An 80-year-old client is diagnosed with pneumonia. Which of the following symptoms may appear first?

Altered mental status and dehydration

Hemoptysis and dyspnea

Pleuritic chest pain and hypertension

Fever and chills

Answer and Explanation

The Correct Answer is D

A.   While altered mental status can occur in older adults with pneumonia, especially due to hypoxia or infection, it is often a result of more advanced disease or complications rather than an early symptom. Dehydration can also occur but is not a direct symptom of pneumonia.
B.   Hemoptysis (coughing up blood) is not a common early symptom of pneumonia, especially in older adults. Dyspnea (difficulty breathing) may occur, but it generally arises as the pneumonia worsens. These symptoms might not be the first to present.
C.   Pleuritic chest pain (pain upon breathing) can be associated with pneumonia but is not necessarily an early symptom, especially in the elderly. Hypertension may be present but is not a hallmark of pneumonia and can vary widely among patients.
D.   Fever and chills are common initial symptoms of pneumonia and are part of the body’s response to infection. In elderly patients, fever may sometimes be less pronounced or atypical, but it is still one of the first signs of pneumonia.

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Correct Answer is A

Explanation

A. This is a strong indicator of effectiveness. Both antacids and PPIs aim to reduce gastric acidity, which alleviates symptoms such as heartburn, regurgitation, and discomfort. A decrease in gastric distress suggests that the medications are successfully managing the symptoms of GERD.
B. Amylase is an enzyme primarily related to carbohydrate digestion, and its levels are not directly related to GERD or the effectiveness of antacids and PPIs. Normalizing amylase levels would not indicate the effectiveness of treatment for GERD, making this option irrelevant in this context.
C. While a decrease in vomiting may indicate an improvement in GERD symptoms, it is not the primary focus of treatment with antacids and PPIs. GERD primarily involves symptoms like heartburn and acid reflux rather than vomiting. However, if vomiting was due to severe reflux, improvement might indicate effectiveness.
D. Gastric motility refers to the movement of food through the gastrointestinal tract. While normal gastric motility can be beneficial, antacids and PPIs do not primarily aim to increase motility; their focus is on reducing acidity and managing reflux symptoms.

A. Cyanosis B. Restlessness C. Increased respirations D. Hypertension

Correct Answer is B

Explanation

A. Cyanosis is a late sign of hypoxia, occurring when oxygen saturation is significantly low. It's often visible in the mucous membranes and skin.
B. Restlessness is often one of the earliest signs of hypoxia. As oxygen levels decrease, the brain becomes deprived of oxygen, leading to changes in mental status, including restlessness, confusion, and agitation.
C. Increased respirations (tachypnea) can be a sign of hypoxia, but it's often a later response as the body attempts to compensate for decreased oxygen levels.
D. Hypertension is not a typical sign of hypoxia. In fact, severe hypoxia can lead to hypotension as blood pressure decreases.

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An 80-year-old client is diagnosed with pneumonia. Which of the following symptoms may appear first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

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