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NSG 430 Exam 2 – Community Health Nursing Review Part B., Exams of Nursing

NSG 430 Exam 2 – Community Health Nursing Review Part B.

Typology: Exams

2024/2025

Available from 07/02/2025

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NSG 430 Exam 2 Community Health
Nursing Review Part B.
A PATIENT SEEKS CARE IN THE EMERGENCY DEPARTMENT AFTER SHARING NEEDLES FOR
HEROIN INJECTION
WITH A FRIEND WHO HAS HEPATITIS B. TO PROVIDE IMMEDIATE PROTECTION FROM
INFECTION, WHAT
MEDICATION WILL THE NURSE EXPECT TO ADMINISTER?
A. CORTICOSTEROIDS
B. GAMMA GLOBULIN
C. HEPATITIS B VACCINE
D. FRESH FROZEN PLASMA
GAMMA GLOBULIN
THE PATIENT WOULD FIRST RECEIVE ANTIBODIES FOR HEPATITIS B FROM INJECTION OF
GAMMA GLOBULIN.
THE HEPATITIS B VACCINATION SERIES WOULD BE STARTED TO PROVIDE ACTIVE
IMMUNITY. FRESH FROZEN
PLASMA AND CORTICOSTEROIDS WILL NOT BE EFFECTIVE IN PREVENTING HEPATITIS B IN
THE PATIENT.
WE HAVE AN EXPERT-WRITTEN SOLUTION TO THIS PROBLEM!
THE NURSE TEACHES A PATIENT ABOUT DRUG THERAPY AFTER A KIDNEY TRANSPLANT.
WHICH STATEMENT BY
THE PATIENT INDICATES A NEED FOR FURTHER INSTRUCTIONS?
A. ―I NEED TO BE MONITORED CLOSELY FOR DEVELOPMENT OF CANCER.‖
B. ―AFTER A COUPLE OF YEARS, I WILL BE ABLE TO STOP TAKING
IMMUNOSUPPRESSANTS.‖
C. ―IF I DEVELOP AN ACUTE REJECTION EPISODE, I WILL NEED ADDITIONAL TYPES OF
DRUGS.‖
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Download NSG 430 Exam 2 – Community Health Nursing Review Part B. and more Exams Nursing in PDF only on Docsity!

NSG 430 Exam 2 – Community Health

Nursing Review Part B.

A PATIENT SEEKS CARE IN THE EMERGENCY DEPARTMENT AFTER SHARING NEEDLES FOR

HEROIN INJECTION

WITH A FRIEND WHO HAS HEPATITIS B. TO PROVIDE IMMEDIATE PROTECTION FROM

INFECTION, WHAT

MEDICATION WILL THE NURSE EXPECT TO ADMINISTER?

A. CORTICOSTEROIDS

B. GAMMA GLOBULIN

C. HEPATITIS B VACCINE

D. FRESH FROZEN PLASMA

GAMMA GLOBULIN

THE PATIENT WOULD FIRST RECEIVE ANTIBODIES FOR HEPATITIS B FROM INJECTION OF

GAMMA GLOBULIN.

THE HEPATITIS B VACCINATION SERIES WOULD BE STARTED TO PROVIDE ACTIVE

IMMUNITY. FRESH FROZEN

PLASMA AND CORTICOSTEROIDS WILL NOT BE EFFECTIVE IN PREVENTING HEPATITIS B IN

THE PATIENT.

WE HAVE AN EXPERT-WRITTEN SOLUTION TO THIS PROBLEM!

THE NURSE TEACHES A PATIENT ABOUT DRUG THERAPY AFTER A KIDNEY TRANSPLANT.

WHICH STATEMENT BY

THE PATIENT INDICATES A NEED FOR FURTHER INSTRUCTIONS?

