Botulism – Reportable/notification, S*s, Tx, How Is It Acquired Ch 8 ATI 2. Anthrax – Reportable/notifications, S*s, Tx, How Is It Acquired Ch 8 ATI 3. Heroic/h

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Sample questions from Botulism – Reportable/notification, S*s, Tx, How Is It Acquired Ch 8 ATI 2. Anthrax – Reportable/notifications, S*s, Tx, How Is It Acquired Ch 8 ATI 3. Heroic/h

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

1. 1.During emergency department triage of a 46-year-old client, the nurse identifies progressive weakness. Refer to the client's chart. Which action has the highest priority?

   • A.Complete the food exposure interview.
   • B.Administer the prescribed oral antibiotic.
   • C.Obtain a stool specimen before calling the provider.
   • D.Prepare for emergency airway management.

   Rationale: Progressive bulbar weakness, a respiratory rate decreasing to 10/min, and a forced vital capacity of 14 mL/kg indicate impending respiratory failure requiring immediate airway support. Stool collection and a food exposure interview are important but must not delay stabilization. Oral medication is unsafe with dysphagia, and antibiotics do not treat foodborne botulism.

2. 2.In a rural emergency department, two clients, ages 38 and 61, develop diplopia and dysphagia after sharing home-canned vegetables. Both are afebrile and alert. Which actions should the charge nurse initiate? Select all that apply.

   • A.Arrange airborne isolation for both clients.
   • B.Notify the local or state health department immediately.
   • C.Identify other people who ate the implicated food.
   • D.Wait for toxin confirmation before requesting antitoxin.
   • E.Coordinate collection of specimens without delaying treatment.

   Rationale: A suspected botulism cluster warrants immediate public health notification, specimen coordination, and identification of other exposed people. Waiting for toxin confirmation can delay antitoxin, which prevents additional toxin-mediated injury but does not reverse established paralysis. Airborne isolation is unnecessary because botulism is not spread through respiratory transmission.

3. 3.At change of shift on a medical unit, four clients need follow-up. Which client should the RN assess first?

   • A.A 22-year-old receiving anthrax exposure prophylaxis who reports mild nausea
   • B.A 70-year-old awaiting discharge who asks about reporting requirements
   • C.A 58-year-old recovering from botulism who reports new difficulty clearing secretions
   • D.A 35-year-old with cutaneous anthrax who has an unchanged painless eschar

   Rationale: New difficulty clearing secretions in botulism can indicate worsening bulbar or respiratory weakness and threatens airway protection. An unchanged anthrax eschar and mild medication-related nausea require follow-up but are not the immediate priority. Discharge questions can wait until the client with a potential airway emergency is assessed.

4. 4.On a rehabilitation unit, a 63-year-old client recovering from botulism is stable on prescribed tube feedings and needs assistance with daily care. Which task may the RN delegate to experienced assistive personnel?

   • A.Assist with repositioning according to the established care plan.
   • B.Evaluate the client's response to a reduced ventilator setting.
   • C.Determine whether the client can safely resume oral fluids.
   • D.Teach the spouse how to recognize aspiration.

   Answer and rationale are in the full material.

5. 5.The provider prescribes botulism antitoxin for a 52-year-old client with descending paralysis after eating improperly preserved fish. The client asks why treatment is needed before the laboratory confirms the diagnosis. Which response is best?

   • A.The medication kills bacteria growing in your bloodstream.
   • B.The medication neutralizes circulating toxin, so earlier treatment can limit progression.
   • C.The medication rapidly repairs the nerves that are already paralyzed.
   • D.The medication provides lifelong immunity against future botulism.

   Answer and rationale are in the full material.