ANSWERS s
1. PRE
Thepatientexperiencingananaphylacticreactionmayexperiencewhichof the
s s s s s s s s s s
following signs and symptoms? (Select all that apply.)
s s s s s s s s
Pallor
Dyspnea
s
Laryngealedema Pruritus s s
Bronchospasm:Dyspnea s
Laryngeal edema
s s
Pruritus
Bronchospasm
s
Rationale:Mildsystemicreactionsconsistofperipheraltingling,warmth,asensation of s s s s s s s s s s
fullness in the mouth and throat, nasal congestion, periorbital swelling, pruritus,
s s s s s s s s s s s
sneezing,andtearingoftheeyes.Moderatesystemicreactionsmayincludeflushing and
s s s s s s s s s s s s s
anxietyinadditiontoanyofthemildersymptoms.Moreseriousreactionsinclude
s s s s s s s s s s s s s
bronchospasm,laryngealedema,severedyspnea,cyanosis,andhypotension.Dys-
s s s s s s s s s
phagia(difficultyswallowing),abdominalcramping,vomiting,diarrhea,andseizures can
s s s s s s s s s s
also occur.Cardiac arrest and coma may follow.
s s s s s s s s
2. PRE
When a patient presents to the emergency department with pneumonia, which
s s s s s s s s s s
signs and symptoms would the nurse expect the patient to exhibit? (Select all that
s s s s s s s s s s s s s s
apply.)
s
Nightsweats s
Fever
s
Dyspnea
s
Fatigue
s
Orthopnea:Fever s
Dyspnea
s
Fatigue
Orthopnea
s
1/ 7s s
, Rationale:Feveris present with the infection.Patients will exhibit dyspnea, preferring to be
s s s s s s s s s s s s
propped up or sitting up due to orthopnea (shortness of breath when reclining or supine).
s s s s s s s s s s s s s s s
The patient is fatigued from the work of breathing.
s s s s s s s s s
3. PRE
Whichofthefollowingrepresentinitialsignsandsymptomsofapatientin
s s s s s s s s s s s s
respiratory distress? (Select all that apply.)
s s s s s s
Tachypnea
2/ 7
s s