A client has been taking isoniazid (INH) for TB for 3 weeks. What laboratory result needs to be reported to the HCP immediately?

Elevated WBC

Elevated RBC

Elevated liver function tests

Elevated albumin

Answer and Explanation

The Correct Answer is C

A. Elevated WBC: An elevated white blood cell count may indicate infection or inflammation but is not a common adverse effect directly linked to isoniazid. It should be evaluated, but it does not require the same urgent response as signs of hepatotoxicity.

B. Elevated RBC: An increase in red blood cell count is uncommon and not associated with isoniazid toxicity. It may reflect other physiological processes but is not a priority concern in the context of TB treatment with INH.

C. Elevated liver function tests: Isoniazid can cause hepatotoxicity, especially in older adults or when combined with other hepatotoxic drugs. Elevated liver enzymes (e.g., ALT, AST) indicate liver stress or injury and must be reported immediately to prevent progression to severe liver damage.

D. Elevated albumin: Elevated albumin levels are generally not clinically significant and rarely occur in acute illness. They do not indicate liver dysfunction and are not relevant to monitoring for isoniazid-related toxicity.

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Correct Answer is A

Explanation

A. Drive to breathe may be dependent on low levels of oxygen in the blood: Clients with emphysema may have chronically elevated CO₂ levels, which can blunt their central chemoreceptor response. As a result, their respiratory drive may rely more on peripheral chemoreceptors sensing low oxygen levels.

B. Respiratory rate may be increased a great part of the time: While some clients with emphysema may exhibit tachypnea during exertion or exacerbations, this is not a consistent or defining characteristic across all situations.

C. Lung stretch receptors may fail to monitor the patterns of breathing: Lung stretch receptors play a role in the Hering-Breuer reflex, but there is no evidence that they fail to function in emphysema. The issue in emphysema is gas trapping and reduced surface area for gas exchange, not receptor failure.

D. Intercostal muscles contract during inspiration, but fail to relax during expiration: The intercostal muscles assist with ventilation, particularly during increased respiratory effort. However, their relaxation in expiration is typically passive and not impaired in emphysema.

A. Start the client on a broad-spectrum antibiotic. B. Encourage the client to rinse their mouth after administering fluticasone. C. Document the finding as a known side effect. D. Obtain an oral specimen for culture & sensitivity.

Correct Answer is B

Explanation

A. Start the client on a broad-spectrum antibiotic:Oral lesions from fluticasone are often fungal (e.g., oral candidiasis), not bacterial. Starting antibiotics without identifying the causative agent can worsen fungal infections and is not a first-line or appropriate action.

B. Encourage the client to rinse their mouth after administering fluticasone:Fluticasone, an inhaled corticosteroid, can cause oral thrush if residue remains in the mouth. Rinsing the mouth after each use helps remove residual medication and prevent fungal overgrowth.

C. Document the finding as a known side effect:While oral lesions are a known side effect, documentation alone does not address the issue or help prevent recurrence. Intervention to reduce further irritation or infection is necessary along with documentation.

D. Obtain an oral specimen for culture & sensitivity:A culture may be indicated if the lesions are persistent, worsening, or unresponsive to initial interventions. For early or mild lesions suggestive of candidiasis, encouraging mouth rinsing is the more immediate step.

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A client has been taking isoniazid (INH) for TB for 3 weeks. What laboratory result needs to be reported to the HCP immediately?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Explanation

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