Complex Care Final Exam Practice Questions
1. The nurse is caring for a patient with pneumonia unresponsive to two different
antibiotics.Which action is most important for the nurse to complete before
administering a newly prescribed antibiotic?
a. Teach the patient to cough and deep breathe.
b. Take the temperature, pulse, and respiratory rate.
c. Obtain a sputum specimen for culture and Gram stain.
d. Check the patient's oxygen saturation by pulse oximetryCorrect Answer(s) c. Obtain
a sputum specimen for culture and Gram stain.
A sputum specimen for culture and Gram stain to identify the organism should
be obtained before beginning antibiotic therapy. However, antibiotic administration should
not be delayed if a specimen cannot be readily obtained because delays in antibiotic
therapy can increase morbidity and mortality risks.
2. The nurse is teaching the patient with human immunodeficiency virus (HIV) about
the diagnosis of Candida albicans. What statement made by the patient indicates to
the nurse that further teaching is required?
a. "I will be given amphotericin B to treat the fungus."
b. "I got this fungus because I am immunocompromised."
c. "I need to be isolated from my family and friends so they won't get it."
d. "The effectiveness of my therapy can be monitored with fungal serology
titers."Correct Answer(s) c. "I need to be isolated from my family and friends so they
won't get it."
The patient with an opportunistic fungal infection does not need to be isolated be- cause it
is not transmitted from person to person. This immunocompromised patient will be likely to
,have a serious infection so it will be treated with IV amphotericin B. The effectiveness of
the therapy can be monitored with fungal serology titers.
3. A patient is diagnosed with a lung abscess. What should the nurse include when
teaching the patient about this diagnosis?
a. Lobectomy surgery is usually needed to drain the abscess.
b. IV antibiotic therapy will be used for a 6-month period of time.
c. Oral antibiotics will be used until there is evidence of improvement.
d. Culture and sensitivity tests are needed for 1 year after resolving the
abscessCorrect Answer(s) c. Oral antibiotics will be used until there is evidence of
improvement.
IV antibiotics are used until the patient and radiographs show evidence of improve- ment.
Then oral antibiotics are used for a prolonged period of time. Culture and sensitivity
testing is done during the course of antibiotic therapy to ensure that
the infecting organism is not becoming resistant to the antibiotic as well as at the
completion of the antibiotic therapy. Lobectomy surgery is only needed when
,reinfection of a large cavitary lesion occurs or to establish a diagnosis when there is
evidence of a neoplasm or other underlying problem.
4. The nurse is caring for a patient with an alteration in airway clearance. What
nursing actions would be a priority to promote airway clearance (select all that apply.)?
a. Maintain adequate fluid intake.
b. Maintain a 30-degree elevation.
c. Splint the chest when coughing.
d. Maintain a semi-Fowler's position.
e. Instruct patient to cough at end of exhalationCorrect Answer(s) a. Maintain
adequate fluid intake.
c. Splint the chest when coughing.
e. Instruct patient to cough at end of exhalation.
Maintaining adequate fluid intake liquefies secretions, allowing easier expectoration. The
nurse should instruct the patient to splint the chest while coughing. This will reduce
discomfort and allow for a more effective cough. Coughing at the end of exhalation
promotes a more effective cough. The patient should be positioned in an upright sitting
position (high Fowler's) with head slightly flexed.
5. The nurse evaluates that discharge teaching for a patient hospitalized with
pneumonia has been effective when the patient makes which statement about measures
to prevent a relapse?
a. "I will seek immediate medical treatment for any upper respiratory infec-
tions."
b. "I should continue to do deep breathing and coughing exercises for at least 12
weeks."
c. "I will increase my food intake to 2400 calories a day to keep my immune system
, well."
d. "I must have a follow-up chest x-ray in 6 to 8 weeks to evaluate the pneumonia's
resolution."Correct Answer(s) d. "I must have a follow-up chest x-ray in 6 to 8 weeks to
evaluate the pneumonia's resolution."
The follow-up chest x-ray examination will be done in 6 to 8 weeks to evaluate pneumonia
resolution. A patient should seek medical treatment for upper respiratory infections that
persist for more than 7 days. It may be important for the patient to continue with coughing
and deep breathing exercises for 6 to 8 weeks, not 12 weeks, until all of the infection has
cleared from the lungs. Increased fluid intake, not caloric intake, is required to liquefy
secretions.
