Patient Data
What order(s) would the nurse question? (Select all that apply.)
Send blood for a complete blood count, electrolytes
Enalapril 10 mg every morning
C Ibuprofen 400 mg every 4 to 6 hours PRN for temperature greater than 100.5°F (38° C)
Admit to the medical floor
Supplemental oxygen 10 L/min via nasal cannula
Vital signs every 4 hours
Continuous pulse oximetry
Chest x-ray
Correct Answer : C,E,H
A. Send blood for a complete blood count, electrolytes: This is appropriate for assessing the client's overall health status and electrolyte balance, which may be affected by pneumonia and enalapril therapy.
B. Enalapril 10 mg every morning: This is the client's maintenance dose of enalapril for managing hypertension, and it should be continued unless there are specific contraindications or concerns about renal function.
C. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can increase blood pressure and interfere with the antihypertensive effects of enalapril. Additionally, NSAIDs can potentially worsen renal function, which may already be compromised in a client with pneumonia.
D. Admit to the medical floor: This is appropriate for a client with pneumonia who may require close monitoring and management of respiratory status and other complications.
E. Supplemental oxygen 10 L/min via nasal cannula: High-flow oxygen can decrease respiratory drive and potentially worsen ventilation-perfusion (V/Q) matching, especially in clients with pneumonia.
F. Vital signs every 4 hours: Regular monitoring of vital signs is essential for assessing the client's response to treatment and identifying any signs of deterioration.
G. Continuous pulse oximetry: Continuous pulse oximetry provides real-time monitoring of oxygen saturation and helps assess the effectiveness of oxygen therapy and the client's respiratory status.
H. While a chest x-ray is often indicated for diagnosing pneumonia, ordering it "now" may not be necessary unless the client's condition is unstable or if there are specific concerns regarding the severity of the pneumonia
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","C","E"]
Explanation
B. Start the client on antibiotic therapy - Antibiotics are typically prescribed to treat bacterial pneumonia, which is a common cause of pneumonia.
C. STAT complete blood count (CBC), basic metabolic panel (BMP), and blood cultures - These tests help in assessing the severity of the infection, evaluating electrolyte balance, and identifying the causative organism respectively.
E. Send sputum for culture & sensitivity - This helps in identifying the specific organism causing the pneumonia and determining the most effective antibiotic for treatment.
A. At an oxygen saturation above 90%, the client does not necessarily require oxygen supplementation
D. A ventilation/ perfusion scan is needed in cases of suspected pulmonary embolism which is unlikely in this case.
F. Another chest X ray is not important as a recent one is present. No much changes is expected in the period of the few hours.
Correct Answer is B
Explanation
B. pH 7.46, PCO2 55 mm Hg, HCO3 36 mEq/L, PO2 95 mm Hg
The pH is high (alkalotic).
The HCO3 level is elevated, indicating metabolic alkalosis.
The PCO2 is high (respiratory acidotic picture due to secondary response). This option matches the criteria for metabolic alkalosis.
A. pH 7.30, PCO2 20 mm Hg, HCO3 22 mEq/L, PO2 85 mm Hg
The pH is low (acidic), not alkalotic.
The HCO3 level is within the normal range.
The PCO2 is low, which could indicate respiratory alkalosis. This option does not match the criteria for metabolic alkalosis.
C. pH 7.49, PCO2 45 mm Hg, HCO3 32 mEq/L, PO2 90 mm Hg The pH is high (alkalotic).
The HCO3 level is elevated, indicating metabolic alkalosis. The PCO2 is within the normal range.
This option does not meet the criteria for metabolic alkalosis D pH 7.29, PCO2 35 mm Hg, HCO3 25 mEq/L, PO2 99 mm Hg
The pH is low (acidic), not alkalotic. The HCO3 level is low, not elevated. The PCO2 is within the normal range.
This option does not match the criteria for metabolic alkalosis.
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