Conditions and Treatments - NCLEX-PN
Card 1 of 4700
A client had just undergone a total right knee replacement and has just returned from the operating room. Later that evening, the client suddenly begins to complain of shortness or breath and chest pain on inspiration. The nurse caring for this client further notes the coughing up of blood and that he is sweating profusely.
Which of the following nursing interventions should the nurse perform first?
A client had just undergone a total right knee replacement and has just returned from the operating room. Later that evening, the client suddenly begins to complain of shortness or breath and chest pain on inspiration. The nurse caring for this client further notes the coughing up of blood and that he is sweating profusely.
Which of the following nursing interventions should the nurse perform first?
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The priority for this client is to ensure a patent airway by placing him the Fowler's or semi upright seated position. Giving oxygen is warranted but will be given after the client is positioned correctly. ABG's would be helpful in this situation but it not the priority. Auscultation of breath sounds and assessment of mental status are not indicated.
The priority for this client is to ensure a patent airway by placing him the Fowler's or semi upright seated position. Giving oxygen is warranted but will be given after the client is positioned correctly. ABG's would be helpful in this situation but it not the priority. Auscultation of breath sounds and assessment of mental status are not indicated.
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Which of the following organisms causes whooping cough?
Which of the following organisms causes whooping cough?
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Whooping cough, a condition that results in severe paroxysmal coughing fits followed by a long wheezing inspiratory gasp (the "whoop") is caused by the bacteria B ordetella pertussis. _Haemophilus influenza_e and Klebsiella pneumoniae both commonly cause pneumonia, and RSV is a virus that is frequently implicated in lower respiratory infections of infants and children.
Whooping cough, a condition that results in severe paroxysmal coughing fits followed by a long wheezing inspiratory gasp (the "whoop") is caused by the bacteria B ordetella pertussis. _Haemophilus influenza_e and Klebsiella pneumoniae both commonly cause pneumonia, and RSV is a virus that is frequently implicated in lower respiratory infections of infants and children.
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How long is the incubation period for pertussis?
How long is the incubation period for pertussis?
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The incubation period for pertussis, also known as the catarrhal stage, can last as little as 4 days or as long as 42 days, but a typical period is 1-3 weeks. During this stage the disease looks like a regular upper respiratory infection, with sneezing, mild cough, and runny nose. The infected individual is highly infectious at this time, with bacteria spread by airborne droplets after sneezing or cough.
The incubation period for pertussis, also known as the catarrhal stage, can last as little as 4 days or as long as 42 days, but a typical period is 1-3 weeks. During this stage the disease looks like a regular upper respiratory infection, with sneezing, mild cough, and runny nose. The infected individual is highly infectious at this time, with bacteria spread by airborne droplets after sneezing or cough.
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In pertussis, what stage follows the incubation (also known as the catarrhal) stage?
In pertussis, what stage follows the incubation (also known as the catarrhal) stage?
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After the catarrhal stage, an individual with pertussis will progress into the paroxysmal stage. It's during this stage that they will experience uncontrollable fits of 5-15 forceful coughs, followed by a "whoop" or gasp as they struggle to inhale. The force of these coughs can be such that they can result in vomiting, epistaxis, subconjunctival hemorrhage, or even broken ribs.
After the catarrhal stage, an individual with pertussis will progress into the paroxysmal stage. It's during this stage that they will experience uncontrollable fits of 5-15 forceful coughs, followed by a "whoop" or gasp as they struggle to inhale. The force of these coughs can be such that they can result in vomiting, epistaxis, subconjunctival hemorrhage, or even broken ribs.
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What is the final stage of a pertussis infection?
What is the final stage of a pertussis infection?
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The final stage of a pertussis infection is known as the convalescent phase. This occurs for 2-6 weeks, after the paroxysmal stage of the disease. During this time coughing decreases, and paroxysms are less severe. The infected individual may experience increased susceptibility to upper and lower respiratory conditions for as much as 6 months after resolution of the infection.
The final stage of a pertussis infection is known as the convalescent phase. This occurs for 2-6 weeks, after the paroxysmal stage of the disease. During this time coughing decreases, and paroxysms are less severe. The infected individual may experience increased susceptibility to upper and lower respiratory conditions for as much as 6 months after resolution of the infection.
