Gram Negative Bacteria Questions

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Sample questions from Gram Negative Bacteria Questions

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.A 72-year-old client in the emergency department has a suspected Escherichia coli urinary infection. The client is confused, temperature is 39.2 C (102.6 F), heart rate is 128/min, blood pressure is 82/46 mm Hg, and lactate is 4.1 mmol/L. Which action should the nurse take first?

   • A.Obtain ordered blood cultures and promptly begin the prescribed broad-spectrum IV antibiotics
   • B.Give the prescribed oral antipyretic and reassess the temperature in 1 hour
   • C.Wait for the urine culture result before administering antibiotics
   • D.Encourage oral fluids and assist the client to the bathroom

   Rationale: The client has signs of septic shock, so cultures should be obtained promptly if this does not delay treatment, followed by rapid prescribed IV antibiotics and resuscitation. An oral antipyretic or oral fluids do not address shock, and waiting for culture results delays lifesaving treatment. The exam takeaway is to recognize sepsis and prioritize timely antimicrobials and hemodynamic support.

2. 2.A 19-year-old college student in the emergency department has fever, severe headache, neck stiffness, and a nonblanching rash; blood pressure is 104/66 mm Hg. Meningococcal meningitis is suspected. Which action is the priority?

   • A.Initiate droplet precautions and notify the team to begin urgent evaluation and treatment
   • B.Place the client in a negative-pressure room for airborne isolation
   • C.Wait to institute isolation until cerebrospinal fluid culture confirms the organism
   • D.Allow visitors to remain at the bedside if they wear gloves

   Rationale: Suspected meningococcal disease requires immediate droplet precautions and urgent treatment because transmission and deterioration can occur quickly. Airborne isolation is not the standard precaution, and waiting for cultures exposes others and delays care. Gloves alone do not prevent respiratory droplet transmission; the exam takeaway is to isolate on clinical suspicion.

3. 3.A 21-year-old client with suspected meningococcal meningitis is admitted to a medical unit. The client has received the first dose of effective antibiotics. When may droplet precautions generally be discontinued?

   • A.After at least 24 hours of effective antimicrobial therapy
   • B.As soon as the fever falls below 38 C (100.4 F)
   • C.After the first dose of antibiotic is completed
   • D.Only after the client has a negative blood culture

   Rationale: Droplet precautions for meningococcal disease are generally continued until the client has received at least 24 hours of effective antimicrobial therapy. Fever resolution and completion of one dose do not reliably establish reduced transmissibility, while a negative blood culture is not required to end isolation. The exam takeaway is to follow organism-specific isolation duration rather than symptoms alone.

4. 4.A 68-year-old client in the ICU has a Pseudomonas aeruginosa bloodstream infection. The client is receiving IV cefepime, and the laboratory reports that the organism is susceptible. Which finding requires the nurse to act immediately?

   • A.New confusion and a blood pressure decrease from 118/70 to 86/48 mm Hg
   • B.A temperature decrease from 39.0 C (102.2 F) to 38.1 C (100.6 F)
   • C.A request for a meal after being NPO for 6 hours
   • D.A peripheral IV site without redness or tenderness

   Answer and rationale are in the full material.

5. 5.A 54-year-old client with cystic fibrosis is admitted with a Pseudomonas aeruginosa pulmonary exacerbation. The client has thick green sputum and an oxygen saturation of 91% on room air. Which nursing action best limits transmission?

   • A.Use the facility's recommended precautions for the organism and dedicate or disinfect shared equipment
   • B.Place the client in airborne isolation because all respiratory bacteria are airborne
   • C.Use the same stethoscope for all clients if it is wiped at the end of the shift
   • D.Keep the client in a shared room because Pseudomonas spreads only by ingestion

   Answer and rationale are in the full material.