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The nurse is providing care to a patient who has tested positive for tuberculosis. The patient is moved into an airborne isolation room and the patient asks. "Why do I need to be moved into this new room?" How should the nurse respond?

"This new room has negative pressure and does six to twelve air changes an hour and disposes the air outside to reduce the infection potential in other patients. I also have to wear this surgical mask"

"It sounds like you have some questions about your new diagnosis. What are you most concerned about?"

"Tuberculosis can seriously impair the lungs and requires a long course of antibiotics to treat it

“Tuberculosis is a small particle that can spread through the air. This new room has a special filter that reduces the spread of the bacteria through the air."

Answer and Explanation

The Correct Answer is D

A. "This new room has negative pressure and does six to twelve air changes an hour and disposes the air outside to reduce the infection potential in other patients. I also have to wear this surgical mask."

While this provides technical information, the surgical mask part is incorrect; the nurse should wear an N95 respirator, not a surgical mask.

B. "It sounds like you have some questions about your new diagnosis. What are you most concerned about?"

While this is a therapeutic communication technique, it does not directly answer the patient's question about airborne precautions.

C. "Tuberculosis can seriously impair the lungs and requires a long course of antibiotics to treat it."

This statement provides disease information but does not explain why airborne isolation is necessary.

D. "Tuberculosis is a small particle that can spread through the air. This new room has a special filter that reduces the spread of the bacteria through the air."

This provides a concise and accurate explanation of airborne precautions in terms the patient can understand.

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Correct Answer is D

Explanation

A. 89-year-old with dementia and NG tube with continuous tube feeding: While this patient requires monitoring, continuous tube feeding is routine, and there is no indication of immediate distress.

B. 73-year-old with hypoactive bowel sounds one day post-cholecystectomy: Hypoactive bowel sounds are expected after surgery, particularly after abdominal procedures. This does not indicate an emergency.

C. 43-year-old with anorexia and nausea for two days who is tolerating a clear liquid diet: This patient’s condition is stable, and nausea is resolving, making them a lower priority.

D. 65-year-old who has dysphagia after suffering from a stroke who is NPO: Dysphagia (difficulty swallowing) increases the risk of aspiration pneumonia, which can be life-threatening. This patient should be assessed first to ensure their airway is protected.

A. It is painful to sit on a bedpan. B. The position encourages the Valsalva maneuver. C. The position does not facilitate downward pressure. D. The cause is unknown and requires further study.

Correct Answer is C

Explanation

A. It is painful to sit on a bedpan. Discomfort may be a factor, but pain alone does not explain the difficulty in having a bowel movement.
B. The position encourages the Valsalva maneuver. The Valsalva maneuver (straining against a closed airway) can occur in any position, but posture is the primary problem here.
C. The position does not facilitate downward pressure. The seated position allows for gravity and proper abdominal muscle engagement, making defecation easier. Lying down does not facilitate intra-abdominal pressure.
D. The cause is unknown and requires further study. The relationship between position and defecation is well understood in physiology.

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Laboratory Test	Reference Range	Patient Results
White Blood Cells	5,000- 10,000/mm3	9,500/mm3
Neutrophil Count	2.500-8,000/mm3	5,200/mm3
HIV	Negative	Positive

The nurse is providing care to a patient who has tested positive for tuberculosis. The patient is moved into an airborne isolation room and the patient asks. "Why do I need to be moved into this new room?" How should the nurse respond?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse has received a report for the following patients. Which patient should be seen first?

Correct Answer is D

Explanation

A client is having difficulty having a bowel movement laying on the bedpan. What is the physiologic reason for this problem?

Correct Answer is C

Explanation

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