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You are the nurse taking care of a 40-year old African-American female who complains of fatigue and shortness of breath. Her physical exam is remarkable for erythema nodosum on the bilateral lower extremities. A chest x-ray is performed that demonstrates bilateral hilar infiltrates. She lives and works in a suburb, has not traveled outside of the United States recently, and does not work in a healthcare setting. Which of the following is the most likely diagnosis?
You are the nurse taking care of a 40-year old African-American female who complains of fatigue and shortness of breath. Her physical exam is remarkable for erythema nodosum on the bilateral lower extremities. A chest x-ray is performed that demonstrates bilateral hilar infiltrates. She lives and works in a suburb, has not traveled outside of the United States recently, and does not work in a healthcare setting. Which of the following is the most likely diagnosis?
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The correct answer is "Sarcoidosis." Sarcoidosis is the correct answer as this inflammatory condition is frequently found in African-American women in their 40's who present with fatigue and shortness of breath among other symptoms, who also have erythema nodosum on the lower extremities, and have bilateral hilar infiltrates on chest x-ray. This constellation of findings is highly suggestive of sarcoidosis. Sarcoidosis results in the formation of numerous non-necrotizing granulomas, most commonly found in the lungs, that can play a role in the symptoms experienced by these patients. Other findings suggestive of sarcoidosis include elevated serum calcium levels with normal serum PTH levels.
Tuberculosis can present in a similar manner to sarcoidosis, however given the patient's suburban living environment, lack of a travel history, and lack of healthcare exposure, the likelihood of being exposed to tuberculosis is very low, making sarcoidosis a more likely etiology.
While lung cancer can present as shortness of breath with hilar infiltration in chest x-ray, in a relatively young otherwise healthy patient who also has erythema nodosum and in whom the hilar infiltrates are bilateral, sarcoidosis would be a more likely etiology.
The patient does not have any findings consistent with meningitis (leg rash in meningitis is petechial, not erythema nodosum) or pharyngitis.
The correct answer is "Sarcoidosis." Sarcoidosis is the correct answer as this inflammatory condition is frequently found in African-American women in their 40's who present with fatigue and shortness of breath among other symptoms, who also have erythema nodosum on the lower extremities, and have bilateral hilar infiltrates on chest x-ray. This constellation of findings is highly suggestive of sarcoidosis. Sarcoidosis results in the formation of numerous non-necrotizing granulomas, most commonly found in the lungs, that can play a role in the symptoms experienced by these patients. Other findings suggestive of sarcoidosis include elevated serum calcium levels with normal serum PTH levels.
Tuberculosis can present in a similar manner to sarcoidosis, however given the patient's suburban living environment, lack of a travel history, and lack of healthcare exposure, the likelihood of being exposed to tuberculosis is very low, making sarcoidosis a more likely etiology.
While lung cancer can present as shortness of breath with hilar infiltration in chest x-ray, in a relatively young otherwise healthy patient who also has erythema nodosum and in whom the hilar infiltrates are bilateral, sarcoidosis would be a more likely etiology.
The patient does not have any findings consistent with meningitis (leg rash in meningitis is petechial, not erythema nodosum) or pharyngitis.
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What is the most common cause of renal failure in the United States?
What is the most common cause of renal failure in the United States?
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The most common cause of renal failure in the US is diabetic nephropathy due to diabetes mellitus. Diabetic nephropathy can include multiple complications including arteriosclerosis, glomerulosclerosis, pyelonephritis and renal failure.
The most common cause of renal failure in the US is diabetic nephropathy due to diabetes mellitus. Diabetic nephropathy can include multiple complications including arteriosclerosis, glomerulosclerosis, pyelonephritis and renal failure.
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Which of the following is an insect vector-borne illness?
Which of the following is an insect vector-borne illness?
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Insect vector-borne illnesses are given to humans through insects like ticks, mosquitoes, and chiggers. Rocky mountain spotted fever is caused by Rickettsia rickettsii. Ticks are the most common vector for rocky mountain spotted fever. Prevention of tick bites is a crucial teaching point in preventing the spread of the disease. Although misleading, the infection can be obtained throughout the United States of America. Roundworm is caused by a fungus. Rabies is a viral disease that is typically transmitted between mammals through bites. Cat scratch fever is a bacterial infection that can cause severe neurological, musculoskeletal, circulatory, and other system damage in immunocompromised individuals; in healthy people, no treatment is necessary and the infection is fought. Scabies causes extreme itchy red bumps commonly in between the fingers, on the wrist, and around the abdomen. The organism that causes this disease is actually in the arachnid family and is not an insect.
