Which patient does the LPN/LVN identify at high risk for hospital-acquired pneumonia?

A 35-year-old patient using the incentive spirometer following abdominal surgery

A 55-year-old patient who is eating in the chair following a rhinoplasty

A 40-year-old patient who refuses to cough and deep breath following a splenectomy

A24-year-old patient ambulating in the hall following an appendectomy

Answer and Explanation

The Correct Answer is C

C. This patient is at high risk for hospital-acquired pneumonia. After a splenectomy (removal of the spleen), patients may experience pain and discomfort, which can make them reluctant to perform necessary activities like coughing and deep breathing. These activities are crucial for preventing lung complications such as atelectasis and pneumonia.
A. This patient is actively using an incentive spirometer, which is a device that encourages deep breathing and helps keep the lungs clear. This practice significantly reduces the risk of developing pneumonia by preventing atelectasis (collapse of part of the lung) and promoting lung expansion.

B. This patient is out of bed and eating, which indicates they are relatively mobile and maintaining normal respiratory function. Rhinoplasty, a surgical procedure on the nose, generally does not impair lung function or significantly increase the risk of pneumonia. Being active and upright further reduces the risk of HAP.
D. This patient is actively ambulating, which is highly beneficial for lung function and overall recovery. Walking and moving around helps to prevent respiratory complications, including pneumonia, by promoting lung expansion and circulation.

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Correct Answer is C

Explanation

C. Persistent shortness of breath after using an inhaler could indicate an inadequate response to treatment or worsening asthma exacerbation. The nurse should therefore see this patient first.
A. In COPD patients pulse oximetry oxygen saturations of more than 90% are acceptable. In the treatment of exacerbations of chronic obstructive pulmonary disease (COPD), oxygen should be titrated to achieve a target oxygen saturation range of 88-92%. This results in a greater than twofold reduction in mortality, compared with the routine administration of high-concentration oxygen therapy.
B. Administering antibiotics can be prioritized, but it may not require immediate attention compared to addressing acute respiratory distress or hypoxemia.
D. Collecting a sputum specimen for laboratory analysis is important for diagnosing and managing respiratory infections, but it may not be as time-sensitive as addressing acute respiratory distress or hypoxemia.

A. Decubitus ulcer B. Gastric ulcer C. Esophageal ulcer D. Duodenal ulcer

Correct Answer is D

Explanation

D. Duodenal ulcers are peptic ulcers that develop in the first part of the small intestine, known as the duodenum. They are the most common type of peptic ulcer. The classic symptom of a duodenal ulcer is intermittent upper abdominal pain that occurs about 2 to 3 hours after eating, particularly meals that contain acidic or spicy foods. The pain often wakes the patient from sleep and is relieved by eating or taking antacids.
A. Decubitus ulcers, also known as pressure ulcers or bedsores, are caused by prolonged pressure on the skin, typically over bony prominences. They occur due to impaired blood flow and tissue damage, often in individuals who are bedridden or immobile.
B. Gastric ulcers are peptic ulcers that develop in the lining of the stomach. While gastric ulcers can cause upper abdominal pain, they typically occur shortly after eating or during meals, rather than 3 hours after eating or at night.
C. Esophageal ulcers are peptic ulcers that develop in the lining of the esophagus. They are relatively rare compared to gastric and duodenal ulcers. Esophageal ulcers can cause symptoms such as chest pain, difficulty swallowing, and heartburn, but they are not typically associated with the timing of symptoms described by the client.

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Which patient does the LPN/LVN identify at high risk for hospital-acquired pneumonia?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

After change of shift, the nurse has the following patients on her assignment. Which one should she see first?

Correct Answer is C

Explanation

Your client has told you that they have been experiencing intermittent upper abdominal pain about 3 hours after eating and at times will even be awaken in the middle of the night by this pain. You suspect that your client may have which type of peptic ulcer?

Correct Answer is D

Explanation

The nurse is teaching a patient recently diagnosed with type 1 diabetes mellitus (DM) about the disease. What information should the nurse include?

The nurse enters a room of a patient who is acutely short of breath. Which action should the nurse take first?

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

A nurse is preparing to administer liquid famotidine 20 mg PO every 6 hr for GERD. Available is famotidine 40 mg/5 mL. How many mL should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

Gas exchange occurs in which of the following structures?

Which breakfast menu is most appropriate for a patient with diabetes?

Management of asthma involves avoidance of triggers. Which environmental triggers will the nurse suggest the patient eliminate? Select all that apply. (Select All that Apply.)

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?