A. ―I NEED TO BE MON ITORED CLOSELY FOR DEVELOPMENT OF CANCER .‖

B. ―AFTER A COUPLE O F YEARS, I WILL BE ABLE TO STOP TAKING

IMMUNOSUPPRESSANTS.‖

C. ―IF I DEVELOP AN ACUTE REJECTION EPISODE, I WILL NEED ADDITIONAL TYPES OF

DRUGS.‖

D. ―THE DRUGS ARE CO MBINED TO INHIBIT DIFFERENT WAYS THE KIDNEY CAN BE

REJECTED.‖

―AFTER A COUPLE OF Y EARS, I WILL BE ABLE TO STOP TAKING IMMUN OSUPPRESSANTS.‖

IMMUNOSUPPRESSANTS WILL NEED TO BE CONTINUED FOR LIFE. THE OTHER PATIENT

STATEMENTS ARE

ACCURATE AND INDICATE THAT NO FURTHER TEACHING IS NECESSARY ABOUT THOSE

TOPICS.

AN OLDER ADULT PATIENT HAS A PRESCRIPTION FOR CYCLOSPORINE FOLLOWING A

KIDNEY TRANSPLANT.

WHICH INFORMATION IN THE PATIENT'S HEALTH HISTORY HAS IMPLICATIONS FOR

PLANNING PATIENT

TEACHING ABOUT THE SAFE USE OF CYCLOSPORINE?

A. THE PATIENT RESTRICTS SALT TO 2 GRAMS PER DAY.

B. THE PATIENT EATS GREEN LEAFY VEGETABLES DAILY.

C. THE PATIENT DRINKS GRAPEFRUIT JUICE EVERY DAY.

D. THE PATIENT DRINKS 3 TO 4 QUARTS OF FLUID EACH DAY.

THE PATIENT DRINKS GRAPEFRUIT JUICE EVERY DAY.

GRAPEFRUIT JUICE CAN INCREASE THE TOXICITY OF CYCLOSPORINE. THE PATIENT SHOULD

BE TAUGHT TO

AVOID GRAPEFRUIT JUICE. NORMAL FLUID AND SODIUM INTAKE OR EATING GREEN LEAFY

VEGETABLES WILL

NOT AFFECT CYCLOSPORINE LEVELS OR RENAL FUNCTION.

PATIENT IS ADMITTED TO THE HOSPITAL WITH ACUTE REJECTION OF A KIDNEY

TRANSPLANT. WHICH

INTERVENTION WOULD THE NURSE EXPECT FOR THIS PATIENT?

A. TESTING FOR HUMAN LEUKOCYTE ANTIGEN (HLA) MATCH

A PATIENT IN THE HEALTH CARE PROVIDER'S OFFICE FOR ALLERGEN TESTING USING THE

CUTANEOUS SCRATCH

METHOD DEVELOPS ITCHING AND SWELLING AT THE SKIN SITE. WHICH ACTION WOULD

THE NURSE PLAN TO

TAKE FIRST?

A. MONITOR THE PATIENT'S EDEMA.

B. ADMINISTER A DOSE OF EPINEPHRINE.

C. OBTAIN A PRESCRIPTION FOR ORAL ANTIHISTAMINES.

D. ASSESS THE PATIENT'S USE OF NEW SKIN PRODUCTS

ADMINISTER A DOSE OF EPINEPHRINE

RAPID ADMINISTRATION OF EPINEPHRINE WHEN EXCESSIVE ITCHING OR SWELLING AT

THE SKIN SITE IS

OBSERVED CAN PREVENT THE PROGRESSION TO ANAPHYLAXIS. THE INITIAL SYMPTOMS

OF ANAPHYLAXIS ARE

ITCHING AND EDEMA AT THE SITE OF THE EXPOSURE. THE NURSE SHOULD NOT WAIT AND

ASSESS FOR

DEVELOPMENT OF MORE EDEMA. HYPOTENSION, TACHYCARDIA, DILATED PUPILS, AND

WHEEZES OCCUR

LATER. EXPOSURE TO SKIN PRODUCTS DOES NOT ADDRESS THE IMMEDIATE CONCERN OF

A POSSIBLE

ANAPHYLACTIC REACTION.

A PATIENT IN THE EMERGENCY ROOM IS ANXIOUS AND REPORTS DIFFICULTY BREATHING

AFTER BEING STUNG

BY A WASP. WHICH ACTION WOULD THE NURSE TAKE FIRST?

