A patient with right lower-lobe pneumonia has been treated with IV antibiotics for 3 days. Which assessment data obtained by the nurse indicates that the treatment is effective?
The patient's white blood cell (WBC) count is 6000/μL.
Bronchial breath sounds are heard at the right base.
Increased tactile fremitus is palpable over the right chest.
The patient coughs up small amounts of green mucus.
The Correct Answer is A
A. A decrease in the white blood cell count toward normal levels indicates that the infection is responding to antibiotic treatment. A WBC count of 6000/μL is within the normal range for adults (usually 4,000–11,000/μL), which suggests that the body is no longer fighting a significant infection.
B. Bronchial breath sounds heard at the right base indicate consolidation, a sign of ongoing pneumonia or unresolved infection. This would suggest that the infection is not yet controlled, rather than an improvement.
C. Increased tactile fremitus indicates consolidation, which is commonly seen in pneumonia. It suggests that the infection is still present and has not resolved with treatment.
D. Green mucus can indicate the presence of purulent sputum and ongoing infection. Although the color of the mucus may change during the course of pneumonia, the presence of green mucus does not confirm that the infection is resolving, especially after three days of antibiotics.
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Related Questions
Correct Answer is C
Explanation
A. Green tea, while it contains some caffeine, is generally not considered a significant risk factor for the development of peptic ulcers. It may have protective effects due to its antioxidant properties, unlike substances that directly irritate the stomach lining.
B. Moderate alcohol consumption, such as a glass of wine, may irritate the stomach lining but is not a primary risk factor for peptic ulcers unless excessive drinking occurs. This would not be the most significant factor for ulcer development.
C. NSAID use is a well-established risk factor for peptic ulcers. NSAIDs inhibit the production of prostaglandins, which protect the stomach lining from acid damage. Chronic use of NSAIDs can lead to ulcer formation due to this inhibition.
D. Bulimia can lead to acid reflux or esophageal irritation, but it is not a direct risk factor for the formation of peptic ulcers. The primary risk factors for peptic ulcers include H. pylori infection and the use of NSAIDs.
Correct Answer is D
Explanation
A. Tympany upon chest percussion is typically associated with the presence of air, such as in cases of pneumothorax or gastric distention. It is not a typical finding in pneumonia.
B. Unequal pupils (anisocoria) are not a common symptom of pneumonia and may indicate a neurological issue rather than a respiratory infection.
C. Hypertension is not a characteristic finding in community-acquired pneumonia. Pneumonia may cause changes in blood pressure, but hypotension or normal blood pressure is more likely.
D. Confusion is a common finding in older adults with pneumonia. This can be due to factors such as hypoxia, dehydration, or infection-related changes in mental status, often referred to as "pneumonia delirium" or "acute confusion." Older adults are particularly susceptible to cognitive changes due to infection.
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