A client is diagnosed with active tuberculosis and is started on medications. The nurse is aware that which parameter best indicates that the prescribed therapy has been effective? The client has:
a negative sputum culture.
decreased hemoptysis.
an improved chest x-ray.
a decreased rate of coughing.
The Correct Answer is A
Choice A Reason
A negative sputum culture is the most definitive indicator of the effectiveness of tuberculosis (TB) treatment. When a patient with active TB starts on medication, the goal is to eliminate the Mycobacterium tuberculosis bacteria from the body. A sputum culture that turns from positive to negative signifies that the bacteria have been eradicated from the respiratory secretions, indicating successful treatment.
Choice B Reason
While decreased hemoptysis (coughing up blood) is a positive sign and indicates an improvement in the patient's condition, it is not the most reliable parameter for determining the effectiveness of TB therapy. Hemoptysis may decrease as the patient's overall condition improves, but it does not confirm the eradication of the TB bacteria.
Choice C Reason
An improved chest x-ray can show a reduction in the lesions caused by TB, which is a good sign of recovery. However, chest x-rays cannot confirm whether the TB bacteria have been completely eliminated. They are more of a supportive indicator rather than a definitive one.
Choice D Reason
A decreased rate of coughing is another sign that the patient is responding to treatment, as coughing is a primary symptom of TB. However, similar to hemoptysis and chest x-ray improvements, a decrease in coughing does not necessarily mean that the TB bacteria have been fully cleared from the body.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice a reason:
A cream to soothe itching may be used if the client is experiencing pruritus, which can sometimes accompany biliary issues due to bile salts in the skin. However, pruritus is not a direct symptom of biliary colic, which is characterized primarily by pain.
Choice b reason:
Pain medication is the appropriate treatment for biliary colic. Biliary colic is caused by the temporary blockage of the bile duct by a gallstone, leading to intense pain in the upper right abdomen or the center of the abdomen. Pain relief is typically achieved with anti-inflammatory drugs or antispasmodics, and in some cases, opioids may be necessary.
Choice c reason:
An antibiotic would be prescribed if there was an infection, such as cholecystitis or cholangitis. Biliary colic itself does not necessarily indicate an infection unless accompanied by other symptoms such as fever or elevated white blood cell count.
Choice d reason:
A laxative is not typically used to treat biliary colic. While laxatives can help relieve constipation, biliary colic is a result of gallstones obstructing the bile duct, not bowel movement issues.
Correct Answer is B
Explanation
Choice A Reason:
Asking the client to share the joke may imply that the nurse believes the client is laughing at a joke, which may not be the case. It's important to recognize that uncontrollable laughter can be a symptom of schizophrenia and not necessarily a response to humor.
Choice B Reason:
This response is open-ended and nonjudgmental, inviting the client to explain their behavior without making assumptions. It allows the client to share their experience, which could be related to an internal stimulus such as a hallucination or simply a response they cannot control.
Choice C Reason:
Asking "Why are you laughing?" could be perceived as confrontational or accusatory. It might make the client feel defensive or misunderstood, especially if the laughter is a symptom of their condition and not something they are doing voluntarily.
Choice D Reason:
Saying "I don't think I said anything funny" focuses on the nurse's perspective rather than the client's experience. It could inadvertently dismiss the client's behavior as inappropriate or unjustified, which is not supportive in a therapeutic relationship.
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