A. PROVIDE HIGH-FLOW OXYGEN.

B. ADMINISTER ANTIHISTAMINES.

C. ASSESS THE PATIENT'S AIRWAY.

D. REMOVE THE STINGER FROM THE SITE.

ASSESS THE PATIENT'S AIRWAY.

THE INITIAL ACTION WITH ANY PATIENT WITH DIFFICULTY BREATHING IS TO ASSESS AND

MAINTAIN THE

AIRWAY. THE PATIENT'S SYMPTOMS OF ANXIETY AND DIFFICULTY BREATHING MAY HAVE

OTHER CAUSES

THAN ANAPHYLAXIS, SO ADDITIONAL ASSESSMENT IS WARRANTED. THE OTHER ACTIONS

ARE PART OF THE

EMERGENCY MANAGEMENT PROTOCOL FOR ANAPHYLAXIS, BUT THE PRIORITY IS AIRWAY

ASSESSMENT AND

MAINTENANCE.

IMMEDIATELY AFTER THE NURSE ADMINISTERS AN INTRADERMAL INJECTION OF AN

ALLERGEN ON THE FOREARM,

THE PATIENT REPORTS ITCHING AT THE SITE, WEAKNESS, AND DIZZINESS. WHICH ACTION

WOULD THE NURSE

TAKE FIRST?

A. APPLY ANTIINFLAMMATORY CREAM.

B. PLACE A TOURNIQUET ABOVE THE SITE.

C. ADMINISTER SUBCUTANEOUS EPINEPHRINE.

D. RESCHEDULE THE PATIENT'S OTHER ALLERGEN TESTS.

PLACE A TOURNIQUET ABOVE THE SITE.

APPLICATION OF A TOURNIQUET WILL DECREASE SYSTEMIC CIRCULATION OF THE

ALLERGEN AND SHOULD BE

THE FIRST REACTION. THE OTHER ACTIONS MAY OCCUR, BUT THE TOURNIQUET

APPLICATION SLOWS THE

ALLERGEN PROGRESS INTO THE PATIENT'S SYSTEM, ALLOWING TREATMENT OF THE

ANAPHYLACTIC RESPONSE. A

LOCAL ANTIINFLAMMATORY CREAM MAY BE APPLIED TO THE SITE OF A CUTANEOUS TEST

FOR PERSISTENT

ANGIOEDEMA IS CHARACTERIZED BY SWELLING OF THE EYELIDS, LIPS, AND TONGUE.

WHEAL AND FLARE

LESIONS, CLEAR NASAL DRAINAGE, AND HYPOTENSION AND TACHYCARDIA ARE

CHARACTERISTIC OF OTHER

ALLERGIC REACTIONS

WE HAVE AN EXPERT-WRITTEN SOLUTION TO THIS PROBLEM!

A NURSE HAS OBTAINED DONOR TISSUE TYPING INFORMATION ABOUT A PATIENT WHO

IS WAITING FOR A

KIDNEY TRANSPLANT. WHICH RESULT SHOULD THE NURSE REPORT TO THE TRANSPLANT

SURGEON?

A. THE PATIENT-DONOR CROSSMATCH IS POSITIVE.

B. SIX ANTIGEN MATCHES ARE PRESENT IN HLA TYPING.

C. THE PATIENT IS RH POSITIVE AND DONOR IS RH NEGATIVE.

D. PANEL OF REACTIVE ANTIBODIES (PRA) PERCENTAGE IS LOW.

THE PATIENT-DONOR CROSSMATCH IS POSITIVE.

POSITIVE CROSS MATCHING IS AN ABSOLUTE CONTRAINDICATION TO KIDNEY

TRANSPLANTATION BECAUSE A

HYPERACUTE REJECTION WILL OCCUR AFTER THE TRANSPLANT. THE OTHER

INFORMATION SHOWS THAT THE

TISSUE MATCH BETWEEN THE PATIENT AND POTENTIAL DONOR IS ACCEPTABLE.

WE HAVE AN EXPERT-WRITTEN SOLUTION TO THIS PROBLEM!

