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 A
Explanation
Choice A rationale
Cromolyn is a mast cell stabilizer that works by inhibiting the release of inflammatory mediators (e.g., histamine, leukotrienes) from mast cells. Its mechanism of action is prophylactic, meaning it prevents the cellular cascade leading to bronchospasm when administered before exposure to a trigger, such as exercise. It has no bronchodilatory effect.
Choice B rationale
Administering cromolyn at the initial onset of an attack is ineffective because it does not have acute bronchodilatory properties. Once the inflammatory cascade is initiated and bronchoconstriction has begun, cromolyn cannot reverse the symptoms. Rescue inhalers like albuterol are needed for acute symptom relief.
Choice C rationale
Cromolyn is a prophylactic medication and does not provide symptomatic relief during an acute asthma attack. Its role is to stabilize mast cells to prevent the release of inflammatory mediators that cause bronchoconstriction and inflammation. Therefore, it is not used to alleviate symptoms once an attack is in progress.
Choice D rationale
While cromolyn can be prescribed for regular daily use, the specific instruction for exercise-induced asthma is to take it before exercise. Taking it as often as 4 times a day without considering the timing relative to triggers may not be optimal for preventing exercise-induced symptoms, as its effect is primarily preventive.
Correct Answer is D
Explanation
Choice A rationale
Wrapping the infant too snugly, especially around the head, can lead to overheating, which is a known risk factor for SIDS. Overheating can interfere with an infant's ability to arouse from sleep, a protective mechanism against SIDS, and disrupt thermal regulation.
Choice B rationale
Positioning the infant prone (on their stomach) for sleep significantly increases the risk of SIDS. The prone position is associated with rebreathing of exhaled air, leading to carbon dioxide accumulation and oxygen depletion. It also increases the risk of airway obstruction and overheating, both contributing factors to SIDS.
Choice C rationale
Sitting an infant up in an infant seat for sleep is not recommended as a primary sleep position for preventing SIDS. While useful for transport, prolonged sleep in an infant seat can lead to airway compression, head entrapment, and an increased risk of positional asphyxiation, especially if the infant's head slumps forward.
Choice D rationale
Placing infants on their backs or sides for sleep significantly reduces the risk of SIDS. The supine (back) position prevents airway obstruction from rebreathing exhaled air and allows for optimal oxygenation. The side position, while acceptable, is less stable than the back position and is not as strongly recommended.
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