A physician is noting the recent vital signs for several clients on an acute medical ward of a hospital. Which hospital client with a noninfectious diagnosis would be most likely to have a fever?

Correct Answer: B

Rationale: In this scenario, option B, a 33-year-old female with a postoperative deep vein thrombosis and pulmonary embolism, is most likely to have a fever. Postoperative patients are at risk for fever due to the body's response to surgical trauma, anesthesia, and the healing process. Additionally, deep vein thrombosis and pulmonary embolism can trigger an inflammatory response, leading to fever as a symptom. Option A, the 71-year-old female with limited mobility, COPD, and vascular dementia, is less likely to have a fever related to her noninfectious diagnoses unless she develops a secondary infection like pneumonia. Option C, the 51-year-old obese male with hepatic encephalopathy secondary to alcohol abuse, is more likely to present with altered mental status and liver-related symptoms rather than fever. Option D, the 71-year-old male with congestive heart failure and peripheral edema, is less likely to have a fever unless there is an underlying infection or inflammatory condition. In an educational context, understanding the relationship between different medical conditions and fever is crucial for nurses and healthcare providers to assess and manage patients effectively. Recognizing the potential causes of fever in various clinical scenarios helps in providing appropriate care and interventions to address the underlying issues.

Correct Answer: C

Rationale: In the context of multiple sclerosis (MS), physical overexertion (Option C) is most likely to have contributed to the woman's relapse. MS is an autoimmune condition where the immune system attacks the protective covering of nerves, leading to communication issues between the brain and the rest of the body. Physical overexertion can exacerbate MS symptoms as it increases inflammation and can trigger immune responses, potentially leading to a relapse. Emotional stress (Option A) can also impact MS symptoms due to its effects on the immune system and overall health, but research suggests that physical overexertion has a more direct impact on disease activity in MS patients. Dietary indiscretion (Option B) may affect overall health but is less likely to directly trigger an MS relapse compared to physical overexertion. Adequate rest and relaxation (Option D) are essential for managing MS symptoms, but lack of physical activity alone is not a direct contributor to a relapse in MS. In an educational context, understanding the triggers for MS relapse is crucial for patients to manage their condition effectively. Educating patients about the impact of physical overexertion on their symptoms can help them make informed lifestyle choices to minimize the risk of relapses and maintain better overall health while living with MS.

Correct Answer: C

Rationale: In this case, the correct answer is C) Tuberculosis. Tuberculosis is a chronic bacterial infection caused by Mycobacterium tuberculosis that primarily affects the lungs. The symptoms presented by the patient such as fatigue, weight loss, night sweats, productive cough, and hemoptysis are classic manifestations of pulmonary tuberculosis. Option A) Lung cancer is less likely in this scenario as the symptoms are more indicative of an infectious process rather than a malignancy. Option B) Pneumonia could present with similar symptoms but the chronicity and hemoptysis are more characteristic of tuberculosis. Option D) Pulmonary embolism typically presents with sudden onset shortness of breath, chest pain, and can cause hemoptysis, but it is less likely in this case given the chronic nature of the symptoms. Understanding the clinical presentation of different pulmonary conditions is crucial for nurses to provide prompt and appropriate care. Recognizing the signs and symptoms of tuberculosis is essential for early detection and treatment to prevent further transmission and potential complications. Nurses play a vital role in identifying, educating, and supporting patients with tuberculosis, making this knowledge critical in clinical practice.

Correct Answer: C

Rationale: In the context of caring for a client with heart failure experiencing pulmonary edema, the prioritized intervention should be to administer oxygen therapy to improve oxygenation (Option C). This is the correct answer because in pulmonary edema, there is a buildup of fluid in the lungs leading to impaired oxygen exchange. Administering oxygen therapy helps to increase oxygen levels, improving tissue perfusion and respiratory function, which is crucial in this emergency situation. Option A, administering diuretics to reduce fluid overload, is important in managing heart failure, but in the acute setting of pulmonary edema, addressing oxygenation takes precedence over diuresis. Option B, positioning the client in high-Fowler's position, can help with respiratory mechanics but does not directly address the immediate need for improved oxygenation. Option D, restricting fluid intake, is not the priority when the client is in respiratory distress and needs immediate interventions to support oxygen exchange. In an educational context, understanding the rationale behind prioritizing interventions in acute situations like pulmonary edema is crucial for nurses to provide safe and effective care. It highlights the importance of critical thinking, quick decision-making, and prioritization based on the client's condition and needs. By prioritizing oxygen therapy in this scenario, the nurse can effectively address the client's immediate physiological needs and stabilize their condition before addressing other aspects of care.

Correct Answer: C

Rationale: Rationale: In responding to the patient's question about the cause of pernicious anemia, the nurse should explain that a decrease in intrinsic factor is the most likely cause. Intrinsic factor is a protein produced by the parietal cells of the stomach and is essential for the absorption of vitamin B12 in the small intestine. Without intrinsic factor, vitamin B12 cannot be absorbed, leading to a deficiency and subsequent development of anemia. Option A, Ferritin, is a protein that stores iron in the body and is not directly related to the cause of pernicious anemia. Option B, Gastric enzymes, play a role in digestion but do not specifically impact vitamin B12 absorption. Option D, Erythropoietin, is a hormone produced by the kidneys that stimulates red blood cell production and is not directly involved in the pathophysiology of pernicious anemia. Educationally, understanding the role of intrinsic factor in vitamin B12 absorption is crucial for healthcare professionals to recognize and manage pernicious anemia effectively. This knowledge helps in explaining the disease process to patients and highlights the importance of appropriate treatment strategies, such as vitamin B12 supplementation or intramuscular injections in cases of intrinsic factor deficiency.