The nurse is assigned to care for a client admitted to the hospital with chronic obstructive pulmonary disease (COPD).
Which medication does the nurse anticipate to decrease this client’s risk for developing a respiratory infection?

An influenza vaccine.

A broad-spectrum antibiotic.

A bronchodilator.

A corticosteroid.

Answer and Explanation

The Correct Answer is A

This is because people with COPD are more likely to catch respiratory infections such as colds, flu and pneumonia, which can worsen their symptoms and cause further lung damage. An influenza vaccine can help prevent flu and reduce the risk of complications.

Choice B. A broad-spectrum antibiotic is wrong because antibiotics are only effective against bacterial infections, not viral ones. Antibiotics are usually prescribed for COPD exacerbations caused by bacterial infections, but not for prevention.

Choice C. A bronchodilator is wrong because bronchodilators are medications that relax the muscles around the airways and make breathing easier. They are used to treat the symptoms of COPD, but they do not prevent respiratory infections.

Choice D. A corticosteroid is wrong because corticosteroids are anti inflammatory drugs that reduce swelling and mucus production in the airways. They are also used to treat the symptoms of COPD, but they do not prevent respiratory infections. In fact, long-term use of corticosteroids may increase the risk of infections by suppressing the immune system.

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Correct Answer is D

Explanation

Withholding food and oral fluids until intestinal mobility has returned. This is because the client may have postoperative ileus (POI), which is a reduction of gastrointestinal motility after abdominal surgery. POI is characterized by abdominal distension, lack of bowel sounds, accumulation of gas and fluids in the bowel, and delayed passage of flatus and stools.

Giving food and fluids to a client with POI may worsen the condition and cause complications.

Choice A is wrong because high fat foods may slow down GI motility and increase the risk of constipation.

Choice B is wrong because solid food intake may also aggravate POI and cause abdominal discomfort.

Choice C is wrong because fiber intake may increase gas production and distension in the bowel. The nurse should auscultate the abdomen for bowel sounds, and if they are present, or the client reports passing flatus, clear fluids can commence, and aperients can be administered. However, bowel sounds are not a reliable indicator of the end of POI, as they may not be associated with the time of first flatus.

Therefore, withholding food and oral fluids until intestinal mobility has returned is the most appropriate action by the nurse.

A. The runner may lose consciousness due to heat stroke. B. It is not necessary to call 911. C. It is normal to vomit and not sweat during a marathon. D. Getting the patient to a cooler, air-conditioned place will reverse the heat exhaustion.

Correct Answer is A

Explanation

Heat stroke is a serious condition caused by overheating of the body, usually as a result of prolonged exposure to or physical exertion in high temperatures. It can damage the brain and other internal organs, and can be fatal if not treated promptly.

Some of the symptoms of heat stroke are:

• High body temperature of 104 F (40 C) or higher

• Altered mental state or behavior, such as confusion, agitation, slurred speech, seizures or coma

• Lack of sweating despite the heat

• Red, hot and dry skin

• Rapid and strong pulse

• Throbbing headach

• Nausea and vomiting

Choice B is wrong because it is necessary to call 911 if someone has heat stroke. Heat stroke is a medical emergency that requires immediate attention and cooling of the body.

Choice C is wrong because it is not normal to vomit and not sweat during a marathon. Vomiting and lack of sweating are signs of dehydration and heat stroke, which indicate that the body is unable to regulate its temperature properly.

Choice D is wrong because getting the patient to a cooler, air-conditioned place will not reverse the heat exhaustion.

Heat exhaustion is a milder form of heat-related illness that can lead to heat stroke if not treated. Heat exhaustion symptoms include heavy sweating, weakness, dizziness, nausea and muscle cramps. Getting the patient to a cooler place may help with heat exhaustion, but heat stroke requires more aggressive cooling measures such as immersing the patient in cold water or applying ice packs to the body.

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The nurse is assigned to care for a client admitted to the hospital with chronic obstructive pulmonary disease (COPD). Which medication does the nurse anticipate to decrease this client’s risk for developing a respiratory infection?

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Naxlex Comprehensive Predictor Exams

The nurse is conducting an assessment on a client who is 36 hours postoperative following an appendectomy. During the assessment, the nurse is unable to hear any bowel sounds. The client denies passing flatus (gas). Given this information, which action is most appropriate by the nurse?

Correct Answer is D

Explanation

A nurse is cheering on participants in a marathon and one runner collapses nearby. He begins to vomit and complain of a throbbing headache. The nurse notes that he is not sweating, yet his skin is red and very hot to touch, and his pulse is 170 bpm and strong. The nurse knows that:

Correct Answer is A

Explanation

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Which of the following nursing diagnoses would the nurse be LEAST likely to choose for a patient with appendicitis?

The nurse is assigned to care for a client admitted to the hospital with chronic obstructive pulmonary disease (COPD).
Which medication does the nurse anticipate to decrease this client’s risk for developing a respiratory infection?