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

Exhibits

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

Yellow sclera

Increasing AST level

Weight loss

Mantoux test result

Increasing ALT level

Reddishorange urine color

Answer and Explanation

Correct Answer : A,B,E

A. Yellow sclera: This may indicate hepatotoxicity, a serious adverse effect of isoniazid and rifampin. The provider should be notified immediately to assess liver function and adjust medications if necessary.
B. Increasing AST level: The AST increased from 35 to 36 units/L, which is within the normal range but may suggest early signs of liver dysfunction, especially in combination with other findings like jaundice.
C. Weight loss: While weight loss is a symptom of tuberculosis (TB), the client reported a 3.2 kg (7 lb) loss before admission. Since this is an expected finding with TB, it does not necessarily require immediate provider notification unless it continues despite treatment.
D. Mantoux test result: A 12 mm induration is considered positive in highrisk populations but does not confirm active TB. Given that the client already has a chest Xray showing caseation, a positive skin test is not the most critical finding to report.
E. Increasing ALT level: The ALT increased from 36 to 38 SI/L, which is a slight rise but, along with the AST increase and jaundice, suggests possible liver dysfunction due to TB medications.
F. Reddishorange urine color: This is a normal side effect of rifampin and does not indicate harm. It does not require provider notification.

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Correct Answer is D

Explanation

A. Analgesic. While aspirin has painrelieving (analgesic) properties, it is not prescribed at 325 mg for postMI clients primarily for pain relief. Instead, its role in preventing platelet aggregation is the key factor in reducing future cardiovascular events.
B. Antipyretic. Aspirin can reduce fever (antipyretic effect) by inhibiting prostaglandin synthesis in the hypothalamus. However, postMI clients are not prescribed aspirin for fever reduction but rather for its cardiovascular protective effects.
C. Antiinflammatory. Aspirin is a nonsteroidal antiinflammatory drug (NSAID) and can reduce inflammation. However, at low doses (81–325 mg), its primary function is not antiinflammatory but rather to reduce clot formation and prevent arterial blockage.
D. Antiplatelet aggregate. This is correct. Aspirin inhibits platelet aggregation by blocking cyclooxygenase1 (COX1), which prevents thromboxane A₂ production, thereby reducing the risk of clot formation. This action is critical for preventing recurrent myocardial infarction or stroke in highrisk clients.

A. Firstdegree heart block B. Atrial fibrillation C. Sinus bradycardia D. Supraventricular tachycardia

Correct Answer is B

Explanation

A. Firstdegree heart block is characterized by a prolonged PR interval (>0.20 seconds) while maintaining a regular rhythm. In this case, the PR interval is unmeasurable, and the rhythm is irregular, making firstdegree heart block unlikely.
B. Atrial fibrillation (AFib) is the most accurate interpretation. Key characteristics of AFib include:Irregular rhythm (hallmark finding), absent P waves (due to disorganized atrial electrical activity), unmeasurable PR interval and narrow QRS complex (typically <0.12 seconds). In AFib, the atria quiver instead of contracting effectively, leading to an irregularly irregular rhythm with no identifiable P waves.
C. Sinus bradycardia is characterized by a regular rhythm, a heart rate below 60/min, visible P waves, and a measurable PR interval. This does not match the irregular rhythm and absent P waves seen in this case.
D. Supraventricular tachycardia (SVT) typically presents with a regular, rapid rhythm (>150/min), narrow QRS complex, and absent or hidden P waves. The client’s heart rate of 92/min is not in the tachycardic range, ruling out SVT.

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A nurse on a medicalsurgical unit is caring for a newly admitted client with a diagnosis of R/O tuberculosis. Exhibits Which of the following findings should the nurse report to the provider?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

Correct Answer is B

Explanation

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

Exhibits

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