Exhibits

Complete the following sentence by using the lists of options.

The nurse should first address the client

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followed by the client's

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A Sputum cultures for AFB are used to detect the presence of Mycobacterium tuberculosis, the bacteria causing TB. A negative result means that the sputum samples tested do not contain viable TB bacteria that can be transmitted to others. It indicates that the client's TB treatment has been effective in reducing the bacterial load to non-infectious levels.

B. The Quantiferon-TB Gold test is a blood test used to detect TB infection based on the immune response to TB antigens. A positive result indicates TB infection but does not differentiate between latent TB infection (not infectious) and active TB disease (potentially infectious).

C. The Mantoux tuberculin skin test (TST) is another test used to detect TB infection based on a delayed- type hypersensitivity reaction to TB antigens. An induration of less than 1 mm is considered negative and suggests that the client does not have a significant immune response to TB antigens, which could mean they are not infected with TB or the infection is not significant. This finding does not provide information on the client's infectiousness.

D. This indicates improvement in the client's symptoms, as coughing up blood-tinged sputum (hemoptysis) is a common symptom of active pulmonary TB. While improvement in symptoms is an important aspect of TB treatment, it does not directly indicate whether the client is no longer infectious. Infectiousness is primarily determined by microbiological tests such as sputum cultures for AFB.

A While this statement is factual, it may come off as dismissive of the client’s concerns. The client may feel that their feelings and autonomy are not being respected. It's important to provide education but also to engage the client in a conversation about their concerns.

B. While this statement is intended to provide reassurance and encouragement, it may not be accurate for all clients or situations. It could also oversimplify the client's concerns and may not address the specific reasons for their reluctance to take the medication.

C. This response emphasizes the potential consequences of not adhering to the prescribed treatment plan. It highlights the importance of the medication in managing or treating the client's condition effectively. However, it may come across as threatening or coercive, which is not conducive to building a trusting and collaborative relationship with the client.

D. This is an appropriate response as it acknowledges the client’s autonomy and concern. It indicates that the nurse respects the client’s wishes and that the client will have the opportunity to discuss their concerns further with the provider. This fosters open communication and may lead to a better understanding of the necessity of the medication.