MS LEC | P2W3 | CHECK FOR

UNDERSTANDING 8/30/22
Total points50/50
 
SESSIONS 20-24
The respondent's email (anpa.florentino.coc@phinmaed.com) was recorded on submission of
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0 of 0 points
LAST NAME, FIRST NAME M.I.*
Florentino Angelyn P

CLINICAL INSTRUCTOR*
April Den Canonigo

SECTION*
C-03

SESSION 20
10 of 10 points
MULTIPLE CHOICE

 
An elderly client with pneumonia may appear with which of the following symptoms
first?*
1/1
Altered mental status and dehydration
 
Fever and chills
Hemoptysis and dyspnea
Pleuritic chest pain and cough

 
Which of the following pathophysiological mechanisms that occurs in the lung
parenchyma allows pneumonia to develop?*
1/1
Atelectasis
Bronchiectasis
Effusion
Inflammation
 
 
After a patient with right lower-lobe pneumonia has been treated with intravenous (IV)
antibiotics for 2 days, which assessment data obtained by the nurse indicates that the
treatment has been effective?*
1/1
Bronchial breath sounds are heard at the right base.
The patient coughs up small amounts of green mucus.
The patient's white blood cell (WBC) count is 9000/μl.
 
Increased tactile fremitus is palpable over the right chest.

 
Which of the following organisms most commonly causes community-acquired
pneumonia in adults?*
1/1
Hemophilus influenzae
Klebsiella pneumoniae
Streptococcus pneumoniae
 
Staphylococcus aureus

 
Clients with chronic illnesses are more likely to get pneumonia when which of the
following situations is present?*
1/1
Dehydration
Group living
 
Malnutrition
Severe periodontal disease

 
A patient with bacterial pneumonia has rhonchi and thick sputum. Which action will the
nurse use to promote airway clearance?*
1/1
Assist the patient to splint the chest when coughing.
 
Educate the patient about the need for fluid restrictions.
Encourage the patient to wear the nasal oxygen cannula.
Instruct the patient on the pursed lip breathing technique.

 
Which statement by a patient who has been hospitalized for pneumonia indicates a
good understanding of the discharge instructions given by the nurse?*
1/1
"I will call the doctor if I still feel tired after a week."
"I will need to use home oxygen therapy for 3 months."
"I will continue to do the deep breathing and coughing exercises at home."
 
"I will schedule two appointments for the pneumonia and influenza vaccines."

 
Which nursing action will be most effective in preventing aspiration pneumonia in
patients who are at risk?*
1/1
Turn and reposition immobile patients at least every 2 hours.
Place patients with altered consciousness in side-lying positions.
 
Monitor for respiratory symptoms in patients who are immunosuppressed.
Provide for continuous subglottic aspiration in patients receiving enteral feedings.

 
During assessment of the chest in a patient with pneumococcal pneumonia, the nurse
would expect to find*
1/1
vesicular breath sounds.
increased tactile fremitus.
 
dry, nonproductive cough.
hyperresonance to percussion.

 
Following assessment of a patient with pneumonia, the nurse identifies a nursing
diagnosis of ineffective airway clearance. Which information best supports this
diagnosis?*
1/1
Weak, nonproductive cough effort
 
Large amounts of greenish sputum
Respiratory rate of 28 breaths/minute
Resting pulse oximetry (SpO2) of 85%

SESSION 21
10 of 10 points
MULTIPLE CHOICE

 
The nurse recognizes that the goals of teaching regarding the transmission of
pulmonary tuberculosis (TB) have been met when the patient with TB
*
1/1
demonstrates correct use of a nebulizer.
washes dishes and personal items after use.
covers the mouth and nose when coughing.
 
reports daily to the public health department.

 
A staff nurse has a tuberculosis (TB) skin test of 16-mm induration. A chest radiograph
is negative, and the nurse has no symptoms of TB. The occupational health nurse will
plan on teaching the staff nurse about the
*
1/1
use and side effects of isoniazid (INH).
 
standard four-drug therapy for TB.
need for annual repeat TB skin testing.
bacilli Calmette-Guérin (BCG) vaccine.

