A patient with TB who is in respiratory isolation must go to the x-ray department. Which action should the nurse take?

Place a mask over the patient's nose and mouth.

Notify the x-ray department that the test must be cancelled.

Place a gown and gloves on the patient.

Call the x-ray department to make sure the waiting room is empty.

Answer and Explanation

The Correct Answer is A

A. Place a mask over the patient's nose and mouth: When a patient with active TB leaves the isolation room, they must wear a surgical mask to prevent airborne transmission. This protects others from inhaling Mycobacterium tuberculosis in shared spaces.

B. Notify the x-ray department that the test must be cancelled: There is no need to cancel the diagnostic test. Proper precautions like masking the patient enable safe transport and continuation of necessary medical care.

C. Place a gown and gloves on the patient: Gowns and gloves are used for contact precautions, not airborne. TB transmission is airborne, and a surgical mask is the appropriate protective measure for the patient not gowning or gloving.

D. Call the x-ray department to make sure the waiting room is empty: While minimizing exposure is ideal, it is not sufficient or necessary if the patient wears a mask. Standard protocol centers on masking the patient and notifying departments of isolation status, not on room occupancy control.

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Correct Answer is D

Explanation

A. Physical therapy for homebound therapy services:Physical therapy is not routinely indicated in TB management unless the patient has specific mobility deficits. TB treatment focuses more on medication adherence and infection control rather than physical rehabilitation.

B. Occupational therapy for job retraining:There is no direct indication for job retraining in a TB patient unless the illness has caused long-term disability or affected occupational function, which is not suggested in this scenario.

C. Community social worker for Meals on Wheels:Meals on Wheels may assist with nutrition, but it is not specific to TB care. Social services do not directly ensure adherence to TB therapy, which is crucial for treatment success and public health safety.

D. Visiting Nurses for directly observed therapy:Directly observed therapy (DOT) ensures the client takes prescribed TB medications under supervision, which is essential to prevent noncompliance, reduce drug resistance, and promote cure. Visiting nurses are best positioned to provide this support during long-term outpatient TB treatment.

A. Crackles are heard in bases. - The nurse encourages the client to cough forcefully. B. Wheezes are heard in central areas. - The nurse administers an inhaled bronchodilator. C. Vesicular sounds are heard over the periphery. - The nurse has the client breathe D. Hollow sounds are heard over the trachea. - The nurse increases the oxygen flow rate.

Correct Answer is B

Explanation

A. Crackles are heard in bases. – The nurse encourages the client to cough forcefully:
Crackles are caused by fluid in the alveoli and are often not cleared with coughing. Encouraging coughing may help with mucus, but for fluid-related crackles (e.g., in heart failure), diuretics or other interventions are more appropriate.

B. Wheezes are heard in central areas. – The nurse administers an inhaled bronchodilator:Wheezes result from narrowed airways, commonly seen in asthma or bronchospasm. Bronchodilators relax airway smooth muscle, improving airflow and reducing wheezing.

C. Vesicular sounds are heard over the periphery. – The nurse has the client breathe:
Vesicular breath sounds are normal over the peripheral lung fields. No action is needed when these sounds are heard, so prompting the client to breathe differently is unnecessary.

D. Hollow sounds are heard over the trachea. – The nurse increases the oxygen flow rate:Hollow, tubular sounds (bronchial) are expected over the trachea. These are normal findings and not an indication of hypoxia. Increasing oxygen unnecessarily could be harmful.

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A patient with TB who is in respiratory isolation must go to the x-ray department. Which action should the nurse take?

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