A patient is admitted to a respiratory unit with a diagnosis of bacterial pneumonia. Findings include a fever and a weak, congested-sounding cough with moist crackles throughout the lung fields. How should the nurse prioritize care?

Difficulty with breathing

Inability to clear the airway

Confusion from fever

Inadequate oxygen level

Answer and Explanation

The Correct Answer is B

B. The inability to clear the airway is a critical issue. This patient has a weak, congested-sounding cough and moist crackles, indicating that secretions are present and not being effectively cleared. This can lead to airway obstruction, decreased oxygenation, and further respiratory complications. Clearing the airway is a top priority to ensure the patient can breathe properly and prevent further deterioration.
A. Difficulty breathing (dyspnea) is a serious concern as it can indicate respiratory distress or failure. However, it is often a symptom rather than a primary issue, and its underlying causes (such as an inability to clear the airway or inadequate oxygen levels) must be addressed first.
C. Confusion can result from high fever, infection, or hypoxia. While it is important to address the fever and its underlying cause, confusion itself is usually a secondary issue. Addressing the primary respiratory issues will often improve the patient's mental status as well.
D. Hypoxia can result from severe pneumonia, and resolving it involves ensuring the patient has a clear airway and adequate ventilation. Measuring and correcting oxygen levels (e.g., with supplemental oxygen) is crucial, but the underlying cause (such as airway obstruction) must also be managed.

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Correct Answer is A

Explanation

A. Lean proteins like baked turkey breast are generally well-tolerated by individuals with GERD. Turkey is low in fat, which reduces the likelihood of triggering reflux symptoms.
B. Spaghetti with red sauce can be problematic for individuals with GERD due to the acidity of the tomato sauce, which can exacerbate reflux symptoms. Tomato-based foods are often best avoided or consumed in moderation by those with GERD.
C. Corned beef brisket is high in fat, which can increase the risk of reflux symptoms. Fatty foods, especially those high in saturated fat like corned beef, are known triggers for GERD.
D. Citrus flavors, including lemon, can trigger reflux symptoms in some individuals. However, if the dish is prepared with a small amount of lemon pepper seasoning and does not cause symptoms for the individual, it may be acceptable.

A. Decubitus ulcer B. Gastric ulcer C. Esophageal ulcer D. Duodenal ulcer

Correct Answer is D

Explanation

D. Duodenal ulcers are peptic ulcers that develop in the first part of the small intestine, known as the duodenum. They are the most common type of peptic ulcer. The classic symptom of a duodenal ulcer is intermittent upper abdominal pain that occurs about 2 to 3 hours after eating, particularly meals that contain acidic or spicy foods. The pain often wakes the patient from sleep and is relieved by eating or taking antacids.
A. Decubitus ulcers, also known as pressure ulcers or bedsores, are caused by prolonged pressure on the skin, typically over bony prominences. They occur due to impaired blood flow and tissue damage, often in individuals who are bedridden or immobile.
B. Gastric ulcers are peptic ulcers that develop in the lining of the stomach. While gastric ulcers can cause upper abdominal pain, they typically occur shortly after eating or during meals, rather than 3 hours after eating or at night.
C. Esophageal ulcers are peptic ulcers that develop in the lining of the esophagus. They are relatively rare compared to gastric and duodenal ulcers. Esophageal ulcers can cause symptoms such as chest pain, difficulty swallowing, and heartburn, but they are not typically associated with the timing of symptoms described by the client.

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A patient is admitted to a respiratory unit with a diagnosis of bacterial pneumonia. Findings include a fever and a weak, congested-sounding cough with moist crackles throughout the lung fields. How should the nurse prioritize care?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reinforcing dietary teaching with a client who has GERD. Which of the following food choices by the client indicates an understanding of the teaching?

Correct Answer is A

Explanation

Your client has told you that they have been experiencing intermittent upper abdominal pain about 3 hours after eating and at times will even be awaken in the middle of the night by this pain. You suspect that your client may have which type of peptic ulcer?

Correct Answer is D

Explanation

A nurse is collecting data from a client who has peptic ulcer disease. Which of the following findings is a manifestation of gastrointestinal perforation?

The LPN/LVN is providing teaching for a patient with type 2 diabetes. Which statement indicates an understanding by the patient?

The nurse is teaching a patient recently diagnosed with type 1 diabetes mellitus (DM) about the disease. What information should the nurse include?

A nurse is reinforcing teaching about dietary recommendations for a client who has a hiatal hernia. Which of the following client statements indicate understanding of the teaching? (Select all that apply.)

The nurse is providing discharge education about signs and symptoms of hypoglycemia and hyperglycemia. For each sign/symptom, indicate whether it is manifestation of hypoglycemia or hyperglycemia. Select one option in each row.

43. A nurse is reinforcing teaching about use of a metered-dose inhaler (MDI) with a client who has a new diagnosis of asthma. Identify the sequence the client should follow. (Move the steps into the box on the right, placing them in the selected order of performance. Use all steps.)

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