 
When teaching the patient who is receiving standard multidrug therapy for tuberculosis
(TB) about possible toxic effects f the antitubercular medications, the nurse will give
instructions to notify the health care provider if the patient develops?
*
1/1
yellow-tinged skin.
 
changes in hearing.
orange-colored sputum.
thickening of the fingernails.

 
An alcoholic and homeless patient is diagnosed with active tuberculosis (TB). Which
intervention by the nurse will be most effective in ensuring adherence with the treatment
regimen?
*
1/1
Educating the patient about the long-term impact of TB on health
Giving the patient written instructions about how to take the medications
Teaching the patient about the high risk for infecting others unless treatment is followed
Arranging for a daily noontime meal at a community center and giving the medication then
 
 
After 2 months of tuberculosis (TB) treatment with a standard four-drug regimen, a
patient continues to have positive sputum smears for acid-fast bacilli (AFB). Which
action should the nurse take next?
*
1/1
Ask the patient whether medications have been taken as directed.
 
Discuss the need to use some different medications to treat the TB.
Schedule the patient for directly observed therapy three times weekly.
Educate about using a 2-drug regimen for the last 4 months of treatment.

 
The health care provider writes an order for bacteriologic testing for a patient who has a
positive tuberculosis skin test. Which action will the nurse take?
*
1/1
Repeat the tuberculin skin testing.
Teach about the reason for the blood tests.
Obtain consecutive sputum specimens from the patient for 3 days.
 
Instruct the patient to expectorate three specimens as soon as possible.

 
Which information will the nurse include in the patient teaching plan for a patient who is
receiving rifampin (Rifadin) for treatment of tuberculosis?
*
1/1
"Your urine, sweat, and tears will be orange colored."
 
"Read a newspaper daily to check for changes in vision."
"Take vitamin B6 daily to prevent peripheral nerve damage."
"Call the health care provider if you notice any hearing loss."

 
Characteristics of the Mycobacterium tuberculosis include all of the following except:
*
1/1
It can be transmitted only by droplet nuclei.
It is acid-fast.
It is able to lie dormant within the body for years.
It survives in anaerobic conditions.
 
 
Which information about a patient who has a recent history of tuberculosis (TB)
indicates that the nurse can discontinue airborne isolation precautions?
*
1/1
Chest x-ray shows no upper lobe infiltrates.
TB medications have been taken for 6 months.
Mantoux testing shows an induration of 10 mm.
Three sputum smears for acid-fast bacilli are negative.
 
 
When caring for a patient who is hospitalized with active tuberculosis (TB), the nurse
observes a family member who is visiting the patient. The nurse will need to intervene if
the family member
*
1/1
washes the hands before entering the patient's room.
hands the patient a tissue from the box at the bedside.
puts on a surgical face mask before visiting the patient.
 
brings food from a "fast-food" restaurant to the patient.

SESSION 22
10 of 10 points
MULTIPLE CHOICE

 
How can the morphology of filoviruses be described?
*
1/1
Very large ball like structure
Long filamentous threads
 
Icosahedral virion
Floppy membranes without defined morphology

 
A client who has recently travelled to Hong Kong comes to the emergency department
(ED) with increasing shortness of breath and is strongly suspected of having a SARS.
Which of these prescribed actions will you take first?
*
1/1
Place the client on contact and airborne precautions
 
Obtain blood, urine, and sputum for cultures
Administer methylprednisolone (Solu-Medrol) 1 gram/IV
Infuse normal saline at 100ml/hr

 
Lassa and Ebola are emergent viruses in W. Africa. What is their origin?
*
1/1
Humans
Primates
Fruit bats
 
Pigs

 
In which order will the nurse perform the following actions as she prepares to leave the
room of a client with airborne precautions after performing oral suctioning? 1. Take off
goggles 2. Take off gown 3. Remove gloves 4. Remove N95 respirator 5. Perform hand
hygiene
*
1/1
1, 2, 3, 4, 5
2, 1, 4, 3, 5
 
3, 4, 1, 2, 5
4, 3, 2, 1, 5

 
The nurse assessed the client and noted shortness of breath and recent trip to China.
The client is strongly suspected of having Middle East Respiratory Syndrome (MERS-
CoV). Which of these prescribed actions will the nurse take first?
*
1/1
Place the client on airborne and contact precautions
 
