A client has tested positive for tuberculosis (TB). While providing client teaching, what information should a nurse prioritize?

The importance of adhering closely to the prescribed medication regimen.

The client must remain in respiratory isolation until medication treatment ends.

The fact that the disease is self-limiting, but can take up to two years to resolve.

The importance of participating in physical therapy to re-establish functional abilities.

Answer and Explanation

The Correct Answer is A

A. The importance of adhering closely to the prescribed medication regimen. Tuberculosis requires strict adherence to a long-term antibiotic regimen, typically lasting 6 to 9 months, to prevent drug resistance, treatment failure, and disease relapse. Noncompliance can lead to multidrug-resistant TB (MDR-TB), which is more difficult to treat. Directly observed therapy (DOT) is often recommended to ensure adherence.
B. The client must remain in respiratory isolation until medication treatment ends. While respiratory isolation is essential for active TB, it is not required until the full course of treatment is completed. Isolation is typically maintained until the client has received at least two weeks of effective therapy, symptoms improve, and three consecutive sputum smears are negative for acid-fast bacilli (AFB).
C. The fact that the disease is self-limiting, but can take up to two years to resolve. TB is not self-limiting; without proper treatment, it can persist indefinitely, worsen, and become fatal. Standard treatment with first-line drugs such as isoniazid, rifampin, ethambutol, and pyrazinamide effectively eradicates the infection within 6 to 9 months in most cases.
D. The importance of participating in physical therapy to re-establish functional abilities. While TB can cause fatigue and weakness, physical therapy is not a primary focus of treatment. The priority is to eradicate the infection through strict medication adherence, as untreated TB can progress to severe pulmonary damage, systemic involvement, and complications.

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Correct Answer is ["A","C","D"]

Explanation

A. Clubbing of the fingers: This finding is often associated with chronic respiratory conditions, including emphysema, due to prolonged hypoxia. The chronic low oxygen levels can lead to changes in the nail beds, resulting in clubbing as the body attempts to compensate for the decreased oxygenation. Therefore, clubbing is a common assessment finding in clients with emphysema.
B. Bradycardia: Emphysema typically does not cause bradycardia; instead, clients may experience tachycardia due to increased respiratory effort and oxygen demand. While individual variations can occur, bradycardia is not a standard finding in clients with emphysema, making this option less likely to be present.
C. Barrel chest: This is a common physical assessment finding in clients with emphysema. The chronic overinflation of the lungs leads to a characteristic increase in the anteroposterior diameter of the chest, resulting in a barrel-shaped appearance. This occurs as the diaphragm becomes flattened and the rib cage is expanded from prolonged air trapping.
D. Dyspnea: Shortness of breath, or dyspnea, is a hallmark symptom of emphysema. As the disease progresses, clients may experience increased difficulty in breathing, especially during exertion, due to the destruction of alveoli and reduced lung elasticity. This finding is expected and significant in the assessment of a client with emphysema.
E. Deep respirations: In emphysema, clients often exhibit shallow, rapid breathing patterns rather than deep respirations. The loss of elasticity in the lungs leads to difficulty in full lung expansion, which can result in a more shallow and increased respiratory rate. Therefore, deep respirations are not a typical finding in clients with emphysema.

A. Repositioning in bed. B. Use of the incentive spirometer. C. Application of antiembolism stockings. D. Chest tube and pleura-vac assessment.

Correct Answer is D

Explanation

A. Repositioning in bed: While repositioning the client is important for comfort and preventing complications such as pressure ulcers, it is not the top priority immediately after a pneumonectomy. Proper positioning can help improve respiratory function, but ensuring the stability and function of chest drainage systems takes precedence in the immediate postoperative period.
B. Use of the incentive spirometer: Encouraging the use of an incentive spirometer is crucial for promoting lung expansion and preventing atelectasis. However, it is essential first to ensure that the client’s chest tube is functioning properly and that there are no complications from the surgery. While this intervention is important, it follows the need to assess the chest tube.
C. Application of antiembolism stockings: While applying antiembolism stockings is a good practice to prevent venous thromboembolism, it is not the highest priority in the immediate postoperative period. Other assessments and interventions, such as monitoring respiratory status and chest tube function, are more critical in this early stage after surgery.
D. Chest tube and pleura-vac assessment: This is the priority nursing intervention in the immediate postoperative period. After a pneumonectomy, monitoring the chest tube's placement, drainage output, and function is vital for ensuring that the pleural space is adequately drained and that there are no complications such as pneumothorax or hemothorax. This assessment is crucial for maintaining respiratory function and overall stability in the postoperative client.

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A client has tested positive for tuberculosis (TB). While providing client teaching, what information should a nurse prioritize?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has emphysema. Which of the following findings should the nurse expect to assess in this client? (Select all that apply.)

Correct Answer is ["A","C","D"]

Explanation

A nurse is caring for a client diagnosed with lung carcinoma and scheduled for a left pneumonectomy. The nurse should prioritize which nursing Intervention in the immediate postoperative period?

Correct Answer is D

Explanation

A clinic nurse is preparing to teach student nurses about care of clients with viral pharyngitis. Which information should the nurse include in the teaching plan? Select all that apply.

A nurse is serving on a continuous quality improvement (CQI) committee that has been assigned to develop a program to reduce the number of medication administration errors following a sentinel event at the facility. Which of the following strategies should the committee plan to initiate first?

A nurse is caring for a client who has an acute respiratory failure (ARF). The nurse should monitor the client for which of the following manifestations of this condition? (Select all that apply.)

A nurse is caring for a client who asks how albuterol helps his breathing. Which of the following responses should the nurse make? (Select all that apply.)

A nurse is reviewing arterial blood gas results for a client diagnosed with chronic obstructive pulmonary disease (COPD). The nurse should expect which abnormal finding?

A nurse is caring for a client diagnosed with pneumonia and assesses labored breathing and copious tracheobronchial secretions. What priority action should the nurse encourage with the client?