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An older adult client with chronic respiratory disease tells the nurse it is unnecessary to receive the pneumococcal pneumonia vaccine because the influenza vaccine was just received two months ago. Which response by the nurse is most appropriate?

The vaccine that you received will protect you against the flu, but the pneumonia vaccine will protect you from bacterial pneumonia.

That’s great. You are fully protected against influenza and pneumonia this year.

You are correct. Influenza will cause pneumonia in many cases.

You have some protection, but it would be best to get the pneumonia vaccine to prevent you from carrying the disease to other people.

Answer and Explanation

The Correct Answer is A

Choice A reason: The influenza vaccine and the pneumococcal pneumonia vaccine protect against different pathogens. The influenza vaccine protects against the flu virus, while the pneumococcal vaccine protects against Streptococcus pneumoniae, a common cause of bacterial pneumonia. It is important for individuals, especially those with chronic respiratory diseases, to receive both vaccines to reduce the risk of severe respiratory infections.

Choice B reason: Stating that the client is fully protected against both influenza and pneumonia with just the flu vaccine is incorrect. The flu vaccine does not provide protection against bacterial pneumonia caused by Streptococcus pneumoniae. Therefore, it is essential to receive the pneumococcal vaccine as well.

Choice C reason: While influenza can lead to secondary bacterial pneumonia, it is not accurate to say that influenza will cause pneumonia in many cases. The primary purpose of the influenza vaccine is to prevent the flu, not pneumonia. The pneumococcal vaccine specifically targets the bacteria that cause pneumonia.

Choice D reason: Suggesting that the client should get the pneumonia vaccine to prevent carrying the disease to others is not the most appropriate response. The primary reason for receiving the pneumococcal vaccine is to protect the individual from developing bacterial pneumonia, not just to prevent transmission.

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Correct Answer is A

Explanation

Clients on tuberculosis (TB) medications, particularly those on isoniazid, rifampin, and pyrazinamide, are at risk for hepatotoxicity. Therefore, regular monitoring of liver function tests (LFTs) is crucial to detect any liver damage early and adjust treatment as necessary.

Choice A reason:

Liver function studies are essential for clients on TB medications. Drugs like isoniazid, rifampin, and pyrazinamide can cause liver toxicity. Monitoring liver enzymes such as ALT (alanine aminotransferase) and AST (aspartate aminotransferase) helps in early detection of hepatotoxicity, allowing for timely intervention to prevent severe liver damage. Regular LFTs ensure that any adverse effects on the liver are identified and managed promptly.

Choice B reason:

White blood cells (WBCs) are not typically monitored monthly for clients on TB medications. While WBC counts can be affected by various conditions and treatments, they are not specifically indicative of the side effects of TB medications. Monitoring WBCs might be necessary if there are signs of infection or other hematologic issues, but it is not a standard monthly requirement for TB treatment.

Choice C reason:

Coagulation studies are not routinely required for clients on TB medications. These tests are more relevant for patients on anticoagulant therapy or those with bleeding disorders. TB medications do not typically affect coagulation parameters, so regular monitoring of coagulation studies is not necessary unless there is a specific clinical indication.

Choice D reason:

Red blood cells (RBCs) are also not typically monitored monthly for clients on TB medications. While anemia can occur in TB patients, it is not a direct side effect of the medications used to treat TB. Monitoring RBCs might be necessary if there are symptoms of anemia or other hematologic concerns, but it is not a standard part of monthly TB treatment monitoring.

A. Sputum culture of Mycobacterium tuberculosis B. Tuberculin (PPD) skin test C. Acid-fast bacillus smear D. Chest X-ray

Correct Answer is A

Explanation

Choice A reason:

A sputum culture of Mycobacterium tuberculosis is the definitive test for diagnosing tuberculosis (TB). This test involves collecting a sputum sample and culturing it to detect the presence of Mycobacterium tuberculosis, the bacteria that cause TB. It is considered the gold standard for confirming active TB infection.

Choice B reason:

The Tuberculin (PPD) skin test, also known as the Mantoux test, is used to screen for TB infection. It can indicate whether a person has been exposed to TB bacteria, but it cannot confirm active TB disease. A positive result requires further testing, such as a sputum culture, to confirm the diagnosis.

Choice C reason:

An acid-fast bacillus (AFB) smear is a quick test that can detect the presence of mycobacteria in a sputum sample. While it can provide a preliminary indication of TB, it is not definitive. A positive AFB smear must be followed by a sputum culture to confirm the diagnosis.

Choice D reason:

A chest X-ray can show abnormalities in the lungs that are suggestive of TB, such as cavities or infiltrates. However, it cannot confirm the diagnosis on its own. Chest X-rays are used in conjunction with other tests, such as sputum culture and AFB smear, to diagnose TB.

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An older adult client with chronic respiratory disease tells the nurse it is unnecessary to receive the pneumococcal pneumonia vaccine because the influenza vaccine was just received two months ago. Which response by the nurse is most appropriate?

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