Chapter 31: Care of Patients with Infectious Respiratory Problems Ignatavicius

Chapter 31: Care of Patients with Infectious Respiratory Problems Ignatavicius

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. A nurse working in a geriatric clinic sees clients with “cold” symptoms and rhinitis. Which drug would be appropriate to teach these clients to take for their symptoms?
   1. Chlorpheniramine (Chlor-Trimeton)
   2. Diphenhydramine (Benadryl)
   3. Fexofenadine (Allegra)
   4. Hydroxyzine (Vistaril)

ANS:   C

First-generation antihistamines are not appropriate for use in the older population. These drugs include chlorpheniramine, diphenhydramine, and hydroxyzine. Fexofenadine is a second-generation antihistamine.

DIF:     Remembering/Knowledge                 REF: 584                     KEY: Antihistamines| older adults| histamine blocker                                MSC: Integrated Process: Teaching/Learning                       NOT:                                                 Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

2. A nurse in a family practice clinic is preparing discharge instructions for a client reporting facial pain that is worse when bending over, tenderness across the cheeks, and postnasal discharge. What instruction will be most helpful?
   1. “Ice packs may help with the facial pain.”
   2. “Limit fluids to dry out your sinuses.”
   3. “Try warm, moist heat packs on your face.”
   4. “We will schedule you for a computed tomography scan this week.”

ANS:   C

This client has rhinosinusitis. Comfort measures for this condition include breathing in warm steam, hot packs, nasal saline irrigations, sleeping with the head elevated, increased fluids, and avoiding cigarette smoke. The client does not need a CT scan.

DIF:     Understanding/Comprehension         REF: 584                     KEY: Infectious respiratory problems| nonpharmacologic comfort interventions| patient education MSC: Integrated Process: Teaching/Learning      NOT:                         Client Needs Category: Physiological Integrity: Basic Care and Comfort

3. Which teaching point is most important for the client with bacterial pharyngitis?
   1. Gargle with warm salt water.
   2. Take all antibiotics as directed.
   3. Use a humidifier in the bedroom.
   4. Wash hands frequently.

ANS:   B

Any client on antibiotics must be instructed to complete the entire course of antibiotics. Not completing them can lead to complications or drug-resistant strains of bacteria. The other instructions are appropriate, just not the most important.

DIF:            Understanding/Comprehension         REF:    585                   KEY: Antibiotics| infectious respiratory problems| patient education                 MSC: Integrated Process: Teaching/Learning          NOT:          Client Needs Category: Physiological Integrity: Physiological Adaptation

4. A client is in the family practice clinic reporting a severe “cold” that started 4 days ago. On examination, the nurse notes the client also has a severe headache and muscle aches. What action by the nurse is best?
   1. Educate the client on oseltamivir (Tamiflu).
   2. Facilitate admission to the hospital.
   3. Instruct the client to have a flu vaccine.
   4. Teach the client to sneeze in the upper sleeve.

ANS:           D

Sneezing and coughing into one’s sleeve helps prevent the spread of upper respiratory infections. The client does have manifestations of the flu (influenza), but it is too late to start antiviral medications; to be effective, they must be started within 24 to 48 hours of symptom onset. The client does not need hospital admission. The client should be instructed to have a flu vaccination, but now that he or she has the flu, vaccination will have to wait until next year.

DIF:     Applying/Application             REF:    587       KEY: Influenza| antiviral| medications| patient education| infection control MSC:      Integrated Process: Teaching/Learning                       NOT: Client Needs Category: Health Promotion and Maintenance