A PATIENT WHO IS RECEIVING IMMUNOTHERAPY HAS JUST RECEIVED AN ALLERGEN

INJECTION. WHICH

FINDING IS MOST IMPORTANT TO COMMUNICATE TO THE HEALTH CARE PROVIDER?

A. THE PATIENT'S IGG LEVEL IS INCREASED.

B. THERE IS REDNESS AND SWELLING AT THE INJECTION SITE.

C. THERE IS A 2-CM WHEAL AT THE SITE OF THE INJECTION.

D. THE PATIENT'S SYMPTOMS DID NOT IMPROVE IN 2 MONTHS.

THERE IS A 2-CM WHEAL AT THE SITE OF THE INJECTION.

A LOCAL REACTION LARGER THAN QUARTER SIZE MAY INDICATE THAT A DECREASE IN THE

ALLERGEN DOSE IS

NEEDED. AN INCREASE IN IGG SHOWS THAT THE THERAPY IS EFFECTIVE. REDNESS AND

SWELLING AT THE

SITE ARE NOT UNUSUAL. BECAUSE IMMUNOTHERAPY USUALLY TAKES 1 TO 2 YEARS TO

ACHIEVE AN EFFECT,

AN IMPROVEMENT IN THE PATIENT'S SYMPTOMS IS NOT EXPECTED AFTER A FEW

MONTHS.

THE NURSE IS ADMITTING A PATIENT WITH POSSIBLE RHEUMATIC FEVER. WHICH

QUESTION ON THE

ADMISSION HEALTH HISTORY FOCUSES ON A PERTINENT RISK FACTOR FOR RHEUMATIC

FEVER?

A. ―DO YOU USE ANY ILLEGAL IV DRUGS?‖

B. ―HAVE YOU EVER INJURED YOUR CHEST?‖

C. ―HAVE YOU HAD A RECENT SORE TH ROAT?‖

D. ―DO YOU HAVE A FA MILY HISTORY OF HEAR T DISEASE?‖

―HAVE YOU HAD A RECENT SORE THROAT?‖

RHEUMATIC FEVER OCCURS BECAUSE OF AN ABNORMAL IMMUNE RESPONSE TO A

STREPTOCOCCAL INFECTION.

ALTHOUGH IV DRUG USE SHOULD BE DISCUSSED WITH THE PATIENT BEFORE DISCHARGE,

IT IS NOT A RISK

FACTOR FOR RHEUMATIC FEVER. FAMILY HISTORY IS NOT A RISK FACTOR FOR

RHEUMATIC FEVER. CHEST INJURY

WOULD CAUSE MUSCULOSKELETAL CHEST PAIN RATHER THAN RHEUMATIC FEVER.

―I WILL BE IMMUNE TO FUTURE EPISODES OF RHEUMATIC FEVER AFTER THIS

INFECTION.‖

PATIENTS WITH A HISTORY OF RHEUMATIC FEVER ARE MORE SUSCEPTIBLE TO A SECOND

EPISODE. PATIENTS

WITH RHEUMATIC FEVER WITHOUT CARDITIS REQUIRE PROPHYLAXIS UNTIL AGE 20 YEARS

AND FOR A

MINIMUM OF 5 YEARS. THE OTHER PATIENT STATEMENTS ARE CORRECT.

WHICH ACTION WOULD THE NURSE INCLUDE IN A COMMUNITY HEALTH PROGRAM TO

DECREASE THE

INCIDENCE OF RHEUMATIC FEVER?

A. VACCINATE HIGH-RISK GROUPS IN THE COMMUNITY WITH STREPTOCOCCAL VACCINE.

B. TEACH COMMUNITY MEMBERS TO SEEK TREATMENT FOR STREPTOCOCCAL

PHARYNGITIS.

C. TEACH ABOUT THE IMPORTANCE OF MONITORING TEMPERATURE WHEN SORE

THROATS OCCUR.

D. TEACH ABOUT PROPHYLACTIC ANTIBIOTICS TO THOSE WITH A FAMILY HISTORY OF

RHEUMATIC

FEVER.

