Inflammation

Which statement is most important for the nurse to include in the teaching of a male patient undergoing treatment for invasive amebiasis?

The patient has a peripherally inserted central catheter (PICC) for the long-term administration of parenteral nutrition, oxacillin, and gentamicin. Which assessment findings, if present in the patient, indicate the patient is experiencing a complication of the PICC line? Select all that apply.

The patient with severe abdominal pain and distention, elevated white blood cell count, fever, and disorientation is diagnosed with toxic megacolon due to Clostridium difficile infection. Which order for this patient does the nurse question?

The 10-year-old patient presents to the emergency room following a fever as high as 105°F for 5 days. The patient’s mother reports the child has had red, watery eyes, poor appetite, and has felt ill during this time. The child was brought to the emergency room upon the appearance of a red rash that started on the child’s face and spread to the neck and chest. Which question will be most helpful in order to determine the cause of this patient’s symptoms?

The unvaccinated child presents to the emergency department with a fever lasting 6 days, malaise, and a new, diffuse, maculopapular rash that started on the face and has spread to the chest and arms. Prior to entering the room to assess the patient, the nurse dons which personal protective equipment (PPE)? Select all that apply.

The school nurse who works in an area with poor vaccination compliance learns a child has developed measles after being in class for the past week. Twenty other children in the class have not received the measles vaccine. The nurse anticipates how many of these children will contract measles?

The 4-year-old child is admitted with measles. Which medication does the nurse prepare to administer initially?

The patient was intubated in the field following a severe motor vehicle accident and is being managed in the intensive care unit. One day after the accident, increased oxygen requirement and diminished lung sounds are noted, and a radiograph is obtained. The chest x-ray reveals consolidation in bilateral lower lobes. The nurse anticipates which diagnosis for this patient?

The family practice nurse is reviewing telephone messages from patients. Which call is to be returned first?

The nurse is caring for the 3.7 kg neonate who was born at 38 weeks gestation after an uncomplicated pregnancy and delivery in the newborn nursery. Which immunization does the nurse administer to the patient prior to discharge from the hospital?

A patient has a white blood cell (WBC) count of 17,000 cells per ml. What is the possible etiology? Select all that apply.

The nurse applies a transparent dressing to which type of wound?

The nurse is assessing the elderly patient in the long-term care facility. Which findings suggest urinary catheter-associated urinary tract infection (CAUTI)? Select all that apply.

The nurse is caring for the woman in labor whose body temperature is 102.8°F and heart rate is 114 bpm. Which order does the nurse carry out first?

The day after administering a blood product to the anemic patient, the nurse learns it was contaminated with a fungal pathogen due to improper processing. The nurse is vigilant for which symptom(s)?

The healthcare team is answering questions for a 24-year-old black woman scheduled for a thyroidectomy. She states her mother had the same procedure and has a huge scar that is bigger than the original incision. The nurse understands the mother experienced which type of wound derangement?

The 7-day-old neonate born at 32-weeks’ gestation has an axillary temperature of 38.9°C. The nurse notes the infant is lethargic, with pale extremities and flash central capillary refill. Which nursing action is appropriate?

The nurse reviewing the vaccination record of a 12-month-old infant expects the infant to have completed which vaccine series?

The 34-week-gestation neonate is born weighing 1.7 kg to a mother who is hepatitis B surface antigen (HBsAg) positive; all other infectious disease serologies are negative. Which orders are appropriate for this patient? Select all that apply.

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 patient presents to the emergency department (ED) stating, “I started getting this terrible pressure in my chest after mowing the lawn. I just know I’m having a heart attack.” Following testing, the patient is diagnosed with angina pectoris. The patient asks, “If I didn’t have a heart attack, why did I have such bad chest pain?” Which response is appropriate?

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 medication is a member of the biologic pharmacologic class?

The 35-year-old woman is interested in starting hormonal birth control. Which characteristic, if found in the patient's medical record, indicates the patient requires an alternative form of contraceptive?

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 patient with a lung mass that was discovered on imaging is scheduled for a flexible bronchoscopy. Which nursing action is appropriate to prepare the patient for the procedure?

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?

The patient with a severe peanut allergy was inadvertently exposed to peanuts at work. Dyspnea persists despite the patient using the epinephrine autoinjector and emergency medical services was contacted. Which concentration of epinephrine does the first responder prepare for intramuscular injection?

The nurse assesses the cuff pressure of the patient's tracheostomy. Which cuff pressure prompts the nurse to document the finding and proceed with the assessment?

Which symptoms, if present in the patient receiving a blood transfusion, indicate the patient is experiencing an acute hemolytic transfusion reaction? Select all that apply.

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

The nurse planning care for the neonate with myelomeningocele plans interventions to ensure the child does not develop an allergy to which substance?

The nurse is supervising the student nurse preparing for the return of a neonate from surgery to repair a myelomeningocele. Which item, if brought into the room by the student nurse, does the nurse remove immediately?

The nurse is providing discharge teaching to the patient admitted with anaphylaxis after blowing up a rubber balloon. Which foods, if selected by the patient as safe to eat, indicate a need for further teaching? Select all that apply.

The nurse is counseling the parents of an 8-month-old child born with myelomeningocele on appropriate baby foods to introduce to the child. Which foods, if selected by the parents, indicate teaching was effective? Select all that apply.

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 patient admitted with asthma is receiving beclomethasone HFA PRN and nebulized albuterol PRN. Which patient assessment is most appropriate to report to the respiratory therapist assigned to care for the patient?

The nurse notes a sinusoidal pattern on the fetal heart rate tracing of a patient who is 32-weeks pregnant. Which information is most important for the nurse to determine?

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

The nonverbal patient is improving in the intensive care unit following a motor vehicle accident; as such, the continuous hydromorphone infusion is being weaned according to a schedule. The nurse provides education to the patient’s guardian about which signs and symptoms that the pain medicine is being weaned too quickly? Select all that apply.

The 14-year-old patient was admitted following surgical reduction of an open femur fracture. The patient, who has reported good pain control with the patient-controlled analgesia (PCA) pump, is sleeping peacefully. During hourly rounding, the nurse observes the parent press the button to administer the bolus of pain medication. Which action by the nurse is appropriate?

The patient is receiving alefacept. Which finding indicates the patient is having the desired response to therapy?

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