After 2 months of prescribed treatment with isoniazid, rifampin, pyrazinamide, and ethambutol, a patient continues to have positive sputum smears for acid-fast bacilli (AFB). Which action would the nurse take next?

Ask the healthcare provider about prescribing Streptomycin.

Discuss injectable antibiotics with the health care provider.

Teach about drug-resistant TB.

Ask the patient whether medications were taken as directed.

Answer and Explanation

The Correct Answer is D

Choice A reason: Streptomycin treats TB, but persistent AFB after 2 months suggests resistance or non-adherence. Requesting it now skips assessing compliance, which is critical first, as adding drugs prematurely may worsen resistance.

Choice B reason: Injectable antibiotics (e.g., amikacin) address resistant TB, but without confirming adherence, this is premature. Non-compliance is common; discussing this assumes resistance without evidence, delaying root cause investigation.

Choice C reason: Teaching about drug-resistant TB is relevant if resistance is confirmed, not assumed. Positive AFB may reflect non-adherence, so education is secondary to verifying medication use, which drives next steps.

Choice D reason: Asking about adherence checks if the patient took drugs as directed, a common reason for persistent AFB. Non-compliance delays sputum conversion, making this the first action to guide further treatment decisions.

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Correct Answer is C

Explanation

Choice A reason: Mantoux induration of 10 mm indicates TB exposure, not active infection status. It’s a diagnostic tool, not a marker for contagiousness, so it doesn’t guide discontinuation of airborne precautions in treatment.

Choice B reason: Six months of TB meds suggests treatment progress, but contagiousness persists until sputum clears. Duration alone isn’t enough; microbiologic evidence is required to lift precautions, per infection control standards.

Choice C reason: Negative sputum smears for acid-fast bacilli (three consecutive) confirm non-infectiousness in TB. This microbiological clearance allows discontinuation of airborne precautions, as the patient no longer spreads viable bacteria via droplets.

Choice D reason: Clear x-ray (no infiltrates) shows healing, but sputum can remain infectious. Radiologic improvement lags behind contagiousness, so negative smears, not imaging, determine when precautions can safely end.

A. Cyanosis and hypertension. B. Pulmonary edema and fibrosis. C. Dyspnea and increased heart rate. D. Dysrhythmias and expiratory wheezing

Correct Answer is C

Explanation

Choice A reason: Cyanosis requires deoxygenated hemoglobin, not typical in anemia unless hypoxia coexists. Hypertension isn’t linked; anemia often lowers pressure from reduced viscosity, making this pair unlikely in severe cases.

Choice B reason: Pulmonary edema and fibrosis stem from heart or lung disease, not anemia directly. Low hemoglobin reduces oxygen delivery, but these reflect fluid or scarring, not primary anemic findings.

Choice C reason: Dyspnea and tachycardia occur in severe anemia as low hemoglobin limits oxygen transport. The heart compensates with faster beats, and lungs work harder, matching physiologic response to tissue hypoxia.

Choice D reason: Dysrhythmias may occur late in anemia from hypoxia, but wheezing suggests airway issues, not anemia. These aren’t primary findings; respiratory and cardiac strain manifest differently in this condition.

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After 2 months of prescribed treatment with isoniazid, rifampin, pyrazinamide, and ethambutol, a patient continues to have positive sputum smears for acid-fast bacilli (AFB). Which action would the nurse take next?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is C

Explanation

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