A client has tested positive for tuberculosis (TB). While providing client teaching, what information should a nurse prioritize?

The importance of adhering closely to the prescribed medication regimen.

The client must remain in respiratory isolation until medication treatment ends.

The fact that the disease is self-limiting, but can take up to two years to resolve.

The importance of participating in physical therapy to re-establish functional abilities.

Answer and Explanation

The Correct Answer is A

A. The importance of adhering closely to the prescribed medication regimen. Tuberculosis requires strict adherence to a long-term antibiotic regimen, typically lasting 6 to 9 months, to prevent drug resistance, treatment failure, and disease relapse. Noncompliance can lead to multidrug-resistant TB (MDR-TB), which is more difficult to treat. Directly observed therapy (DOT) is often recommended to ensure adherence.
B. The client must remain in respiratory isolation until medication treatment ends. While respiratory isolation is essential for active TB, it is not required until the full course of treatment is completed. Isolation is typically maintained until the client has received at least two weeks of effective therapy, symptoms improve, and three consecutive sputum smears are negative for acid-fast bacilli (AFB).
C. The fact that the disease is self-limiting, but can take up to two years to resolve. TB is not self-limiting; without proper treatment, it can persist indefinitely, worsen, and become fatal. Standard treatment with first-line drugs such as isoniazid, rifampin, ethambutol, and pyrazinamide effectively eradicates the infection within 6 to 9 months in most cases.
D. The importance of participating in physical therapy to re-establish functional abilities. While TB can cause fatigue and weakness, physical therapy is not a primary focus of treatment. The priority is to eradicate the infection through strict medication adherence, as untreated TB can progress to severe pulmonary damage, systemic involvement, and complications.

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Correct Answer is C

Explanation

A. Use of Passy Muir speaking valve: While this is an important aspect of communication for a client who has undergone a laryngectomy, it is not the highest priority at the time of discharge. The use of the speaking valve can be addressed after ensuring that the client is equipped to handle immediate safety concerns and emergencies related to their condition.
B. Phone number of healthcare provider to report complications: Providing the client with contact information for their healthcare provider is essential for ongoing support and to address any concerns that may arise after discharge. However, this information is secondary to ensuring the client can effectively communicate their condition and limitations, particularly in an emergency situation.
C. Emergency personal identification that client is unable to speak: This is the highest priority for discharge teaching because it directly addresses the client’s safety. Having emergency identification is crucial for informing healthcare providers and first responders about the client's inability to speak, especially in situations where communication may be vital for receiving appropriate care. Ensuring that the client can communicate their condition in emergencies takes precedence over other aspects of post-operative care.
D. Ability to perform tracheostomy care: While it is important for the client to be educated on tracheostomy care to ensure ongoing health and safety, this teaching can be considered after addressing immediate safety needs. The ability to care for the tracheostomy is vital but does not take priority over having emergency identification that communicates the client’s needs to others who may not be aware of their condition.

A. "I feel frustrated when you interrupt me. It's important for us to take turns speaking during client discussions." B. "If you keep interrupting me, I'll report you to our supervisor for disciplinary action." C. "You always interrupt me when I'm talking. Can't you see how disrespectful that is?" D. "I can't work with someone who constantly takes over conversations. You need to find another partner."

Correct Answer is A

Explanation

A. "I feel frustrated when you interrupt me. It's important for us to take turns speaking during client discussions." This response demonstrates assertive behavior because it expresses the nurse's feelings directly and respectfully while addressing the specific behavior that is problematic. By focusing on "I feel" statements, the nurse communicates personal feelings without blaming or attacking the colleague. This approach encourages a constructive dialogue and promotes a more collaborative working relationship.
B. "If you keep interrupting me, I'll report you to our supervisor for disciplinary action." This response is not assertive; it is more aggressive and threatening. It shifts the focus from the behavior to a punitive action and can escalate conflict rather than fostering a constructive conversation. It may create defensiveness in the colleague and is unlikely to resolve the underlying issue.
C. "You always interrupt me when I'm talking. Can't you see how disrespectful that is?" This response is accusatory and confrontational, which is not assertive behavior. While it addresses the behavior, it does so in a way that may cause the colleague to become defensive or hostile. Effective assertiveness involves expressing feelings and needs without assigning blame or using harsh language.
D. "I can't work with someone who constantly takes over conversations. You need to find another partner." This statement is dismissive and aggressive, effectively shutting down communication rather than encouraging teamwork. It does not allow for resolution or discussion of the behavior, making it counterproductive in promoting effective collaboration. Assertive communication should focus on addressing issues while maintaining a willingness to work together.

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A client has tested positive for tuberculosis (TB). While providing client teaching, what information should a nurse prioritize?

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Naxlex Comprehensive Predictor Exams

A nurse is preparing to discharge a client who is a status post-operative laryngectomy. The nurse should recognize which of the following discharge teaching is the highest priority?

Correct Answer is C

Explanation

A nurse is working with a colleague who frequently interrupts and takes over during client care discussions. The nurse wants to assertively address this behavior to ensure effective teamwork. Which response by the nurse demonstrates assertive behavior?

Correct Answer is A

Explanation

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