A nurse on a medical-surgical unit is caring for a newly admitted client with a diagnosis of R/O tuberculosis.

Which of the following findings should the nurse report to the provider?

Nurses' Notes

Day 1:

0900:

Client admitted from emergency department with hemoptysis, dull chest pain, increasing fatigue, anorexia, nausea, chest tightness, and 3.2 kg (7 Ib) weight loss in 2 weeks. Heart rate regular, lung sounds with crackles in bilateral upper lobes. No edema. Airborne precautions initiated upon admission.

Day 2:

Client reports shortness of breath, nausea, and fatigue. Crackles auscultated bilaterally throughout lung fields. Productive cough, with thick, blood-streaked sputum. Bowel sounds active, no edema.

Yellow sclera

Increasing AST level

Weight loss

Mantoux test result

Answer and Explanation

The Correct Answer is A

This is because tuberculosis can affect the liver and cause hepatotoxicity, especially if the client is taking anti-tuberculosis medications. The nurse should monitor the client's liver function tests, such as AST and ALT levels, and observe for signs of liver damage, such as yellow sclera, dark urine, clay-colored stools, and abdominal pain.

Nursing Test Bank

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Correct Answer is A

Explanation

Pyrazinamide is a medication used to treat tuberculosis that can cause renal damage and crystal formation in the urine if not adequately hydrated. The client should also avoid alcohol and have regular liver function tests while taking this medication. Isoniazid should not be taken with antacids, as they can decrease its absorption and effectiveness. Sputum cultures are expected to be negative after 2 months of therapy, not 6 months. Providing a sputum specimen every 2 weeks is not an instruction for the client, but a part of the monitoring process by the health care team.

A. Pain B. Pruritus C. Purplish in color D. Purulent drainage

Correct Answer is C

Explanation

Malignant melanoma is a rare but aggressive type of skin cancer that originates from melanocytes, the cells that produce pigment in the skin. It can appear as a new or changing mole that has an irregular shape, uneven color, large size, or bleeding tendency. It may also be purplish in color due to vascular invasion or hemorrhage within the lesion.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is teaching a client who has tuberculosis and is to start medication therapy with isoniazid, rifampin and pyrazinamide. Which of the following instructions should the nurse include?

Correct Answer is A

Explanation

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Correct Answer is C

Explanation

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