NR511 Nursing Diagnosis Midterm Exam With Answers (401 Solved Questions)

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1QbankquestionsRespiratoryAnadulthasupperrespiratorysymptomsandcoughforthepast14days.Whatshouldbeconsidered?(Pertussis)Pertussis should always be considered in adults who present with acute cough of greater than 5 days’duration.Theincubationperiodforpertussisisabout7-10days.PatientspresentwithURIsymptomsfor1-2weeks.Theclassicparoxysmalcoughusuallybeginsinthesecondweekoftheillness.Thedurationofsymptoms and cough are about 3 months even when treated with antibiotics. This is highly infectiousandisareportable disease.Mycoplasmapneumoniaeis:(adiseasewithextrapulmonarymanifestations)Mycoplasma is an atypical pathogen and produces atypical pneumonia. It can be difficult to diagnosebecause symptoms can be varied and involve multiple body systems (extrapulmonary manifestations).Infection with Mycoplasma may present with a normal white blood cell count, maculopapular rash, GIsymptoms, tender joints and aches, and, though rare, cardiac rhythm disturbances. Respiratorysymptoms may not be pronounced. On chest X-ray there are some unique findings (peribronchialpattern)withMycoplasma.Theseincludethickenedbronchialshadow,streaksofinterstitialinfiltration,andatelectasis.These aremorelikely tooccurin thelowerlobes.Whichmedicationbelowiscontraindicatedinanasthmapatientbecauseitmayincreaseriskofsuddendeathifusedalone?(Long-acting bronchodilator)Along-actingbronchodilatorcanbeusedtotreatasthmawhenitisusedincombinationwithaninhaledsteroid. Otherwise, using a long-acting bronchodilator like salmeterol is contraindicated. There is anincreased risk of sudden death with asthma exacerbations when this class is used solo to treat asthma.Theotherchoicescanbeusedtotreatasthma.Choicesvarydependingonthepatient.A75-year-oldfemalewithemphysemawhohasbeentreatedwithinhaledsteroidsformanyyearsshould:(shouldbescreenedforosteoporosis)Olderfemalesareathigherriskthanothersforosteoporosis.Thisfemalepatient,whohasusedinhaledsteroids and smokes, has multiple risk factors for osteoporosis. Additionally, she probably hasemphysema because she smoked (or still smokes). If she is Asian or Caucasian, she has still another riskfactor. Screening for osteoporosis should be consideredwhen managing patients with multiple riskfactors.A patient received the pneumonia immunization at age 60 years. He is 65 years old and presents toyourclinictoday.Whatrecommendationshouldbemadeaboutthepneumococcalimmunization?(Heshouldreceiveanotherone today)Thispatientshouldreceiveanotheronetodaybecauseheis65yearsoldandatleast5yearshaselapsedsince his last one. The CDC does not recommend immunizing this patient every 5 years. Twoimmunizations are available, PCV13 and PPSV23. He needs both, but PCV13 should be administeredtoday.PPSV23shouldbeadministeredatleast1yearlater.

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