The nurse is admitting a client with possible tuberculosis (TB). The client is placed in a private room with airborne precautions pending diagnostic test results.
Which diagnostic test should the nurse review to confirm the diagnosis of TB?
Hemoccult test on sputum collected from hemoptysis.
Sputum culture positive for Mycobacterium tuberculosis.
Positive purified protein derivative (PPD) skin test.
Chest X-ray or computed tomography (CT).
The Correct Answer is B
Choice A rationale:
Hemoccult test on sputum collected from hemoptysis is not a diagnostic test for TB. It is a test for blood in the stool, which can be a symptom of TB but is not specific to TB.
Hemoptysis, or coughing up blood, can occur in various conditions, including bronchitis, pneumonia, lung cancer, and TB. The Hemoccult test cannot differentiate between these causes, making it an unreliable test for diagnosing TB.
Choice B rationale:
Sputum culture positive for Mycobacterium tuberculosis is the definitive diagnostic test for TB.
It involves collecting a sample of sputum, which is the mucus coughed up from the lungs, and culturing it in a laboratory to see if Mycobacterium tuberculosis, the bacteria that causes TB, grows.
This test is highly specific for TB, meaning that a positive result is almost always indicative of TB infection. It is also sensitive, meaning that it can detect TB infection even when there are few bacteria present.
Choice C rationale:
Positive purified protein derivative (PPD) skin test indicates exposure to TB but does not confirm active infection.
The PPD skin test involves injecting a small amount of tuberculin, a protein derived from Mycobacterium tuberculosis, into the skin.
If a person has been exposed to TB, their immune system will react to the tuberculin, causing a raised red bump to appear at the injection site.
However, a positive PPD skin test does not necessarily mean that a person has active TB infection.
It could also mean that they have been exposed to TB in the past but have successfully fought off the infection. Further testing, such as a sputum culture, is needed to confirm the diagnosis of TB.
Choice D rationale:
Chest X-ray or computed tomography (CT) can show abnormalities in the lungs that are suggestive of TB, but they cannot definitively diagnose TB.
These imaging tests can reveal changes in the lungs, such as nodules, inflammation, or fluid buildup, which can be caused by TB or other conditions.
Therefore, a chest X-ray or CT scan alone is not sufficient to diagnose TB. A sputum culture is still needed to confirm the diagnosis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Drinking plenty of water whenever thirsty is not the most appropriate action for a patient with hypernatremia. While it's important to stay hydrated, excessive water intake can potentially worsen hypernatremia by diluting blood sodium levels further. This is because the body tries to balance sodium levels by either retaining water or excreting it through urine. In hypernatremia, the body is already short on water relative to sodium, so consuming too much water can exacerbate the imbalance.
Choice B rationale:
Reviewing food labels for sodium content is crucial for managing hypernatremia. It empowers patients to make informed choices and limit their sodium intake.
Sodium is a major contributor to hypernatremia, and reducing dietary sodium intake is a key strategy to lower blood sodium levels.
By carefully reading food labels and selecting low-sodium options, patients can effectively manage their sodium intake and promote a gradual return to normal sodium levels.
This approach addresses the root cause of hypernatremia and promotes long-term control of blood sodium levels.
Choice C rationale:
Monitoring daily urine output volume can be helpful in tracking fluid status, but it's not the primary action for managing hypernatremia.
While urine output can provide insights into fluid balance, it doesn't directly address the underlying issue of excessive sodium. Focusing on dietary sodium intake is a more direct and effective approach to correcting hypernatremia.
Choice D rationale:
Using salt tablets after strenuous exercise is not recommended for patients with hypernatremia.
Salt tablets are intended to replenish electrolytes lost through sweating, but they can worsen hypernatremia by further increasing sodium levels.
Patients with hypernatremia should focus on reducing sodium intake, not increasing it.
Correct Answer is A
Explanation
Choice A rationale:
Pneumonia is the most likely diagnosis given the rapid development of pulmonary infiltrates within a 24-hour period. Pneumonia is an infection of the lungs that can be caused by bacteria, viruses, or fungi. It typically presents with symptoms such as fever, cough, shortness of breath, and chest pain. The presence of pulmonary infiltrates on imaging studies, such as a chest X-ray, is a key diagnostic feature of pneumonia.
The distribution of the infiltrates, involving the lower lobes with a predominance on the right side, is also consistent with pneumonia. This is because the lower lobes are more susceptible to pneumonia due to their anatomy and gravity.
The absence of active processes on Day 1 makes other diagnoses less likely. For example, tuberculosis typically develops more slowly over weeks or months, and bronchitis usually does not cause pulmonary infiltrates.
Pulmonary embolism can cause pulmonary infiltrates, but it would typically be associated with other symptoms such as sudden onset of shortness of breath, chest pain, and tachycardia.
Choice B rationale:
Tuberculosis is a chronic infection that typically develops slowly over weeks or months. It is less likely to cause rapid development of pulmonary infiltrates as seen in this case.
Tuberculosis often involves the upper lobes of the lungs, and it may be associated with other symptoms such as fever, night sweats, and weight loss.
Choice C rationale:
Bronchitis is an inflammation of the bronchi, the large airways that carry air to the lungs. It typically causes a cough, but it does not usually cause pulmonary infiltrates.
Bronchitis is often caused by a virus, and it usually resolves on its own within a few weeks.
Choice D rationale:
Pulmonary embolism is a blockage of a pulmonary artery, one of the blood vessels that carries blood to the lungs. It can cause pulmonary infiltrates, but it would typically be associated with other symptoms such as sudden onset of shortness of breath, chest pain, and tachycardia.
Pulmonary embolism is often caused by a blood clot that travels from a vein in the leg to the lungs.
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