TEACH COMMUNITY MEMBERS TO SEEK TREATMENT FOR STREPTOCOCCAL PHARYNGITIS.

THE INCIDENCE OF RHEUMATIC FEVER IS DECREASED BY TREATMENT OF STREPTOCOCCAL

INFECTIONS WITH

ANTIBIOTICS. FAMILY HISTORY IS NOT A RISK FACTOR FOR RHEUMATIC FEVER. THERE IS

NO IMMUNIZATION

THAT IS EFFECTIVE IN DECREASING THE INCIDENCE OF RHEUMATIC FEVER. TEACHING

ABOUT MONITORING

TEMPERATURE WILL NOT DECREASE THE INCIDENCE OF RHEUMATIC FEVER.

WE HAVE AN EXPERT-WRITTEN SOLUTION TO THIS PROBLEM!

WHICH FINDING FOR A PATIENT WITH MITRAL VALVE STENOSIS WOULD BE OF MOST

CONCERN TO THE NURSE?

A. DIASTOLIC MURMUR

B. PERIPHERAL EDEMA

C. SHORTNESS OF BREATH ON EXERTION

D. RIGHT UPPER QUADRANT TENDERNESS

SHORTNESS OF BREATH ON EXERTION

THE PRESSURE GRADIENT CHANGES IN MITRAL STENOSIS LEAD TO FLUID BACKUP INTO

THE LUNGS, RESULTING

IN HYPOXEMIA AND DYSPNEA. THE OTHER FINDINGS ALSO MAY BE ASSOCIATED WITH

MITRAL VALVE

DISEASE BUT ARE NOT INDICATORS OF HYPOXEMIA, WHICH IS A PRIORITY.

A 21-YR-OLD WOMAN IS CONSIDERING HEART VALVE REPLACEMENT SURGERY. WHICH

INFORMATION WOULD

THE NURSE INCLUDE WHEN EXPLAINING THE DIFFERENCES IN ONGOING CARE REQUIRED

WITH DIFFERENT

TYPES OF VALVES?

A. BIOLOGIC VALVES REQUIRE IMMUNOSUPPRESSIVE DRUGS AFTER SURGERY.

B. MECHANICAL MITRAL VALVES NEED TO BE REPLACED SOONER THAN BIOLOGIC VALVES.

C. LIFELONG ANTICOAGULANT THERAPY IS NEEDED AFTER MECHANICAL VALVE

REPLACEMENT.

D. ONGOING CARE BY A HEALTH CARE PROVIDER IS NOT NECESSARY AFTER VALVE

REPLACEMENT.

LIFELONG ANTICOAGULANT THERAPY IS NEEDED AFTER MECHANICAL VALVE

REPLACEMENT.

LONG-TERM ANTICOAGULATION THERAPY IS NEEDED AFTER MECHANICAL VALVE

REPLACEMENT, AND THIS

WOULD RESTRICT DECISIONS ABOUT CAREER AND CHILDBEARING IN THIS PATIENT.

MECHANICAL VALVES ARE

C. TEACH THE PATIENT TO USE SUBLINGUAL NITROGLYCERIN FOR CHEST PAIN.

D. RAISE THE HEAD OF THE BED 60 DEGREES TO DECREASE VENOUS RETURN.

PROMOTE REST TO DECREASE MYOCARDIAL OXYGEN DEMAND.

REST IS RECOMMENDED TO BALANCE MYOCARDIAL OXYGEN SUPPLY AND DEMAND AND

TO DECREASE CHEST

PAIN. THE PATIENT WITH AORTIC STENOSIS REQUIRES HIGHER PRELOAD TO MAINTAIN

CARDIAC OUTPUT, SO

NITROGLYCERIN AND MEASURES TO DECREASE VENOUS RETURN ARE CONTRAINDICATED.

ANTICOAGULATION IS

NOT RECOMMENDED UNLESS THE PATIENT HAS ATRIAL FIBRILLATION.

WE HAVE AN EXPERT-WRITTEN SOLUTION TO THIS PROBLEM!

