A nurse is caring for a client who comes to the clinic to be tested for tuberculosis (TB) after a close family contact tests positive. Which of the following measures should the nurse anticipate preparing for this client?

Bacille Calmette-Guérin (bCG) vaccine

Chest x-ray

Sputum culture for acid fast bacillus (AFB)

Tuberculin skin test

Answer and Explanation

The Correct Answer is D

A.   The BCG vaccine is a vaccine used to prevent tuberculosis (TB) disease. However, its effectiveness varies widely and is primarily used in countries with a high prevalence of TB. Therefore, administering the BCG vaccine is not typically part of the evaluation process for TB exposure in a client.
B.   A chest x-ray is commonly used to evaluate for active pulmonary TB disease. It can identify characteristic findings such as infiltrates, cavitations, or nodular lesions in the lungs that suggest TB infection. A chest x- ray is often performed as part of the initial evaluation for TB after exposure or to assess for active disease.
C.   Sputum culture for AFB is a definitive diagnostic test for tuberculosis. It involves collecting sputum samples and culturing them in a laboratory to detect the presence of Mycobacterium tuberculosis, the bacterium that causes TB.
D.   The tuberculin skin test (TST), also known as the Mantoux test, involves injecting a small amount of purified protein derivative (PPD) into the skin of the forearm. After 48-72 hours, a healthcare provider assesses the size of the induration (swelling) at the injection site. A positive TST indicates exposure to TB but does not differentiate between latent TB infection (LTBI) and active TB disease.

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Correct Answer is A

Explanation

A. Repositioning the client regularly is a critical measure to prevent pressure ulcers. This helps relieve pressure on vulnerable areas of the body and improves circulation. Turning the client every 2 hours is a common guideline to prevent prolonged pressure on any one area.
B. Keeping the head of the bed elevated continuously is not recommended as it can increase shear and friction, leading to skin breakdown.
C. Keeping the client's skin moisturized is important for maintaining skin integrity, but excessive moisture can increase the risk of skin breakdown, especially in areas susceptible to pressure ulcers. The nurse should aim to keep the skin clean, dry, and free from excessive moisture to prevent maceration.
D. Massaging bony prominences is not recommended as a preventive measure for pressure ulcers. In fact, massaging these areas can increase the risk of tissue damage due to friction and shearing forces. The focus should be on relieving pressure through proper positioning and support surfaces rather than massage.

A. "Eating yogurt can help decrease gas odor that I have." B. "Carbonated beverages can help control odor." C. "I should eliminate pasta from my diet so that I don't have as many loose stools." D. "My largest meal of the day should be in the evening."

Correct Answer is A

Explanation

A. This statement demonstrates an understanding that consuming yogurt can potentially help reduce the odor associated with gas. Yogurt contains probiotics, which can promote digestive health and possibly reduce the intensity of gas odors. This is a reasonable approach for managing symptoms related to colostomy.
B. Carbonated beverages are not typically recommended for controlling odor related to a colostomy. In fact, carbonated drinks can sometimes increase gas production and may exacerbate gas-related symptoms. Therefore, this statement does not indicate an appropriate understanding of dietary management for a colostomy.
C. Pasta and other starchy foods like rice and bread are generally well-tolerated and can help thicken stool consistency, which may be beneficial for individuals with a colostomy. Therefore, eliminating pasta from the diet is not necessary and does not reflect an accurate understanding of dietary recommendations post-colostomy.
D. Distributing meals evenly throughout the day is generally recommended to promote balanced nutrition and manage digestion. There is no specific requirement that the largest meal must be in the evening. This statement does not directly relate to dietary management specific to colostomy care.

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A nurse is caring for a client who comes to the clinic to be tested for tuberculosis (TB) after a close family contact tests positive. Which of the following measures should the nurse anticipate preparing for this client?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is A

Explanation

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