A client has been diagnosed with tuberculosis (TB). What action by the nurse takes highest priority?
Educating the client on adherence to the treatment regimen.
Encouraging the client to eat a well-balanced diet.
Informing the client about follow-up sputum cultures.
Teaching the client ways to balance rest with activity.
The Correct Answer is A
Choice A rationale
Adherence to the prescribed treatment regimen is paramount for successful tuberculosis (TB) therapy due to the long duration of treatment and the risk of developing drug-resistant strains if medication is taken inconsistently. Scientific principles dictate that maintaining therapeutic drug levels continuously is essential to effectively kill Mycobacterium tuberculosis and prevent the emergence of mutations that confer resistance, ensuring complete eradication of the infection and preventing relapse.
Choice B rationale
While a well-balanced diet supports overall health and immune function, it is secondary to medication adherence in the acute management of tuberculosis. Nutritional support can aid recovery by replenishing energy stores and supporting the immune system, which is crucial for combating chronic infection. However, without consistent pharmacological intervention, dietary factors alone cannot eradicate the Mycobacterium tuberculosis bacilli or prevent disease progression.
Choice C rationale
Follow-up sputum cultures are vital for monitoring treatment effectiveness and confirming cure, but educating on adherence takes precedence. Sputum cultures are a diagnostic tool to assess bacterial load and viability, providing objective evidence of treatment success or failure. They guide decisions regarding treatment duration and drug susceptibility, but their value is contingent upon the client consistently taking their medication to achieve bacterial clearance in the first place.
Choice D rationale
Balancing rest with activity is important for managing fatigue and promoting recovery, but it is less critical than adherence to the medication regimen. Rest allows the body to conserve energy and focus resources on healing, reducing metabolic demands on the already stressed physiological systems during an active infection. Activity, when tolerated, can prevent deconditioning. However, neither directly targets the elimination of the causative organism like antimicrobial therapy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Long-acting beta agonists (LABAs) are not rescue medications and should not be carried for immediate use during an asthma attack. Their onset of action is too slow to provide rapid relief, and their use for acute symptoms could mask worsening asthma, delaying appropriate treatment with a short-acting beta agonist.
Choice B rationale
LABAs are designed for maintenance therapy to prevent asthma symptoms over an extended period. Taking them only when an asthma attack begins is an inappropriate use, as they are not meant for acute symptom relief and will not provide immediate bronchodilation required during an exacerbation.
Choice C rationale
LABAs are prescribed as a daily maintenance medication to provide sustained bronchodilation and help prevent acute asthma attacks. Consistent daily use, typically in the morning, helps to control airway inflammation and reactivity, reducing the frequency and severity of future exacerbations by maintaining open airways.
Choice D rationale
Weaning off LABA medication should only be done under the direct supervision of a healthcare provider. Abrupt discontinuation can lead to a rebound in asthma symptoms. The decision to discontinue or adjust medication is based on a comprehensive assessment of asthma control and lung function, not just symptom absence.
Correct Answer is ["A","B","C","D"]
Explanation
Choice A rationale
Stuffed toys can accumulate dust mites, which are common allergens for individuals with asthma. Exposure to these allergens can trigger bronchospasm, inflammation of the airways, and exacerbate asthma symptoms, leading to respiratory distress. Therefore, minimizing exposure by discouraging stuffed toys helps prevent asthma attacks.
Choice B rationale
Pet ownership, particularly of animals with fur or dander, can introduce significant allergens into the home environment. Proteins in pet dander, saliva, and urine can trigger allergic reactions and asthma symptoms in sensitized individuals. Avoiding pet ownership is a key strategy for reducing allergen exposure and managing asthma effectively.
Choice C rationale
Gymnastics, a high-intensity physical activity, can often induce exercise-induced bronchoconstriction in individuals with asthma. The rapid breathing during strenuous exercise can lead to airway cooling and drying, triggering narrowing of the airways and symptoms such as coughing, wheezing, and shortness of breath.
Choice D rationale
Basketball is an activity characterized by intermittent high-intensity exertion, which can readily trigger exercise-induced bronchoconstriction in asthmatic individuals. The sudden bursts of activity and rapid breathing patterns contribute to airway cooling and drying, leading to an increased risk of acute asthma symptoms during or after play.
Choice E rationale
Cotton blankets are generally considered hypoallergenic and are less likely to harbor dust mites compared to synthetic materials or wool. Cotton is breathable and can be washed frequently at high temperatures, which helps to eliminate allergens. Therefore, discouraging cotton blankets would be counterproductive to asthma management.
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