Infection

The 18-year-old patient calls the clinic two weeks after receiving the 2nd vaccination in the three-dose series for human papillomavirus (HPV). She states, “I didn’t realize it when I got the vaccine, but I was 6 weeks pregnant. Will my baby be okay?” Which response by the nurse is most appropriate?

The nurse is providing discharge education to the patient regarding immunizations following a hematopoietic stem cell transplant. When does the nurse instruct the patient to visit the clinic for the Haemophilus influenzae type b (Hib) vaccine?

The public health nurse encourages which individuals to receive the hepatitis A vaccine? Select all that apply.

The 18-year-old healthy female presents to the clinic requesting to receive the vaccinations her mother refused for her when she was a child. Reviewing the chart, the nurse notes the patient never received the measles, mumps, rubella (MMR) vaccine. Prior to administering the vaccination, which test is most important?

The patient presents to the emergency room (ER) after having a fever for three days and new onset severe chest pain behind the sternum. The patient asks, “What is wrong with me? Do I have pneumonia? It hurts when I breathe.” Upon assessment, the nurse notes a heart rate of 124 bpm, temperature of 37.9°C, and an intermittent friction rub upon auscultation. The lungs are clear. The nurse suspects further testing will lead to a diagnosis of which condition?

The nurse assists with a pericardiocentesis to drain a pericardial effusion and notes serosanguinous fluid. The nurse suspects which condition?

The patient presents to the emergency department (ED) with nausea, vomiting, fever, severe knee and wrist pain, nosebleed, and lymphadenopathy. A new murmur is noted, as well. The nurse asks the patient about a recent history of which infection?

Which neurologic alteration is associated with acute rheumatic fever?

Which comorbidities increase the risk for refeeding syndrome in the chronically ill patient who is started on total parenteral nutrition (TPN)? Select all that apply.

The nurse notices that the patient’s peripheral IV insertion site is red and indurated. What action does the nurse perform first?

A man who has remediated water-damaged basements for over thirty years presents to an acute care clinic for ongoing breathing problems. He has never smoked, has never been exposed to asbestos, and is afebrile. The nurse knows the man is most likely suffering from what condition?

Which is the most common symptom of the child with bronchiectasis?

The registered nurse is caring for a 48-year-old patient with a surgical wound infected with methicillin-resistant Staphylococcus aureus (MRSA) requiring q6h intravenous antibiotic infusions and dressing changes twice per shift. The patient with which diagnosis is most appropriate to be added to this nurse’s assignment?

The charge nurse is planning room assignments during an outbreak of Shiga toxin-producing Escherichia coli (STEC). Due to the influx of patients, only one private room is available. Which patient with STEC must be placed in this private room?

The nurse is preparing to perform open tracheostomy suctioning for a patient with methicillin-sensitive Staphylococcus aureus (MSSA) tracheitis. Which personal protective equipment does the nurse utilize for this procedure? Select all that apply.

The patient with gastroenteritis is hospitalized for dehydration and stool culture reveals infection with Listeria monocytogenes. Which personal protective equipment does the nurse don prior to entering the room?

The patient presents to the emergency room complaining of fever, malaise, and nuchal rigidity. Which personal protective equipment does the nurse don prior to assessing the patient? Select all that apply.

The nurse learns in shift report the 1-year-old with respiratory distress due to parainfluenza virus has had increased nasal and oral secretions and has had increased coughing fits. Which personal protective equipment does the nurse don prior to caring for the patient? Select all that apply.

The neonate is diagnosed with congenital parvovirus. The nurse requests an order for which transmission prevention precaution?

The 6-month-old patient is admitted to the pediatric intensive care unit for treatment of a pertussis infection. The donning of which personal protective equipment by the unlicensed assistive personnel (UAP) entering this patient’s room would prompt the nurse to intervene and provide additional education?

The nurse observes the physician enter the room of a patient with pneumococcal pneumonia without donning personal protective equipment. Which response by the nurse is appropriate?

The nurse is assisting the provider in lancing the abscess of a patient whose medical history is notable for anaphylaxis after ingestion of oysters. The nurse enters the room as the provider begins swabbing the affected skin with povidone-iodine solution. Which response by the nurse is appropriate?

