Which type of pneumonia is best characterized by an infective agent that produces sputum samples with a peptidoglycan cell wall, expresses endotoxins, replicates readily in broth and on agar, grows in clusters, has pili, and does not stain when exposed to crystal violet?
Selected Answer:
C.
Bacterial
Answers:
A.
Viral
B.
Chlamydial
C.
Bacterial
D.
Mycoplasmal
Response Feedback:
Rationale: Although chlamydiae, viruses, and mycoplasmas all can cause pneumonia, only bacteria have all of these characteristics. Chlamydiae and viruses are obligate intracellular organisms and therefore would grow only in cell culture, and mycoplasmas lack the peptidoglycan cell wall typical of bacteria.
Question 2
2 out of 2 points
The nurse knows which statement best describes a characteristic trait of Rickettsiae related to Rocky Mountain spotted fever? Rickettsiae:
Selected Answer:
D.
have both RNA and DNA.
Answers:
A.
are eukaryotic.
B.
are neither gram-negative nor gram-positive.
C.
have a distinct spiral-shaped morphology.
D.
have both RNA and DNA.
Response Feedback:
Rationale: Rickettsiae combine characteristics of bacteria and viruses. Rickettsiae are prokaryotic but not spiral shaped. Rickettsiae are able to be classified by Gram stain like other microorganisms.
Question 3
2 out of 2 points
A 72-year-old client being treated for rheumatoid arthritis is admitted with suspected ehrlichiosis. What should the nurse implement as a treatment priority?
Selected Answer:
C.
Administration of empirically chosen antibiotics
Answers:
A.
Isolation of the client using contact precautions
B.
Collection of appropriate blood and fluid cultures
C.
Administration of empirically chosen antibiotics
D.
Isotonic intravenous fluids at a minimum rate of 200 mL/hr
Response Feedback:
Rationale: Because the client is older and has rheumatoid arthritis, the nurse should expect a state of immunosuppression. This can be related to the chronic illness and age alone, but may be made worse if the client is on immunosuppressive therapy such as methotrexate or prednisone, which are typical treatments for the client with rheumatoid arthritis. This creates a high risk for the development of sepsis secondary to ehrlichiosis. Evidence validates the importance of empirical antibiotic treatment when the nurse suspects ehrlichiosis, because a fulminant and life-threatening infection is likely with immunocompromised clients. Only if the client’s blood pressure has dropped would intravenous therapy be indicated. Empirical treatment should not be delayed for specimen collection. Routine hospital blood cultures cannot detect Ehrlichia. Laboratory testing for the bacterium involves polymerase chain reaction (PCR) assay.
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