."
-"I will set up a way to properly dispose of all contaminated materials from the wound care."
-"I will scrub my hands with soap and water for 20 seconds before and after touching the infected area."
-"Once I am home, I should start opening my wound to the air to allow healing."
-"Once I am home, I should start opening my wound to the air to allow healing."
The public health nurse is educating social workers working with low-income families about the reasons to encourage their clients to get an annual flu shot. What reasons should the nurse include in the educational session? (Select all that apply.)
a The predominant flu virus strain changes from year to year.
b People living in apartment buildings are at higher risk of getting the flu.
c Infants, young children, and people aged 50 or older are more likely to get the flu.
d People without health insurance are at higher risk of getting the flu.
e The new vaccine has specific antigens predicted for that year.
ACE
A patient was admitted to the intensive care unit 48 hours ago for treatment of a gunshot wound. The patient has recently developed a productive cough and a fever of 104.3 ‘F. The patient is breathing on their own and doesn’t require mechanical ventilation. On assessment, you note coarse crackles in the right lower lobe. A chest x-ray shows infiltrates with consolidation in the right lower lobe. Based on this specific patient scenario, this is known as what type of pneumonia?
A. Aspiration pneumonia
B. Ventilator acquired pneumonia
C. Hospital-acquired pneumonia
D. Community-acquired pneumonia
c
You are assessing your newly admitted patients who are all presenting with atypical signs and symptoms of a possible lung infection. The physician suspects tuberculosis. So, therefore, the patients are being monitored and tested for the disease. Select all the risk factors below that increases a patient’s risk for developing tuberculosis:
A. Diabetes
B. Liver failure
C. Long-term care resident
D. Inmate
E. IV drug user
F. HIV
G. U.S. resident
The answers are C, D, E, and F. Remember from our lecture we discussed the risk factors for developing TB and to remember them I said remember the mnemonic “TB Risk”. It stands for tight living quarters (LTC resident, prison, homeless shelter etc.), below or at the poverty line (homeless), refugee (especially in high risk countries), immune system issue such as HIV, substance abusers (IV drugs or alcohol), Kids less than the age of 5….all these are risk factors.
Which of the following are NOT a sign and symptom of acute glomerulonephritis (poststreptococcal)? SELECT-ALL-THAT-APPLY:
A. Hypotension
B. Increased Glomerular filtration rate
C. Cola-colored urine
D. Massive proteinuria
E. Elevated BUN and creatinine
F. Mild swelling in the face or eyes
A.B.D
The nurse is visiting an older adult patient with cellulitis whose daughter is staying to help her until she can care for herself again.
Which is the priority nursing diagnosis this patient?
-Skin Integrity, Impaired
-Family Processes, Interrupted
-Infection, Risk for
-Fluid Volume: Deficit, Risk for
SKIN INTEGRITY, IMPAIRED
Which antiviral drugs are recommended by the Centers for Disease Control and Prevention (CDC) for the treatment or prophylaxis of influenza?
(Select all that apply.)
a Amantadine
b Zanamivir
c Rimantadine
d Oseltamivir
e Ribavirin
B,D
Which of the following patients are MOST at risk for developing pneumonia? Select-all-that-apply:
A. A 53 year old female recovering from abdominal surgery.
B. A 69 year old patient who recently received the pneumococcal conjugate vaccine.
C. A 42 year old male with COPD and is on continuous oxygen via nasal cannula.
D. A 8 month old with RSV (respiratory syncytial virus) infection.
ACD
You’re teaching a group of long-term care health givers about the signs and symptoms of tuberculosis. What signs and symptoms will you include in your education?
A. Cough for a minimum of 6 weeks
B. Night sweats
C. Weight gain
D. Hemoptysis
E. Chills
F. Fever
G. Chest pain
The answers are B, D, E, F, and G. Option A is wrong because a cough should be present for 3 weeks or more (NOT 6 weeks). Option C is wrong because the patient will experience weight LOSS (not gain).
Within the past month, the admission rate of patients with poststreptococcal glomerulonephritis has doubled on your unit. You are proving an in-service to your colleagues about this condition. Which statement is CORRECT about this condition?
