Progressive Care Nursing Certification (PCCN) Practice Exam

A cardiac patient with DNR status shows signs of pneumonia. What should the nurse most immediately anticipate?

1. Blood and sputum cultures followed by broad spectrum antibiotics

2. Mucolytics and judicious IV fluid administration

3. An antipyretic and conservative management

4. NPO status and encouragement of frequent activity

The correct answer is: Blood and sputum cultures followed by broad spectrum antibiotics

The most immediate action the nurse should anticipate in a cardiac patient with DNR status who shows signs of pneumonia is obtaining blood and sputum cultures followed by the initiation of broad-spectrum antibiotics. In cases of pneumonia, timely identification of the causative organism is critical to determine the appropriate treatment. Blood and sputum cultures are essential diagnostic tools that help identify whether the infection is bacterial and to determine the specific type of organism present. Administering broad-spectrum antibiotics promptly is crucial, especially in individuals with compromised health, such as those with existing cardiac conditions. This approach not only addresses the infection but also helps mitigate further complications that pneumonia could cause in a vulnerable patient. While other options may offer some supportive care, they do not address the immediate need for diagnosing and treating a potentially life-threatening condition like pneumonia. Mucolytics and judicious IV fluid management, for example, are supportive measures but would not replace the necessity for culture and antibiotics. Therefore, the focus should center on promptly identifying the infection and initiating effective treatment.