You are caring for a patient with a positive TB skin test (15mm), productive cough for two months, and unintentional weight loss. Which of the following orders will assist with the diagnosis of active tuberculosis? (Select All that Apply.)
CBC, BMP, HIV viral load, VDRL
Vital signs every shift
Heart healthy diet
Chest x-ray
Collect specimen x3 mornings for acid-fast bacilli
Admit to a negative pressure room
Correct Answer : D,E
A. CBC, BMP, HIV viral load, VDRL: While some of these tests (such as CBC and BMP) may provide useful information, they are not definitive for diagnosing active tuberculosis. The HIV viral load and VDRL (syphilis test) are unrelated to confirming TB infection.
B. Vital signs every shift: Monitoring vital signs is important in any patient’s care, but it does not specifically assist with diagnosing tuberculosis. It is supportive but not diagnostic.
C. Heart healthy diet: While maintaining good nutrition is important, especially if the patient has unintentional weight loss, a heart-healthy diet does not directly contribute to diagnosing or managing active tuberculosis.
D. Chest x-ray: A chest x-ray is a crucial diagnostic tool for identifying active tuberculosis. It can reveal characteristic findings such as infiltrates, cavitation, nodules, or pleural effusions, which are highly suggestive of active pulmonary TB or other signs consistent with active TB.
E. Collect specimen x3 mornings for acid-fast bacilli: Collecting sputum samples for acid-fast bacilli (AFB) smear and culture is a key diagnostic step in confirming active TB, as it identifies the presence of Mycobacterium tuberculosis in the sputum.
F. Admit to a negative pressure room: A negative pressure room is essential to prevent the spread of airborne infectious diseases like tuberculosis however it is a measure to prevent spread of infection but it is not helpful in confirming diagnosis of TB.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","D","G"]
Explanation
A. Cefepime 2grams IV every 12 hours: Cefepime is a broad-spectrum antibiotic, and the patient’s clinical signs, including fever, elevated WBC count, and confusion, suggest a possible infection. Immediate administration of antibiotics is critical to treat any potential infection.
B. Stat lactate level: The elevated lactate level (7.0 mmol/L) is concerning for tissue hypoxia or sepsis. Monitoring lactate levels helps assess the severity of the infection or potential sepsis, and obtaining this level stat is necessary to guide further treatment.
C. Fingerstick glucose every 6 hours: While monitoring blood glucose is important, it is not the highest priority in this acute situation, especially with more pressing concerns like infection and dehydration. However, it will be monitored regularly, as indicated in the provider's orders.
D. Obtain a set of blood cultures: Blood cultures are essential to identify the causative organism if the patient has an infection. With signs of systemic infection and elevated WBC, blood cultures should be obtained to determine the appropriate treatment.
E. Discontinue indwelling catheter: Although removing the catheter is important to reduce the risk of infection (especially with cloudy urine), it is not an immediate priority compared to addressing infection, sepsis, and fluid balance.
F. Discontinue Furosemide: While discontinuing Furosemide may be important due to the patient’s low blood pressure and potential fluid imbalance, it is not the most urgent intervention compared to starting antibiotics, correcting lactate levels, and fluid resuscitation.
G. 1000mL Lactated Ringer's at 170mL/hr: Given the patient’s potential sepsis and dehydration from diuresis, initiating IV fluid resuscitation with Lactated Ringer’s is a priority. This helps restore circulatory volume and supports organ function.
Correct Answer is ["A","B","E"]
Explanation
A. Chocolate: Chocolate contains caffeine and other substances like theobromine, which can relax the lower esophageal sphincter (LES), allowing stomach acid to flow back into the esophagus. This can worsen gastroesophageal reflux disease (GERD) symptoms.
B. French fries: Fried foods, such as French fries, are high in fat. Fatty foods can delay stomach emptying and relax the LES, both of which can increase the likelihood of acid reflux, making them a trigger for GERD symptoms.
C. Oatmeal: Oatmeal is generally considered a safe and healthy food for patients with GERD. It is low in fat and high in fiber, which can help absorb stomach acid and prevent reflux, making it a good food choice.
D. Chicken: Skinless, lean chicken is usually not problematic for people with GERD and is often recommended as a healthy source of protein. It is low in fat and should not trigger reflux, making it safe to consume.
E. Grapefruit: Grapefruit is acidic, which can irritate the esophagus and trigger reflux symptoms. Citrus fruits, in general, are best avoided by individuals with GERD as they can increase stomach acidity.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.