Introduce normal saline at 75 mL/hr
Give methylprednisolone (SOLU-Medrol) 1 g intravenously (IV)
Take blood, urine, sputum cultures

 
A 10-year-old client contracted SARS when traveling abroad with her parents. The
nurse knows she must put on personal protective equipment to protect herself while
providing care. Based on the mode of SARS transmission, which personal protective
should the nurse wear?
*
1/1
Gloves
Gown and gloves
Gown, gloves, and mask
Gown, gloves, mask, and eye goggles or eye shield
 
 
How can the spread of filoviruses be restricted?
*
1/1
New antivirals
New humanized monoclonal antibodies
Hygiene and social distancing
 
New vaccine

 
The school nurse is asked which action will take to have the most impact on the
incidence of infectious diseases in school. The correct response is:
*
1/1
Grant written information about infection control to all parents
Ensure that students are immunized according to national guidelines
 
Make soap and water easily accessible in the classrooms
Educate students on how to cover their mouths when coughing

 
The school nurse is asked which action will take to have the most impact on the
incidence of infectious diseases in school. The correct response is:
*
1/1
Grant written information about infection control to all parents
Ensure that students are immunized according to national guidelines
 
Make soap and water easily accessible in the classrooms
Educate students on how to cover their mouths when coughing

 
What is the biggest risk factor for infection with Ebola?
*
1/1
Working in a category IV laboratory
Attending a funeral of a victim outside
Nursing a patient at home
 
Attending football matches or large gatherings

SESSION 23
10 of 10 points
MULTIPLE CHOICE

 
A client is suspected of having hepatitis. Which diagnostic test result will assist in
confirming this diagnosis ?
*
1/1
Elevated hemoglobin level
Elevated serum bilirubin level
 
Elevated blood urea nitrogen level
Decreased erythrocyte sedimentation rate

 
Which priority teaching information should the nurse discuss with the client to help
prevent contracting hep. B?
*
1/1
Explain the importance of good hand washing.
 
Tell the client to take the hepatitis B vaccine in three (3) doses.
Tell the client not to ingest unsanitary food or water.
Discuss how to implement standard precautions.

 
A client with acute hepatitis is prescribed lactulose. The nurse knows this medication
will:
*
1/1
Prevent the absorption of ammonia from the bowel.
 
Prevent hypoglycemia.
Remove bilirubin from the blood.
Mobilize iron stores from the liver

 
Which type of hepatitis is transmitted by the fecal-oral route via contaminated food,
water, or direct contact with an infected person?
*
1/1
Hepatitis A
 
Hepatitis B
Hepatitis C
Hepatitis D

 
Which laboratory value increases would the nurse expect to find in a client as a result of
hepatitis? Select that all apply.
*
1/1
SGPT(ALT) and SGOT(AST)
 
Alkaline Phosphatase
 
bilirubin, ESR
 
Leukocytes, Lymphocytes, Neutrophils

 
A patient with hepatitis B is being discharged in 2 days. In the discharge teaching plan
the nurse should include instructions to:
*
1/1
Avoid alcohol for the first 3 weeks
Use a condom during sexual intercourse
 
Have family members get an injection of immunoglobin
Follow a low-protein, moderate-carbohydrate, moderate-fat diet

 
The nurse questions a client with hepatitis B. how long ago could the client have been
exposed to hepatitis B?
*
1/1
3-7 days
7-14 days
40-50 days
60-160 days
 
 
The nurse is performing an assessment on a client being evaluated for viral hepatitis.
Which symptom will the nurse most likely assess on this client?
*
1/1
Arthralgia
 
Excitability
Headache
Polyphagia
 
An adult client complains for frequent episodes of constipation. What is an effective
strategy for preventing constipation?
*
1/1
Reducing fluid intake to encourage bulk formation in the intestinal lumen
Use laxative daily to establish a regular elimination pattern.
A regimen of exercise directed at toning the abdominal muscles.
 
