A nurse is assisting in the plan of care for a client showing signs of pneumonia. Which of the following nursing actions should be included?

Obtain a sputum culture.

Cough and deep breathe every 6 hours.

Encourage fluid intake of 1500 mL/day.

Position the client prone.

Answer and Explanation

The Correct Answer is A

A.   Obtain a sputum culture: Obtaining a sputum culture helps identify the causative organism of pneumonia, which guides appropriate antibiotic therapy.
B.   Cough and deep breathe every 6 hours: While coughing and deep breathing exercises are important for preventing complications such as atelectasis, they are not specific to pneumonia treatment and may not be appropriate for all patients with pneumonia.
C.   Encourage fluid intake of 1500 mL/day: Adequate fluid intake is generally recommended for overall health but is not a specific intervention for pneumonia treatment.
D.   Position the client prone: Positioning the client prone is not a standard intervention for pneumonia treatment. Depending on the severity and type of pneumonia, the client's positioning may vary, but prone positioning is not routinely recommended.

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Correct Answer is B

Explanation

A. Bullae: Bullae are fluid-filled lesions larger than 0.5 cm in diameter.
B. Nodules: Nodules are elevated, solid lesions deeper and firmer than papules, typically larger than 0.5 cm in diameter.
C. Papules: Papules are elevated, solid lesions smaller than 0.5 cm in diameter.
D. Macules: Macules are flat, colored lesions that are smaller than 1 cm in diameter.

A. Thickening of the epidermis. B. Thinning of the epidermis. C. Oiliness of the skin. D. Increased elasticity of the skin.

Correct Answer is B

Explanation

A. Thickening of the epidermis: The epidermis tends to thin rather than thicken with aging.
Thinning of the epidermis can lead to increased vulnerability to injury and slower wound healing.
B. Thinning of the epidermis: Thinning of the epidermis is a common age-related change in the skin. This thinning can result in a decreased barrier function, making the skin more susceptible to damage and infection.
C. Oiliness of the skin: Older adults often experience a decrease in oil production, leading to drier skin rather than oilier skin.
D. Increased elasticity of the skin: With aging, the skin tends to lose elasticity, resulting in sagging and wrinkles rather than increased elasticity.

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A nurse is assisting in the plan of care for a client showing signs of pneumonia. Which of the following nursing actions should be included?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse in a provider's office is collecting data from a client who has skin lesions. The nurse notes that the lesions are 2.5 cm in size, elevated, solid, and deep. The nurse should document the findings as which of the following skin lesions?

Correct Answer is B

Explanation

A nurse is caring for an older client and educating the student nurse on assessing the skin. The student nurse knows that an older client's skin is most likely to experience which of the following changes with aging?

Correct Answer is B

Explanation

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