A client admitted for pneumonia has been tachypneic for several days. When the nurse starts an IV to give fluids, the client asks about this action, saying "I have been drinking tons of water.
How am I dehydrated?" What response by the nurse is best?

Choice A rationale

Antitubercular medications are not typically taken for the rest of a client's life. The standard treatment duration for active pulmonary tuberculosis is a multi-drug regimen lasting typically 6 to 9 months. Prolonged unnecessary use can lead to increased side effects and antibiotic resistance without additional therapeutic benefit.

Choice B rationale

The Mantoux test, or tuberculin skin test, indicates exposure to Mycobacterium tuberculosis but does not confirm active disease or determine treatment effectiveness. A positive Mantoux test can persist for life even after successful treatment. Treatment efficacy is primarily monitored through symptom resolution and sputum smear/culture negativity.

Choice C rationale

A typical course of antitubercular treatment involves a multi-drug regimen administered consistently for 6 to 9 months. This prolonged duration is critical to eradicate the slow-growing Mycobacterium tuberculosis and prevent the development of drug resistance, ensuring complete cure and minimizing relapse. Inconsistent or premature cessation of therapy can lead to treatment failure and resistance.

Choice D rationale

Not all family members of a client with pulmonary tuberculosis will need to take medications. Prophylactic treatment (latent TB infection therapy) is typically recommended for close contacts, especially children and immunocompromised individuals, after they have been evaluated for latent TB infection (positive tuberculin skin test or interferon-gamma release assay) to prevent progression to active disease.

Choice A rationale

Black and tarry stools (melena) typically indicate upper gastrointestinal bleeding, where digested blood causes the dark color. This is not a characteristic of steatorrhea, which is caused by the presence of undigested fat. Steatorrhea results from pancreatic enzyme insufficiency, a common feature of cystic fibrosis.

Choice B rationale

Steatorrheaic stools are classically described as frothy, foul-smelling, and fatty due to the malabsorption of fats. The lack of pancreatic lipase, a characteristic of cystic fibrosis, prevents proper fat digestion. This undigested fat is then excreted, leading to stools that are bulky, pale, and often float due to their high fat content.

Choice C rationale

Clay-colored stools are indicative of a lack of bile pigment, suggesting an obstruction of the bile ducts or liver dysfunction. While liver involvement can occur in cystic fibrosis, clay-colored stools are not the primary descriptor for steatorrhea resulting from pancreatic insufficiency.

Choice D rationale

Orange or green stools are not typical descriptions for steatorrhea. Orange stools can sometimes be due to certain medications or foods, while green stools can result from rapid transit through the digestive system, where bile has not had time to be fully broken down. Neither describes the characteristic appearance of fatty stools.