AN OLDER ADULT PATIENT WHO HAD A MITRAL VALVE REPLACEMENT WITH A

MECHANICAL VALVE IS TAKING

WARFARIN. WHICH INFORMATION WOULD THE NURSE INCLUDE IN DISCHARGE

TEACHING?

A. USE OF DAILY ASPIRIN FOR ANTICOAGULATION.

B. CORRECT METHOD FOR TAKING THE RADIAL PULSE.

C. NEED FOR FREQUENT LABORATORY BLOOD TESTING.

D. PLAN TO AVOID ANY PHYSICAL ACTIVITY FOR 1 MONTH.

NEED FOR FREQUENT LABORATORY BLOOD TESTING

ANTICOAGULATION WITH WARFARIN (COUMADIN) IS NEEDED FOR A PATIENT WITH

MECHANICAL VALVES TO

PREVENT CLOTTING ON THE VALVE. THIS WILL REQUIRE FREQUENT INTERNATIONAL

NORMALIZED RATIO TESTING.

DAILY ASPIRIN USE WILL NOT BE EFFECTIVE IN REDUCING THE RISK FOR CLOTS ON THE

VALVE. MONITORING

OF THE RADIAL PULSE IS NOT NECESSARY AFTER VALVE REPLACEMENT. PATIENTS SHOULD

RESUME ACTIVITIES

OF DAILY LIVING AS TOLERATED.

A PATIENT RECOVERING FROM HEART SURGERY DEVELOPS PERICARDITIS AND REPORTS

LEVEL 6 (0 TO 10

SCALE) CHEST PAIN WITH DEEP BREATHING. WHICH PRESCRIBED PRN MEDICATION WILL

LIKELY BE THE

MOST HELPFUL IN RELIEVING THE PAIN?

A. FENTANYL 1 MG IV

B. IV MORPHINE SULFATE 4 MG

C. ORAL IBUPROFEN (MOTRIN) 600 MG

D. ORAL ACETAMINOPHEN (TYLENOL) 650 MG

ORAL IBUPROFEN (MOTRIN) 600 MG

THE PAIN ASSOCIATED WITH PERICARDITIS IS CAUSED BY INFLAMMATION, SO

NONSTEROIDAL

ANTIINFLAMMATORY DRUGS (E.G., IBUPROFEN) ARE MOST EFFECTIVE. OPIOID

ANALGESICS AND

ACETAMINOPHEN ARE NOT VERY EFFECTIVE FOR THE PAIN ASSOCIATED WITH

PERICARDITIS.

WHICH ASSESSMENT FINDING FOR A PATIENT WITH INFECTIVE ENDOCARDITIS IS

CONSISTENT WITH

EMBOLIZED VEGETATIONS FROM THE TRICUSPID VALVE?

A. FLANK PAIN

B. SPLENOMEGALY

C. SHORTNESS OF BREATH

D. MENTAL STATUS CHANGES

SHORTNESS OF BREATH

THE NURSE IS OBTAINING A HEALTH HISTORY FROM A 24-YR-OLD PATIENT WITH

HYPERTROPHIC

CARDIOMYOPATHY (CMP). WHICH INFORMATION OBTAINED BY THE NURSE IS MOST

IMPORTANT IN

PLANNING CARE?

A. THE PATIENT HAD A RECENT UPPER RESPIRATORY INFECTION.

B. THE PATIENT HAS A FAMILY HISTORY OF CORONARY ARTERY DISEASE.

C. THE PATIENT REPOR TS USING COCAINE ―A FEW TIMES‖ AS A TEEN AGER.

D. THE PATIENT'S 29-YR-OLD BROTHER DIED FROM A SUDDEN CARDIAC ARREST.

THE PATIENT'S 29-YR-OLD BROTHER DIED FROM A SUDDEN CARDIAC ARREST.

ABOUT HALF OF ALL CASES OF HYPERTROPHIC CMP HAVE A GENETIC BASIS, AND IT IS THE

MOST COMMON

CAUSE OF SUDDEN CARDIAC DEATH IN OTHERWISE HEALTHY YOUNG PEOPLE. THE

INFORMATION ABOUT THE

PATIENT'S BROTHER WILL BE HELPFUL IN PLANNING CARE (E.G., AN AUTOMATIC

IMPLANTABLE

CARDIOVERTER-DEFIBRILLATOR [AICD]) FOR THE PATIENT AND IN COUNSELING OTHER

FAMILY MEMBERS.