Setting a routine for bowel elimination just before bedtime

 
To prevent the spread of hepatitis A virus (HAV) infection the nurse is especially careful
when:
*
1/1
Disposing of food trays
Emptying bed pans
 
Taking an oral temperature
Changing IV

SESSION 24
10 of 10 points
MULTIPLE CHOICE

 
A nurse is caring for a client diagnosed with a chlamydia infection. The nurse teaches
the client about disease transmission and advises the client to inform his sexual
partners of the infection. The client refuses, stating, "This is my business and I'm not
telling anyone. Besides, chlamydia doesn't cause any harm like the other STDs." How
should the nurse proceed?
*
1/1
Do nothing because the client's sexual habits place him at risk for contracting other STDs.
Educate the client about why it's important to inform sexual contacts so they can receive
treatment.
 
Inform the health department that this client contracted an STD.
Inform the client's sexual contacts of their possible exposure to chlamydia.
 
A patient comes to the clinic and requests testing for HIV infection. Before administering
testing, what is most important for the nurse to do?
*
1/1
Ask the patient to identify all sexual partners
 
Determine when the patient thinks exposure to HIV occurred
Explain that all test results must be repeated at least twice to be valid
Discuss prevention practices to prevent transmission of the HIV to others

 
A 16-year-old patient comes to the free clinic and is diagnosed with primary syphilis.
The patient states that she contracted this disease by holding hands with someone who
has syphilis. What is the most appropriate nursing diagnosis for this patient?
*
1/1
Alteration in comfort related to impaired skin integrity
Fear related to complications
Noncompliance with treatment regimen related to age
Knowledge deficit related to modes of transmission
 
 
Katrina Sterrett, a 26-year-old preschool teacher, is being seen by a physician who is
part of the internist group where you practice nursing. She is undergoing her annual
physical and is having many lab tests done as a condition of her employment and
upcoming wedding. She is returning for her results and is devastated to learn that she
has the sexually transmitted infection, gonorrhea. What would contribute to her
ignorance of her condition?
*
1/1
Being asymptomatic
 
All options are correct
Being sexually inactive
Knowing the signs and symptoms of STIs

 
What is one of the most significant factors in determining when to start antiretroviral
therapy in a patient with HIV infection?
*
1/1
Whether the patient has high levels of HIV antibodies
Confirmation that the patient has contracted HIV infection
The patient’s readiness to commit to a complex, lifelong, uncomfortable drug regimen
 
Whether the patient has a support system to help manage the costs and side effects of the
drugs

 
The “rapid” HIV antibody testing is performed on a patient at high risk for HIV infection.
What should the nurse explain about this test?
*
1/1
The test measures the activity of the HIV and reports viral loads as real numbers.
This test is highly reliable, and in 5 minutes the patient will know if HIV infection is present.
If the results are positive, another blood test and a return appointment for results will be
necessary.
 
This test detects drug-resistant viral mutations that are present in viral genes to evaluate
resistance to antiretroviral drugs.

 
Treatment with two nucleoside reverse transcriptase inhibitors (NRTIs) and a protease
inhibitor (PI) is prescribed for a patient with HIV infection who has a CD4+ T-cell count
of <400/μL. The patient asks why so many drugs are necessary for treatment. What
should the nurse explain as the primary rationale for combination therapy?
*
1/1
Cross-resistance between specific antiretroviral drugs is reduced when drugs are given in
combination.
Combinations of antiretroviral drugs decrease the potential for development of antiretroviral-
resistant HIV
 
Side effects of the drugs are reduced when smaller doses of three different drugs are used
rather than large doses of one drug.
When CD4+ T-cell counts are <500/μL, a combination of drugs that have different actions is
more effective in slowing HIV growth.

 
A nurse is teaching a client with genital herpes. Education for this client should include
an explanation of:
*
1/1
why the disease is transmittable only when visible lesions are present.
the need for the use of petroleum products.
the option of disregarding safer-sex practices now that he's already infected.
the importance of informing his partners of the disease.
 
 
Which opportunistic disease associated with AIDS is characterized by hyperpigmented
lesions of skin, lungs, and gastrointestinal (GI) tract?
*
1/1
Kaposi sarcoma
 
Herpes simplex type 1 infection
Candida albicans
Varicella-zoster virus infection

 
Within the free clinic where you practice nursing, you hold weekly sexual education
classes open to the public. Within the classroom, you communicate the CDC's numbers
for the incidence of STIs and their impact upon public health. Which is the fastest-
spreading bacterial STI in the United States?
*
1/1
Gonorrhea
Chlamydia
 
Herpes simplex 1
HPV
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