Insect vector-borne illnesses are given to humans through insects like ticks, mosquitoes, and chiggers. Rocky mountain spotted fever is caused by Rickettsia rickettsii. Ticks are the most common vector for rocky mountain spotted fever. Prevention of tick bites is a crucial teaching point in preventing the spread of the disease. Although misleading, the infection can be obtained throughout the United States of America. Roundworm is caused by a fungus. Rabies is a viral disease that is typically transmitted between mammals through bites. Cat scratch fever is a bacterial infection that can cause severe neurological, musculoskeletal, circulatory, and other system damage in immunocompromised individuals; in healthy people, no treatment is necessary and the infection is fought. Scabies causes extreme itchy red bumps commonly in between the fingers, on the wrist, and around the abdomen. The organism that causes this disease is actually in the arachnid family and is not an insect.
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An electrical worker has been brought to the emergency department after an electrical burn injury sustained while in the field. The possibility of additional injuries are greatly increased when dealing with this type of clinical scenario.
The nurse examining the client should be aware that .
An electrical worker has been brought to the emergency department after an electrical burn injury sustained while in the field. The possibility of additional injuries are greatly increased when dealing with this type of clinical scenario.
The nurse examining the client should be aware that .
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The risk for cervical spine injury is high due to electrical workers being subjected to having to work on utility poles that upon electrocution may lead to falls from tall heights. This possibility puts the person at risk for spinal and long bone fractures. Electrical burns often lead to damage below the surface of the skin and may not be fully appreciated on visual inspection. Chemical burns can lead to continual damage over 3 days, myoglobin in the blood stream from muscle damage puts the kidneys at risk for damage and the patient is usually at risk for metabolic acidosis not alkalosis.
The risk for cervical spine injury is high due to electrical workers being subjected to having to work on utility poles that upon electrocution may lead to falls from tall heights. This possibility puts the person at risk for spinal and long bone fractures. Electrical burns often lead to damage below the surface of the skin and may not be fully appreciated on visual inspection. Chemical burns can lead to continual damage over 3 days, myoglobin in the blood stream from muscle damage puts the kidneys at risk for damage and the patient is usually at risk for metabolic acidosis not alkalosis.
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A nurse is caring for a client experiencing the oliguric phase of acute kidney failure. The nurse is aware that this condition is highly associated with electrolyte imbalances, in addition to the kidney's inability to produce sufficient amounts of urine.
Which of the following electrolyte imbalances should the nurse monitor for?
A nurse is caring for a client experiencing the oliguric phase of acute kidney failure. The nurse is aware that this condition is highly associated with electrolyte imbalances, in addition to the kidney's inability to produce sufficient amounts of urine.
Which of the following electrolyte imbalances should the nurse monitor for?
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During the oliguric phase of acute kidney failure (AKF), the kidney is unable to excrete potassium properly, leading to high serum levels that could lead to dangerous ECG changes including peaked T waves and wide QRS complexes. The kidneys are also responsible for activating vitamin D allowing for proper calcium absorption from the GI which becomes decreased during AKF. Bicarbonate is also handled by the kidney and cannot be regenerated properly by the kidney during AKF.
During the oliguric phase of acute kidney failure (AKF), the kidney is unable to excrete potassium properly, leading to high serum levels that could lead to dangerous ECG changes including peaked T waves and wide QRS complexes. The kidneys are also responsible for activating vitamin D allowing for proper calcium absorption from the GI which becomes decreased during AKF. Bicarbonate is also handled by the kidney and cannot be regenerated properly by the kidney during AKF.
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Ed is an 85-year-old male who lives at a long-term care facility. He has recently begun having difficulty brushing his teeth, an activity he would previously complete on his own. He has also appeared to be more confused while engaging in basic conversation with the nursing staff. The nurse should first evaluate Ed for which of the following?
Ed is an 85-year-old male who lives at a long-term care facility. He has recently begun having difficulty brushing his teeth, an activity he would previously complete on his own. He has also appeared to be more confused while engaging in basic conversation with the nursing staff. The nurse should first evaluate Ed for which of the following?
