A nurse working in the emergency department (ED) is admitting a client.

Exhibits

The nurse is reviewing the client's medical record. Which of the following conditions should the nurse identify as a risk factor for pneumonia? Select all that apply.

COPD

Hypertension

Dermatitis

Smoking history

Type 2 diabetes mellitus

Hypothyroidism

Answer and Explanation

Correct Answer : A,D,E

A. COPD: Clients with chronic obstructive pulmonary disease (COPD) are at increased risk for pneumonia due to compromised lung function, chronic inflammation, and decreased mucociliary clearance, making it easier for pathogens to infect the lungs.

B. Hypertension: While hypertension is a significant cardiovascular risk factor, it does not directly increase the risk of pneumonia. Therefore, it is not a relevant factor in this case.

C. Dermatitis: Dermatitis is a skin condition and does not affect lung function or immunity in a way that would increase the risk of pneumonia.

D. Smoking history: Smoking damages the respiratory epithelium and impairs the immune defenses of the lungs, making smokers more susceptible to respiratory infections such as pneumonia.

E. Type 2 diabetes mellitus: Diabetes compromises immune function and increases the risk of infections, including pneumonia, due to hyperglycemia impairing neutrophil function and other immune responses.

F. Hypothyroidism: While hypothyroidism may cause some general symptoms such as fatigue, it does not directly compromise respiratory function or immunity in a way that increases the risk of pneumonia.

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Correct Answer is ["B","C","E","F","G"]

Explanation

A. Perform a vaginal examination every 12 hr. Routine vaginal examinations are not indicated at this stage of care, as there are no signs of labor or uterine contractions. Vaginal exams should only be performed if there are indications of preterm labor or changes in maternal symptoms.

B. Obtain a 24-hr urine specimen. Collecting a 24-hour urine specimen allows for accurate measurement of total protein excretion, which is critical for confirming the severity of preeclampsia. This diagnostic tool helps guide further management decisions.

C. Administer betamethasone. Betamethasone is given to promote fetal lung maturity in the event of a preterm delivery, which is a significant risk at 31 weeks of gestation in the presence of severe preeclampsia. It reduces neonatal morbidity and mortality.

D. Monitor intake and output hourly. While monitoring fluid status is essential, hourly monitoring is not typically required unless there are signs of worsening renal function, oliguria, or fluid imbalance. Regular but less frequent monitoring is sufficient for this client.

E. Give antihypertensive medication. The client's blood pressure readings of 162/112 mm Hg and 166/110 mm Hg require prompt antihypertensive treatment to reduce the risk of complications such as stroke, placental abruption, or eclampsia.

F. Provide a low-stimulation environment. A quiet, low-stimulation environment helps reduce the risk of seizures, which is a concern for clients with severe preeclampsia. This intervention supports neurological stability.

G. Maintain bed rest. Bed rest minimizes physical exertion, helping to lower blood pressure and improve placental perfusion, which is critical for fetal well-being in a client with severe preeclampsia.

Correct Answer is ["6"]

Explanation

Step 1: Calculate the desired dose per minute.

Desired dose = 4 mcg/kg/min * 80 kg = 320 mcg/min

Step 2: Convert mcg/min to mg/hr.

320 mcg/min * 60 min/hr = 19200 mcg/hr = 19.2 mg/hr

Step 3: Calculate the concentration of dopamine in the solution.

Concentration = 800 mg / 250 mL = 3.2 mg/mL

Step 4: Calculate the volume to be infused per hour.

Volume/hr = Dose rate (mg/hr) / Concentration (mg/mL)

Volume/hr = 19.2 mg/hr / 3.2 mg/mL = 6 mL/hr

Therefore, the nurse should set the IV infusion to deliver 6 mL/hr.

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A nurse working in the emergency department (ED) is admitting a client. Exhibits The nurse is reviewing the client's medical record. Which of the following conditions should the nurse identify as a risk factor for pneumonia? Select all that apply.

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Naxlex Comprehensive Predictor Exams

The nurse is continuing to care for the client. Exhibits The nurse is initiating the client's plan of care. Which of the following interventions should the nurse plan to implement? Select all that apply.

Correct Answer is ["B","C","E","F","G"]

Explanation

Correct Answer is ["6"]

Explanation

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A nurse working in the emergency department (ED) is admitting a client.

Exhibits

The nurse is reviewing the client's medical record. Which of the following conditions should the nurse identify as a risk factor for pneumonia? Select all that apply.