A. “This condition tends to present 6 months after a strep infection of the throat or skin.”
B. “It is important the patient consumes a diet rich in potassium based foods due to the risk of hypokalemia.”
C. “Patients are less likely to experience hematuria with this condition.”
D. “This condition is not caused by the streptococcal bacteria attacking the glomerulus, but by the immune system’s response to the bacteria by creating an antigen-antibody complex which inflames the glomerulus.”
D
The nurse is providing discharge teaching to the family of an older adult post-treatment for cellulitis of the left lower arm.
The nurse should inform the family to contact the healthcare provider when which manifestation occurs?
-Temperature over 100oF (37.8oC)
-Increased lethargy
-Warmth of the cellulitis area
-Complaints of gastrointestinal upset
INCREASED LETHARGY
The nurse is working in a primary care setting. Which clients should the nurse identify as being at high risk for influenza or its complications? Select all that apply.
A) A 25-year-old pregnant woman at 20 weeks' gestation
B) A 65-year-old woman
C) A 3-year-old with cystic fibrosis
D) A 35-year-old man with a severe allergy to eggs
E) A 20-year-old healthcare worker
abce
You’re providing discharge teaching to a patient who was admitted for pneumonia. You are discussing measures the patient can take to prevent pneumonia. Which of the following statements by the patient indicates they did NOT understand your education material?
A. “I’ll use hand sanitizer regularly while I’m out in public.”
B. “It is important I don’t receive the Pneumovax vaccine since I’m already immune to pneumonia.”
C. “I will try to avoid large crowds of people during the peak of flu season.”
D. “It is important I try to quit smoking.”
B
A 48-year old homeless man, who is living in a local homeless shelter and is an IV drug user, has arrived to the clinic to have his PPD skin test assessed. What is considered a positive result?
A. 5 mm induration
B. 15 mm induration
C. 9 mm induration
D. 10 mm induration
The answer is D. 15 mm induration is positive in ALL people regardless of health history or risk factors. However, for patients who are homeless (living in homeless shelter) and are IV drug users, a 10 mm or more is considered positive.
1. A 5 year old male is admitted with acute glomerulonephritis. On assessment, you note mild edema predominately in the face and tea-colored urine. The patient’s blood pressure is 165/110, heart rate 95, oxygen saturation 98% on room air, and temperature 98.9 ‘F. In your nursing care plan, what nursing interventions will you include in this patient’s plan of care? SELECT-ALL-THAT-APPLY:
A. Initiate and maintain a high sodium diet daily.
B. Monitor intake and output hourly.
C. Encourage patient to ambulate every 2 hours while awake.
D. Assess color of urine after every void.
E. Weigh patient every daily on a standing scale.
F. Encourage the patient to consume 4 L of fluid per day.
B,DE
The nurse is completing an assessment on a child admitted with cellulitis of the right lower leg. The family reports that they recently returned from vacation, and the child developed the symptoms of cellulitis shortly after their return. During the assessment, the nurse notes a small wound on the child's shin.
Which question should the nurse ask the parents to provide information to help guide treatment decisions?
-"Did the wound bleed much after it happened?"
-"Did your child complain of severe pain when this occurred or in the time since?"
-"Did you clean the wound when it happened and apply antibiotic ointment?"
-"Did this wound occur when your child was swimming in a lake or pond?"
Did this wound occur when your child was swimming in a lake or pond
The nurse makes a home visit to a client recovering from influenza. Which client statements indicate that desired outcomes have been met? Select all that apply.
A) "I'm eating healthy foods now."
B) "I went back to work."
C) "I haven't had chills since I left the hospital."
D) "I slept the whole night without coughing."
E) "I was able to take a walk today."
C,D
Which of the following are typical signs and symptoms of pneumonia? Select-all-that-apply:
A. Stridor
B. Coarse crackles
C. Oxygen saturation less than 90%
D. Non-productive, nagging cough
E. Elevated white blood cells
F. Low PCO2 of less than 35
G. Tachypnea
BCEG
A patient taking Isoniazid (INH) should be monitored for what deficiency?
A. Vitamin C
B. Calcium
C. Vitamin B6
D. Potassium
The answer is C. This medication can lead to low Vitamin B6 levels. Most patients will take a supplement of B6 while taking this medication.