A nurse is caring for a client who has a new diagnosis of tuberculosis (TB). The client asks the nurse why she needs to take four different antituberculotic medications. Which of the following replies should the nurse make?

"The organism that causes TB becomes resistant to antituberculotic medications when you only take one medication."

Taking several antituberculotic medications will protect your liver from toxic effects."

"People who have a severe form of TB need several antituberculotic medications, but those who have less severe TB need just one medication."

"Adverse effects occur more often and are more severe when you take only one antituberculotic medication."

Answer and Explanation

The Correct Answer is A

Choice A Reason:

"The organism that causes TB becomes resistant to antituberculotic medications when you only take one medication." This statement is appropriate.

Tuberculosis bacteria tend to develop resistance to single medications when used alone. Using multiple medications simultaneously helps prevent the bacteria from becoming resistant to any single drug. This strategy, known as combination therapy, is crucial in treating TB effectively and reducing the risk of drug resistance.

When TB bacteria are exposed to just one medication, they can mutate and become resistant to that specific drug. However, using a combination of medications helps ensure that if one medication fails to eliminate some bacteria due to resistance, the other drugs can still work against the resistant strains.

Preventing drug resistance is essential for successful TB treatment and to avoid the need for more complex and less effective medications if resistance develops.

Choice B Reason:

"Taking several antituberculotic medications will protect your liver from toxic effects." This statement is incorrect. While it's true that some antituberculotic medications can have hepatotoxic effects (adverse effects on the liver), the primary reason for using multiple medications in TB treatment isn't solely to protect the liver. The main goal of using multiple medications is to prevent the development of drug-resistant strains of TB bacteria. Protecting the liver is an important consideration in medication selection and monitoring but isn't the primary rationale for multiple medications.

Choice C Reason:

"People who have a severe form of TB need several antituberculotic medications, but those who have less severe TB need just one medication." This statement is incorrect. The severity of TB doesn't determine the number of medications required. The standard treatment approach for TB involves multiple medications, regardless of the severity. This approach aims to prevent the development of drug resistance, ensure effective treatment, and reduce the risk of treatment failure. Using a combination of medications is a fundamental strategy to combat TB effectively.

Choice D Reason:

"Adverse effects occur more often and are more severe when you take only one antituberculotic medication." This statement is incorrect. While it's true that adverse effects can occur with antituberculotic medications, the primary reason for using multiple medications isn't solely to reduce adverse effects. The main concern addressed by using multiple drugs is preventing the development of drug-resistant TB strains. Using a combination of medications reduces the likelihood of resistance developing and increases the effectiveness of treatment, rather than solely minimizing adverse effects.

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Correct Answer is A

Explanation

Choice A Reason:
Replace the unit when the drainage chamber is full is correct. Regularly emptying the drainage chamber when it becomes full is essential to ensure the drainage system functions properly and continues to effectively remove fluids or air from the chest cavity.

Choice B Reason:
Clamp the tube for 30 min every 8 hr. is incorrect.
Clamping a chest tube without a specific medical order or indication can lead to complications such as a buildup of pressure within the chest cavity or potential damage to the lungs. It's generally not a routine action to clamp the tube without proper instruction.

Choice C Reason:
Pin the tubing to the client's bed sheets is incorrect. Pinning the tubing to the bed sheets can cause tension on the chest tube, leading to accidental dislodgment or obstruction. The tubing should be secured but not pinned to prevent inadvertent movement.

Choice D Reason:
Monitor for at least 150 mL of drainage every hour is incorrect. There isn't a standard or prescribed amount of drainage that should occur hourly. The nurse should monitor the drainage rate and characteristics but shouldn't expect a specific volume within a set timeframe. Monitoring for excessive or decreased drainage and changes in characteristics is crucial, but an hourly volume expectation isn't appropriate.

A. Speech therapist B. Respiratory therapist C. Occupational therapist D. Physical therapist

Correct Answer is A

Explanation

Choice A Reason:
Speech therapists, also known as speech-language pathologists, specialize in evaluating and treating swallowing difficulties (dysphagia) among other speech and language issues. They are trained to assess and provide therapies to improve swallowing function, ensuring safe and effective swallowing to prevent aspiration and related complications.
Choice B Reason:
Respiratory therapists primarily focus on the respiratory system and breathing issues. While they play a crucial role in managing respiratory problems, their expertise generally centers around respiratory treatments, ventilator management, and pulmonary function testing. They might assist if dysphagia leads to aspiration and subsequent respiratory complications, but the primary management of dysphagia itself falls within the scope of a speech therapist.
Choice C Reason:
Occupational therapists assist individuals in regaining independence in daily activities. While they may help with certain aspects of dysphagia management, their primary focus isn't specifically on evaluating and treating swallowing disorders. They might address related issues, such as adapting eating utensils or positioning during meals to assist the client, but they may not have the specialized training needed for direct dysphagia therapy.
Choice D Reason:
Physical therapists primarily focus on improving mobility, strength, and physical function. While they might address certain issues related to oral motor function or posture during eating that could affect swallowing, their expertise lies more in physical rehabilitation rather than the specialized treatment of dysphagia.

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A nurse is caring for a client who has a new diagnosis of tuberculosis (TB). The client asks the nurse why she needs to take four different antituberculotic medications. Which of the following replies should the nurse make?

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