The nurse receives report from the operating room regarding a postoperative craniotomy patient and recognizes the patient is at risk for which complications? Select all that apply.

The nurse anticipates administering which medications to the patient with meningitis? Select all that apply.

The nurse is caring for a patient on the night shift in respiratory distress due to influenza. Over the last few hours, the patient has become increasingly confused, perfusion has decreased, and urine output has fallen to zero. The nurse contacts the resident physician to come assess the patient and requests an order for transfer to the intensive care unit. The physician orders the nurse to administer 1L 0.9% NaCl via IV infusion. One hour after the infusion is complete, the patient has made no improvement. What is the nurse’s next action?

The nurse is planning care for the patient receiving adalimumab. Which nursing intervention does the nurse utilize to prevent complications of the medication?

The nurse advocates for the use of secukinumab in which patient?

Which symptom can occur following vertical transmission of Neisseria gonorrhoeae?

The asymptomatic patient tested positive for Neisseria gonorrhoeae during routine screening for sexually transmitted infections (STI). The nurse anticipates administering which medications? Select all that apply.

The patient has had a positive rapid plasma reagin (RPR) test. Further testing will most likely reveal the presence of which organism?

The female patient tells the nurse, “I think the man I had unprotected sex with last night might have herpes. I’m so afraid I’m going to get it, too.” Which response by the nurse is most appropriate?

Which mother is at highest risk for passing herpes simplex virus (HSV) to her fetus/neonate?

The patient presents to the clinic complaining of a painful sore on his penis. Upon assessment, the nurse notes an ulceration with a yellow slough wound base that is soft with an irregular border. The inguinal lymph node on the ipsilateral side of the wound is enlarged and firm. The nurse suspects which organism is the cause of the wound?

The full-term neonate (3.2 kg) born precipitously to a mother of unknown infectious disease status has had a positive rapid plasma reagin (RPR) test. The nurse plans care to perform which intervention first?

The patient is admitted to the hospital with systemic syphilis infection. The patient is ordered to receive a 14-day course of penicillin G 20 million units/day intravenously. Prior to administering the medication, the nurse checks the patient’s allergies and learns the patient experienced anaphylaxis after receiving ampicillin. Which action does the nurse take?

Which cell is responsible for cleaning wounds of microorganisms?

The nurse changes the dressing of the patient with a sacral pressure injury. Upon removal of the dressing, the nurse notes yellow drainage on the dressing with a fruity odor. Place the nurse’s actions in the correct order from first to last.

During routine tracheostomy care, the nurse notes increased drainage from the stoma and a fruity, grape juice odor. The nurse obtains a culture of the secretions and anticipates the results will reveal which organism?

During routine tracheostomy cleaning and care, the nurse notes a strong smell of dirty gym socks coming from the dressing around the stoma. Which action by the nurse is most appropriate?

The unconscious patient presents with the following respiratory pattern: The nurse anticipates further testing will reveal which condition?

Which patients are at risk for restrictive pulmonary disease? Select all that apply.

The patient returns from Mexico with severe diarrhea lasting 4 days. The nurse anticipates the serum electrolyte levels to reflect which imbalances? Select all that apply.

The nurse is caring for a patient diagnosed with measles. Which precautions does the nurse utilize during the patient’s care? Select all that apply.

The patient presents with a blood pressure of 135/95 mm Hg and appears jaundiced. She has a history of alcoholism, cirrhosis, and untreated hepatitis C. While the oncoming nurse is receiving report, the patient begins vomiting a large amount of blood. The nurse knows which to be the most likely cause of the patient’s hematemesis?

Which parasite is the causative agent of malaria?

The patient calls the nurse to the room to report pain at the site of an IV. The nurse notes warmth, redness, and purulent drainage. Which action does the nurse take first?

Two days after an abdominal surgery, the patient develops abdominal distention, tachycardia, fever, and nausea. The provider suspects sepsis. Which order does the nurse implement first?

Following colon resection, the nurse is vigilant for which early symptoms of septic shock? Select all that apply.

On the complete blood cell count with differential, the nurse notes the patient has an elevated number of eosinophils. The nurse explains to the patient that eosinophils become elevated due to which causes? Select all that apply.

Which statement is true regarding the neonate's immune system?