THE PATIENT SHOULD BE COUNSELED AGAINST THE USE OF STIMULANT DRUGS, BUT THE

LIMITED PAST HISTORY

INDICATES THAT THE PATIENT IS NOT CURRENTLY AT HIGH RISK FOR COCAINE USE. VIRAL

INFECTIONS AND

CAD ARE RISK FACTORS FOR DILATED CARDIOMYOPATHY BUT NOT FOR HYPERTROPHIC

CMP.

WHICH PATIENT WILL NEED THE NURSE TO PLAN DISCHARGE TEACHING ABOUT

PROPHYLACTIC ANTIBIOTICS

BEFORE DENTAL PROCEDURES?

A. PATIENT ADMITTED WITH A LARGE ACUTE MYOCARDIAL INFARCTION

B. PATIENT BEING DISCHARGED AFTER AN EXACERBATION OF HEART FAILURE

C. PATIENT WHO HAD A MITRAL VALVE REPLACEMENT WITH A MECHANICAL VALVE

D. PATIENT BEING TREATED FOR RHEUMATIC FEVER AFTER A STREPTOCOCCAL INFECTION

PATIENT WHO HAD A MITRAL VALVE REPLACEMENT WITH A MECHANICAL VALVE

CURRENT AMERICAN HEART ASSOCIATION GUIDELINES RECOMMEND THE USE OF

PROPHYLACTIC ANTIBIOTICS

BEFORE DENTAL PROCEDURES FOR PATIENTS WITH PROSTHETIC VALVES TO PREVENT

INFECTIVE ENDOCARDITIS

(IE). THE OTHER PATIENTS ARE NOT AT HIGH RISK FOR IE.

WE HAVE AN EXPERT-WRITTEN SOLUTION TO THIS PROBLEM!

WHICH ADMISSION PRESCRIPTION WRITTEN BY THE HEALTH CARE PROVIDER FOR A

PATIENT ADMITTED WITH

INFECTIVE ENDOCARDITIS (IE) AND A FEVER WOULD BE A PRIORITY FOR THE NURSE TO

IMPLEMENT?

A. ADMINISTER AN IV ANTIBIOTIC.

B. DRAW BLOOD CULTURES FROM TWO SITES.

C. SCHEDULE A TRANSESOPHAGEAL ECHOCARDIOGRAM.

D. GIVE ACETAMINOPHEN (TYLENOL) PRN FOR FEVER.

DRAW BLOOD CULTURES FROM TWO SITES

TREATMENT OF THE IE WITH ANTIBIOTICS SHOULD BE STARTED AS QUICKLY AS POSSIBLE,

BUT IT IS ESSENTIAL

TO OBTAIN BLOOD CULTURES BEFORE STARTING ANTIBIOTIC THERAPY TO OBTAIN

ACCURATE SENSITIVITY RESULTS.

THE ECHOCARDIOGRAM AND ACETAMINOPHEN ADMINISTRATION ALSO SHOULD BE

IMPLEMENTED RAPIDLY, BUT THE BLOOD CULTURES (AND THEN ADMINISTRATION OF THE

ANTIBIOTIC) HAVE THE HIGHEST PRIORITY.

WHICH ASSESSMENT FINDING IN A PATIENT WHO IS ADMITTED WITH INFECTIVE

ENDOCARDITIS (IE) IS MOST

WE HAVE AN EXPERT-WRITTEN SOLUTION TO THIS PROBLEM!

THE NURSE IS CARING FOR A PATIENT WITH AORTIC STENOSIS. WHICH ASSESSMENT DATA

WOULD BE MOST

IMPORTANT TO REPORT TO THE HEALTH CARE PROVIDER?