1. The nurse is caring for a patient with pneumonia unresponsive to two different
antibiotics.Which action is most important for the nurse to complete before
administering a newly prescribed antibiotic?
a. Teach the patient to cough and deep breathe.
b. Take the temperature, pulse, and respiratory rate.
c. Obtain a sputum specimen for culture and Gram stain.
d. Check the patient's oxygen saturation by pulse oximetryCorrect Answer(s) c. Obtain
a sputum specimen for culture and Gram stain.
A sputum specimen for culture and Gram stain to identify the organism should
be obtained before beginning antibiotic therapy. However, antibiotic administration should
not be delayed if a specimen cannot be readily obtained because delays in antibiotic
therapy can increase morbidity and mortality risks.
2. The nurse is teaching the patient with human immunodeficiency virus (HIV) about
the diagnosis of Candida albicans. What statement made by the patient indicates to
the nurse that further teaching is required?
a. "I will be given amphotericin B to treat the fungus."
b. "I got this fungus because I am immunocompromised."
c. "I need to be isolated from my family and friends so they won't get it."
d. "The effectiveness of my therapy can be monitored with fungal serology
titers."Correct Answer(s) c. "I need to be isolated from my family and friends so they
won't get it."
The patient with an opportunistic fungal infection does not need to be isolated be- cause it
is not transmitted from person to person. This immunocompromised patient will be likely to
,have a serious infection so it will be treated with IV amphotericin B. The effectiveness of
the therapy can be monitored with fungal serology titers.
3. A patient is diagnosed with a lung abscess. What should the nurse include when
teaching the patient about this diagnosis?
a. Lobectomy surgery is usually needed to drain the abscess.
b. IV antibiotic therapy will be used for a 6-month period of time.
c. Oral antibiotics will be used until there is evidence of improvement.
d. Culture and sensitivity tests are needed for 1 year after resolving the
abscessCorrect Answer(s) c. Oral antibiotics will be used until there is evidence of
improvement.
IV antibiotics are used until the patient and radiographs show evidence of improve- ment.
Then oral antibiotics are used for a prolonged period of time. Culture and sensitivity
testing is done during the course of antibiotic therapy to ensure that
the infecting organism is not becoming resistant to the antibiotic as well as at the
completion of the antibiotic therapy. Lobectomy surgery is only needed when
,reinfection of a large cavitary lesion occurs or to establish a diagnosis when there is
evidence of a neoplasm or other underlying problem.
4. The nurse is caring for a patient with an alteration in airway clearance. What
nursing actions would be a priority to promote airway clearance (select all that apply.)?
a. Maintain adequate fluid intake.
b. Maintain a 30-degree elevation.
c. Splint the chest when coughing.
d. Maintain a semi-Fowler's position.
e. Instruct patient to cough at end of exhalationCorrect Answer(s) a. Maintain
adequate fluid intake.
c. Splint the chest when coughing.
e. Instruct patient to cough at end of exhalation.
Maintaining adequate fluid intake liquefies secretions, allowing easier expectoration. The
nurse should instruct the patient to splint the chest while coughing. This will reduce
discomfort and allow for a more effective cough. Coughing at the end of exhalation
promotes a more effective cough. The patient should be positioned in an upright sitting
position (high Fowler's) with head slightly flexed.
5. The nurse evaluates that discharge teaching for a patient hospitalized with
pneumonia has been effective when the patient makes which statement about measures
to prevent a relapse?
a. "I will seek immediate medical treatment for any upper respiratory infec-
tions."
b. "I should continue to do deep breathing and coughing exercises for at least 12
weeks."
c. "I will increase my food intake to 2400 calories a day to keep my immune system
, well."
d. "I must have a follow-up chest x-ray in 6 to 8 weeks to evaluate the pneumonia's
resolution."Correct Answer(s) d. "I must have a follow-up chest x-ray in 6 to 8 weeks to
evaluate the pneumonia's resolution."
The follow-up chest x-ray examination will be done in 6 to 8 weeks to evaluate pneumonia
resolution. A patient should seek medical treatment for upper respiratory infections that
persist for more than 7 days. It may be important for the patient to continue with coughing
and deep breathing exercises for 6 to 8 weeks, not 12 weeks, until all of the infection has
cleared from the lungs. Increased fluid intake, not caloric intake, is required to liquefy
secretions.