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Changes in baseline cognition and functioning of older adults may be due to infection. Urinary tract infections frequently cause confusion. Evaluate for an underlying condition before testing for rare diseases or dementia.
Changes in baseline cognition and functioning of older adults may be due to infection. Urinary tract infections frequently cause confusion. Evaluate for an underlying condition before testing for rare diseases or dementia.
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The fact that an elementary school is shut down due to a measles outbreak is an example of a(n) .
The fact that an elementary school is shut down due to a measles outbreak is an example of a(n) .
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The terms outbreak and epidemic are very similar, except an outbreak is confined to a smaller place. Both indicate an increase in incidence of disease. An endemic disease is always present in the community in a low level. An example is the common cold. A pandemic is an epidemic that occurs across multiple continents. A sporadic disease disease occurs randomly or in scattered incidence.
The terms outbreak and epidemic are very similar, except an outbreak is confined to a smaller place. Both indicate an increase in incidence of disease. An endemic disease is always present in the community in a low level. An example is the common cold. A pandemic is an epidemic that occurs across multiple continents. A sporadic disease disease occurs randomly or in scattered incidence.
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A 3-year-old child is admitted to the pediatric medical unit from the emergency department with suspected rheumatic fever. Which of the following is not indicative of rheumatic fever?
A 3-year-old child is admitted to the pediatric medical unit from the emergency department with suspected rheumatic fever. Which of the following is not indicative of rheumatic fever?
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Rheumatic fever presents with a red rash over the trunk and extremities, fever, and a sore throat. It is caused by an untreated Streptococcus infection in the previous 2-6 weeks, such as strep throat, and can be confirmed with a positive antistreptolysin O titer.
Rheumatic fever presents with a red rash over the trunk and extremities, fever, and a sore throat. It is caused by an untreated Streptococcus infection in the previous 2-6 weeks, such as strep throat, and can be confirmed with a positive antistreptolysin O titer.
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A nurse is teaching a 20-year-old male client newly diagnosed with herpes simplex virus (HSV) type 2.
All of the following teaching points in regards to this condition should be included except which of these?
A nurse is teaching a 20-year-old male client newly diagnosed with herpes simplex virus (HSV) type 2.
All of the following teaching points in regards to this condition should be included except which of these?
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Nystatin is an anti fungal medication, not effective in treating viral infections such HSV. Antiviral medications such as acyclovir, famciclovir, and valacyclovir would be prescribed to control symptoms and shorten episodes. These drugs are not curative.
Nystatin is an anti fungal medication, not effective in treating viral infections such HSV. Antiviral medications such as acyclovir, famciclovir, and valacyclovir would be prescribed to control symptoms and shorten episodes. These drugs are not curative.
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A 35-year-old male has just been admitted to the emergency department in a sickle cell crisis. The nurse caring for this client is aware of the signs and symptoms associated with this condition.
The proper nursing management for this patient should include which of these?
A 35-year-old male has just been admitted to the emergency department in a sickle cell crisis. The nurse caring for this client is aware of the signs and symptoms associated with this condition.
The proper nursing management for this patient should include which of these?
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A sickle cell crisis will require interventions to control the client's pain due to widespread tissue ischemia. Oxygen is needed to treat hypoxia and control the amount of red bood cell sickling. Blood transfusions are usually not first line treatment in a crisis.
A sickle cell crisis will require interventions to control the client's pain due to widespread tissue ischemia. Oxygen is needed to treat hypoxia and control the amount of red bood cell sickling. Blood transfusions are usually not first line treatment in a crisis.
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The SIRS (Systemic Inflammatory Response Syndrome) criteria includes which of the following?
The SIRS (Systemic Inflammatory Response Syndrome) criteria includes which of the following?
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The SIRS criteria includes 4 factors. 1.) temperature greater than 
or less than 
2.) A respiratory rate > 20, or 
< 
, 3.) Heart rate greater than 
, and 4.) 
, 
, or immature neutrophils greater than 10% bands. To meet the SIRS definition must have 2 or more of these findings.
The SIRS criteria includes 4 factors. 1.) temperature greater than
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Which of the following physical exam findings would you expect to find in a patient who overdosed on heroin?
Which of the following physical exam findings would you expect to find in a patient who overdosed on heroin?
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Opioid (heroin) overdose is marked by a decreased respiratory drive, shallow breathing, and pin-point pupils. Treatment is with naloxone and reverses overdose quickly. Heroin overdoses can be fatal if untreated because of the respiratory depression.