A. THE PATIENT REPORTS CHEST PRESSURE WHEN AMBULATING.

B. A LOUD SYSTOLIC MURMUR IS HEARD ALONG THE RIGHT STERNAL BORDER.

C. A THRILL IS PALPATED AT THE SECOND INTERCOSTAL SPACE, RIGHT STERNAL BORDER.

D. THE POINT OF MAXIMUM IMPULSE (PMI) IS AT THE LEFT MIDCLAVICULAR LINE.

THE PATIENT REPORTS CHEST PRESSURE WHEN AMBULATING.

CHEST PRESSURE (OR PAIN) OCCURRING WITH AORTIC STENOSIS IS CAUSED BY CARDIAC

ISCHEMIA AND

REPORTING THIS INFORMATION WOULD BE A PRIORITY. A SYSTOLIC MURMUR AND

THRILL ARE EXPECTED IN A

PATIENT WITH AORTIC STENOSIS. A PMI AT THE LEFT MIDCLAVICULAR LINE IS NORMAL.

WE HAVE AN EXPERT-WRITTEN SOLUTION TO THIS PROBLEM!

TWO DAYS AFTER AN ACUTE MYOCARDIAL INFARCTION (MI), A PATIENT REPORTS

STABBING CHEST PAIN THAT

INCREASES WITH A DEEP BREATH. WHICH ACTION WILL THE NURSE TAKE FIRST?

A. AUSCULTATE THE HEART SOUNDS.

B. CHECK THE PATIENT'S TEMPERATURE.

C. GIVE PRN ACETAMINOPHEN (TYLENOL).

D. NOTIFY THE PATIENT'S HEALTH CARE PROVIDER.

AUSCULTATE THE HEART SOUNDS.

THE PATIENT'S CLINICAL MANIFESTATIONS AND HISTORY ARE CONSISTENT WITH

PERICARDITIS, AND THE FIRST

ACTION BY THE NURSE WOULD BE TO LISTEN FOR A PERICARDIAL FRICTION RUB.

CHECKING THE TEMPERATURE

AND NOTIFYING THE HEALTH CARE PROVIDER ARE ALSO APPROPRIATE ACTIONS BUT

WOULD NOT BE DONE

BEFORE LISTENING FOR A RUB. ACETAMINOPHEN (TYLENOL) IS NOT EFFECTIVE FOR

PERICARDITIS PAIN. AN

ANALGESIC WOULD NOT BE GIVEN BEFORE ASSESSMENT OF A NEW SYMPTOM.

WE HAVE AN EXPERT-WRITTEN SOLUTION TO THIS PROBLEM!

THE NURSE IS CARING FOR A PATIENT WITH MITRAL VALVE REGURGITATION. WHICH

INFORMATION OBTAINED

BY THE NURSE WOULD BE REPORTED TO THE HEALTH CARE PROVIDER IMMEDIATELY?

A. THE PATIENT HAS 4+ PERIPHERAL EDEMA.

B. THE PATIENT HAS DIFFUSE BILATERAL CRACKLES.

C. THE PATIENT HAS A LOUD SYSTOLIC MURMUR ACROSS THE PRECORDIUM.

D. THE PATIENT HAS A PALPABLE THRILL FELT OVER THE LEFT ANTERIOR CHEST.

THE PATIENT HAS DIFFUSE BILATERAL CRACKLES.

CRACKLES THAT ARE AUDIBLE THROUGHOUT THE LUNGS INDICATE THAT THE PATIENT IS

EXPERIENCING SEVERE

LEFT VENTRICULAR FAILURE WITH PULMONARY CONGESTION AND NEEDS IMMEDIATE

INTERVENTIONS SUCH AS

DIURETICS. A SYSTOLIC MURMUR AND PALPABLE THRILL WOULD BE EXPECTED IN A

PATIENT WITH MITRAL

REGURGITATION. ALTHOUGH 4+ PERIPHERAL EDEMA INDICATES A NEED FOR A CHANGE

IN THERAPY, IT DOES

NOT NEED TO BE ADDRESSED URGENTLY.

WHICH ACTION BY THE NURSE WILL DETERMINE IF THERAPIES ORDERED FOR A PATIENT

WITH CHRONIC