A nurse is assessing a client with a temperature of 38.5°C (101.3°F) and a white blood cell count of 15,000/mm³. Which condition is the client most likely experiencing?
Bacterial infection.
Viral infection.
Fungal infection.
Parasitic infection.
The Correct Answer is A
Choice A rationale
Bacterial infection often leads to an elevated white blood cell count (15,000/mm³) and fever (38.5°C). The body’s immune response to bacterial pathogens results in these clinical manifestations.
Choice B rationale
Viral infections can cause fever, but they typically do not lead to a significant increase in white blood cell count.
Choice C rationale
Fungal infections can cause fever and elevated white blood cell count, but they are less common and usually occur in immunocompromised individuals.
Choice D rationale
Parasitic infections can cause fever and elevated white blood cell count, but they are less common and usually present with other specific symptoms.
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Correct Answer is B
Explanation
Choice A rationale
Decreased breath sounds in the lower lobes can indicate areas of the lung that are not ventilating well, but this finding alone does not specifically indicate an exacerbation of COPD. It could be due to other conditions such as pleural effusion or atelectasis.
Choice B rationale
Increased respiratory rate and use of accessory muscles are signs of respiratory distress and indicate that the patient is working harder to breathe. These findings are consistent with an exacerbation of COPD, where the airways are more obstructed, and the patient has difficulty maintaining adequate ventilation.
Choice C rationale
Elevated blood pressure and heart rate can occur in many conditions and are not specific indicators of a COPD exacerbation. These vital sign changes can be due to pain, anxiety, or other stressors.
Choice D rationale
Presence of wheezing and cyanosis are also indicators of a COPD exacerbation. Wheezing indicates airway obstruction, and cyanosis indicates hypoxemia, both of which are common during an exacerbation.
Correct Answer is C
Explanation
Choice A rationale
Wearing an N95 mask is appropriate for airborne precautions, such as tuberculosis, but not specifically for MRSA, which requires contact precautions.
Choice B rationale
Wearing a facemask is suitable for droplet precautions, such as influenza, but MRSA is primarily spread through direct contact, not droplets.
Choice C rationale
Using a separate disposable blood pressure cuff for patients with draining wounds helps prevent the spread of MRSA. MRSA can be transmitted via contaminated medical equipment.
Choice D rationale
Strict hand washing measures are essential but should be performed more frequently than once every 8-hour shift. Hand hygiene should be practiced before and after patient contact.