Opioid (heroin) overdose is marked by a decreased respiratory drive, shallow breathing, and pin-point pupils. Treatment is with naloxone and reverses overdose quickly. Heroin overdoses can be fatal if untreated because of the respiratory depression.
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A patient arrives to the ER in a comatose state. He is shallowly breathing, appears disheveled, and has pin-point pupils. There are track marks on his right arm and it appears swollen. Which of the following conditions does this patient likely have?
A patient arrives to the ER in a comatose state. He is shallowly breathing, appears disheveled, and has pin-point pupils. There are track marks on his right arm and it appears swollen. Which of the following conditions does this patient likely have?
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This patient likely has opioid (heroin) overdose. Common signs of overdose include: altered mental states, decreased respiratory rate and effort, and pin-point pupils. Treatment includes inhalation of naltrexone to remove the opioids off their receptors in the body. Additionally, track marks are a sign that the patient injects heroin.
This patient likely has opioid (heroin) overdose. Common signs of overdose include: altered mental states, decreased respiratory rate and effort, and pin-point pupils. Treatment includes inhalation of naltrexone to remove the opioids off their receptors in the body. Additionally, track marks are a sign that the patient injects heroin.
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A 23 year old female comes in for urinary frequency and dysuria. This morning she noticed that her urine seemed slightly "tea" colored. On urinalysis the nurse sees a large amount of leukocyte esterase, moderate red blood cells, and a pH of 9.5. On lab analysis a Gram-negative anaerobic bacteria with swarming motility is cultured out of her urine sample.
This individual is most likely experiencing a urinary tract infection (UTI) due to which of the following organisms?
A 23 year old female comes in for urinary frequency and dysuria. This morning she noticed that her urine seemed slightly "tea" colored. On urinalysis the nurse sees a large amount of leukocyte esterase, moderate red blood cells, and a pH of 9.5. On lab analysis a Gram-negative anaerobic bacteria with swarming motility is cultured out of her urine sample.
This individual is most likely experiencing a urinary tract infection (UTI) due to which of the following organisms?
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While all of the organisms listed are capable of causing UTI's, Staphylococcus species are all Gram-positive. _Escherichia coli, while responsible for 75-95% of all UTI's, would not result in a urinary pH of 9.5. The high alkalinity of this patient's urine suggest a urea-splitting bacteria such as Proteus.
While all of the organisms listed are capable of causing UTI's, Staphylococcus species are all Gram-positive. _Escherichia coli, while responsible for 75-95% of all UTI's, would not result in a urinary pH of 9.5. The high alkalinity of this patient's urine suggest a urea-splitting bacteria such as Proteus.
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A 23 year old female comes in for urinary frequency and dysuria. This morning she noticed that her urine seemed slightly "tea" colored. On UA the nurse sees a large amount of leukocyte esterase, moderate red blood cells, and a pH of 9.5. On lab analysis a Gram-negative anaerobic bacteria with swarming motility is cultured out of her urine sample.
If the organism identified in this patient's urine sample is Proteus mirabilis, which of the following would be the appropriate treatment?
A 23 year old female comes in for urinary frequency and dysuria. This morning she noticed that her urine seemed slightly "tea" colored. On UA the nurse sees a large amount of leukocyte esterase, moderate red blood cells, and a pH of 9.5. On lab analysis a Gram-negative anaerobic bacteria with swarming motility is cultured out of her urine sample.
If the organism identified in this patient's urine sample is Proteus mirabilis, which of the following would be the appropriate treatment?
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The first-line treatment for uncomplicated urinary tract infection with Proteus mirabilis is a 3 day course of either oral quinolone or trimethoprim/sulfamethoxazole (TMP/SMZ). 10-21 day courses are only appropriate in patients with complicated UTI or co-infections. Ampicillin and cefalexin are poor choices for initial treatment due to a 10-20% rate of resistance in Proteus species.
The first-line treatment for uncomplicated urinary tract infection with Proteus mirabilis is a 3 day course of either oral quinolone or trimethoprim/sulfamethoxazole (TMP/SMZ). 10-21 day courses are only appropriate in patients with complicated UTI or co-infections. Ampicillin and cefalexin are poor choices for initial treatment due to a 10-20% rate of resistance in Proteus species.
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