A nurse is caring for a client who is suspected to have active laryngeal tuberculosis (TB). Which of the following actions should the nurse plan to take to safely care for this client?

Have staff and visitors wear gowns while in the client’s room.

Place the client in a private room with a special ventilation system.

Move the client to a semi-private room with a client who requires droplet precautions.

Remove personal protective equipment in the hallway outside of the client’s room.

Answer and Explanation

The Correct Answer is B

Choice A reason: While gowns may be part of the precautions, they are not sufficient alone for preventing the spread of TB, which is transmitted via airborne particles.

Choice B reason: Placing the client in a private room with a special ventilation system is crucial for preventing the spread of TB. The special ventilation system, typically a negative pressure room, ensures that airborne particles do not escape into other areas, thereby protecting staff and other patients.

Choice C reason: A semi-private room with another patient requiring droplet precautions is inappropriate for a TB patient, as TB requires strict airborne precautions to prevent transmission.

Choice D reason: Removing personal protective equipment in the hallway increases the risk of contaminating the hallway and spreading TB. PPE should be removed inside the room or anteroom to contain potential contaminants.

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Correct Answer is C

Explanation

Choice A reason: Lactulose is a laxative used to treat constipation and hepatic encephalopathy by reducing blood ammonia levels, but it is not effective in lowering serum potassium levels. Therefore, it would not be the appropriate medication for treating hyperkalemia.

Choice B reason: Triamterene is a potassium-sparing diuretic, which means it helps the body retain potassium. Administering Triamterene in a client with high potassium levels (hyperkalemia) would exacerbate the condition rather than improve it. Hence, it is not a suitable choice for this scenario.

Choice C reason: Sodium polystyrene sulfonate (Kayexalate) is used to treat hyperkalemia by binding to potassium in the intestines and facilitating its removal from the body through feces. It effectively reduces serum potassium levels, making it the appropriate medication for a client with hyperkalemia.

Choice D reason: Acetylcysteine is used primarily as a mucolytic agent to break down mucus in the airways or as an antidote for acetaminophen (paracetamol) overdose. It does not have any effect on serum potassium levels and is not suitable for treating hyperkalemia.

A. "Next time you think he needs more medication, call me and I'll push the button." B. "It's a good idea to help make sure your husband can sleep comfortably." C. "Why do you think your husband needs more medication when he is asleep?" D. "Your husband should decide when more medication is needed."

Correct Answer is D

Explanation

Choice A reason: Telling the partner to call the nurse to push the button is not appropriate. PCA is designed to allow the client to self-administer pain medication based on their own perception of pain. Only the client should press the button to avoid the risk of over-sedation and respiratory depression.

Choice B reason: Encouraging the partner to press the button while the client is asleep can lead to over-medication and serious complications such as respiratory depression.

Choice C reason: Asking the partner why they think more medication is needed when the client is asleep does not address the underlying issue of inappropriate use of the PCA pump.

Choice D reason: The correct answer is d because the client should be the one to decide when more medication is needed. This ensures that the client receives the appropriate amount of pain relief based on their individual needs and prevents the risk of over-sedation.

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A nurse is caring for a client who is suspected to have active laryngeal tuberculosis (TB). Which of the following actions should the nurse plan to take to safely care for this client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is D

Explanation

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