A nurse in the emergency department is assessing an older adult client who has community-acquired pneumonia. Which of the following findings should the nurse expect?

Hypertension

Unequal pupils

Confusion

Tympany upon chest percussion

Answer and Explanation

The Correct Answer is C

A. Hypertension is not typically associated with pneumonia, especially in older adults. Pneumonia can lead to hypotension or sepsis, but not usually hypertension.
B. Unequal pupils are not a typical finding associated with pneumonia. This could suggest a neurological issue or a possible eye problem, not a respiratory infection.
C. Confusion is a common sign of pneumonia in older adults, especially in the elderly, who may present with altered mental status due to hypoxia, infection, or dehydration. Delirium or confusion is a common manifestation of pneumonia in this population.
D. Tympany on chest percussion suggests air in the abdominal cavity, not in the lungs, and is not typically associated with pneumonia. Pneumonia is more likely to present with dullness upon percussion due to consolidation in the lungs.

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Correct Answer is D

Explanation

A. Glucocorticoid medications are not used to treat DKA. In fact, glucocorticoids can increase blood glucose levels and exacerbate hyperglycemia.
B. Dextrose 5% in 0.45% sodium chloride is not appropriate for the initial treatment of DKA. Initially, IV fluids containing normal saline (0.9% sodium chloride) are used to correct dehydration and restore electrolyte balance.
C. Oral hypoglycemic medications are not effective in DKA, as it is a serious acute complication of diabetes that requires insulin therapy and IV fluids, not oral medications.
D. 0.9% sodium chloride IV bolus is the first-line treatment for DKA to rehydrate the patient, correct electrolyte imbalances, and dilute the high blood glucose level. After stabilization, insulin therapy is also introduced.

A. HCO3 above 26 mEq/L B. pH below 7.35 C. PaO2 below 70 mm Hg D. PaCO2 above 45 mm Hg

Correct Answer is B

Explanation

A. HCO3 (bicarbonate) levels above 26 mEq/L indicate alkalosis, not acidosis. In metabolic acidosis, the HCO3 levels would be low as the body attempts to neutralize excess acid.
B. In metabolic acidosis, the pH is expected to be below 7.35 because metabolic acidosis indicates an accumulation of acid or loss of bicarbonate, which lowers the blood pH.
C. PaO2 (partial pressure of oxygen) below 70 mm Hg typically indicates hypoxemia, not necessarily metabolic acidosis. The primary concern with metabolic acidosis is the balance of acid-base status, not oxygenation.
D. PaCO2 above 45 mm Hg would suggest respiratory acidosis rather than metabolic acidosis. In metabolic acidosis, the body compensates by hyperventilating to blow off CO2 and raise the pH, resulting in a normal or low PaCO2.

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A nurse in the emergency department is assessing an older adult client who has community-acquired pneumonia. Which of the following findings should the nurse expect?

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Naxlex Comprehensive Predictor Exams

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