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 D

Explanation

D. Sucralfate should be taken on an empty stomach, typically 1 hour before meals. This timing allows the medication to coat the ulcer site effectively and protect it from the acidic environment of the stomach, which increases after eating.
A. Taking sucralfate with an antacid can interfere with its action. Sucralfate works by forming a protective barrier on the ulcer site, and antacids can prevent sucralfate from binding properly to the ulcer. It's generally recommended to take sucralfate at least 30 minutes before or after antacids.
B. Sucralfate is not taken on an "as needed" basis for pain relief. It is prescribed as a regular, scheduled medication to provide continuous protection of the ulcer site. Pain relief from peptic ulcers comes as the ulcer heals, which sucralfate aids by protecting the mucosal lining.
C. Sucralfate does not need to be stored in the refrigerator. It should be stored at room temperature, away from moisture and heat, according to standard storage guidelines for most medications.

A. Shake the canister 3 to 5 seconds vigorously. B. Place her lips firmly around the mouthpiece. C. Inhale slowly over 3 to 5 seconds while pushing down on the canister. D. Hold her breath for 10 seconds. E. Exhale slowly through pursed lips.

Correct Answer is A, B, C, D, E

Explanation

A. Shake the canister 3 to 5 seconds vigorously.
Before each use, it's important to shake the MDI to ensure proper mixing of the medication.
B. Place her lips firmly around the mouthpiece.
Creating a tight seal around the mouthpiece ensures that the medication is delivered directly into the airways.
C. Inhale slowly over 3 to 5 seconds while pushing down on the canister.
While pressing down on the canister, the client should inhale slowly to allow the medication to reach the lungs.
D. Hold her breath for 10 seconds.
After inhaling the medication, holding the breath for 10 seconds allows for better absorption of the medication into the lungs.
E. Exhale slowly through pursed lips.
After holding the breath, exhaling slowly through pursed lips helps to fully exhale and ensures that the medication remains in the airways.

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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 teaching a client who has peptic ulcer disease and is starting therapy with sucralfate. Which of the following instructions should the nurse include in the teaching?

Correct Answer is D

Explanation

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.)

Correct Answer is A, B, C, D, E

Explanation

A nurse is reinforcing teaching with the parents of a child who is starting to use a spacer with a metered-dose inhaler (MDI) to treat asthma. Which of the following information should the nurse include in the teaching?

A nurse is reinforcing discharge teaching with a client following an episode of status asthmaticus. The client has a prescription for two inhalations from an albuterol metered-dose inhaler. Which of the following statements by the client indicates an understanding of the teaching?

After reinforcing teaching on peptic ulcer disease, the nurse evaluates the patient as understanding the education if the patient states which of the following is a primary cause of peptic ulcer disease?

The nurse knows a patient with type 1 diabetes needs more education when the patient makes which of the following statements?

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.

The patient with emphysema comes to the emergency department with difficulty breathing. What finding should the nurse anticipate during data collection? Select all that apply

The nurse is preparing to teach about the long-term complications for patients diagnosed with diabetes. Which finding is accurate?

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.)