The nurse implements a secondary prevention program for tuberculosis in a rural health clinic. Which outcome indicates that the program was effective?

At-risk clients received an increased number of routine health screenings.

More than 60% of clients taking rifampin completed the course of therapy.

Overcrowding in prisons was addressed at a local town hall meeting.

Clients report having new confidence in avoiding people who are coughing.

Answer and Explanation

The Correct Answer is B

A. Increasing routine health screenings represents primary prevention strategies, which aim to identify health risks before disease occurs, not interventions targeted at clients already at risk or exposed to tuberculosis.

B. This is the correct choice because secondary prevention focuses on early detection and treatment of disease to prevent progression and complications. Tuberculosis therapy adherence, such as completing a rifampin course, directly reflects effective secondary prevention by treating latent or active infection and preventing further spread.

C. Addressing overcrowding in prisons is a community-level primary prevention effort aimed at reducing TB transmission risk, but it does not reflect the effectiveness of a secondary prevention program directed at already at-risk or infected individuals.

D. Clients reporting confidence in avoiding sick people reflects health education and behavioral change, which is more aligned with primary prevention and health promotion, rather than measurable outcomes of secondary prevention like disease detection or treatment completion.

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Correct Answer is C

Explanation

A. Instructing the UAP to return and perform handwashing is unnecessary in this situation. Alcohol-based hand rubs are an acceptable and recommended method for hand hygiene when hands are not visibly soiled. There is no indication that the UAP performed the technique incorrectly or that soap and water are required, so this action is not appropriate.

B. Wearing gloves for all vital sign measurements is not required and may lead to inappropriate overuse of gloves. Standard precautions indicate glove use only when there is potential contact with blood, body fluids, or contaminated surfaces. This option does not address the observed action.

C. Proper use of alcohol-based hand rub requires rubbing hands together until they are completely dry to ensure effective microbial kill. Reinforcing correct technique supports infection control practices and promotes safe, evidence-based care.

D. Supervising the UAP later does not address the current opportunity for immediate teaching. The nurse should provide timely feedback to reinforce proper technique rather than delay evaluation.

A. Increase rate of ventilation. B. Decrease expiratory pressure. C. Decrease expiratory flow time. D. Increase ventilator tidal volume.

Correct Answer is A

Explanation

A. The client’s arterial blood gas values show respiratory acidosis (low pH of 7.26 and elevated PaCO₂ of 68 mm Hg), indicating hypoventilation and CO₂ retention. Increasing the rate of ventilation will enhance CO₂ elimination by increasing minute ventilation, thereby lowering PaCO₂ and helping to correct the acidosis. This is the most immediate and effective intervention.

B. Decreasing expiratory pressure (such as PEEP) primarily affects oxygenation, not CO₂ elimination. In this case, the PaO₂ is within the normal range (92 mm Hg), so oxygenation is adequate. This intervention does not address the primary problem of hypercapnia and acidosis.

C. Decreasing expiratory flow time would shorten the time available for exhalation, potentially leading to air trapping and worsening CO₂ retention. This could further increase PaCO₂ and exacerbate respiratory acidosis, making it an inappropriate intervention.

D. Increasing tidal volume can also increase minute ventilation and help eliminate CO₂; however, it carries a higher risk of complications such as barotrauma or volutrauma, especially in mechanically ventilated clients. Typically, adjusting the respiratory rate is the safer first-line intervention. Therefore, while it may help, it is not the best initial action compared to increasing the ventilation rate.

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The nurse implements a secondary prevention program for tuberculosis in a rural health clinic. Which outcome indicates that the program was effective?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse observes an unlicensed assistive personnel (UAP) applying an alcohol-based hand rub while leaving a client's room after taking vital signs. Which action should the nurse take?

Correct Answer is C

Explanation

A client receiving mechanical ventilation has a pH of 7.26, PaCO2 of 68 mm Hg, and a PaO2 of 92 mm Hg. Which intervention should the nurse implement? Reference Range: pH [7.35 to 7.45] PaCO2 [35 to 45 mm Hg] PaO2 [80 to 100 mm Hg]

Correct Answer is A

Explanation

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