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 A

Explanation

A. Increase the oxygen flow rate. The client is experiencing worsening hypoxia, tachypnea, and dyspnea, indicating progressive respiratory distress due to pulmonary embolism (PE). Increasing the oxygen flow rate is the priority to improve oxygenation, reduce the work of breathing, and prevent further hypoxemia. Providing supplemental oxygen helps stabilize the client while preparing for further interventions. The client’s rapidly deteriorating condition, suggests potential hemodynamic instability. Immediate provider notification ensures urgent evaluation for interventions such as anticoagulation, thrombolytics, or intensive monitoring.
B. Increase the oxygen flow rate, then elevate the head of the bed. While elevating the head of the bed can assist breathing by improving lung expansion, it does not address the underlying pathophysiology of PE. Notifying the provider is more critical, as the client may need immediate pharmacologic or procedural interventions to prevent further deterioration.
C. Administer pain medication, then notify the healthcare provider. Pain relief is important, but in acute respiratory distress, oxygenation and circulatory stability take precedence. Narcotics can depress respiratory drive and worsen hypoxia, making them a lower priority until the client’s respiratory status is stabilized.
D. Encourage deep breathing exercises, then check capillary refill. Deep breathing is beneficial for lung expansion but is not an effective treatment for acute PE. The priority is ensuring oxygenation and immediate medical intervention rather than focusing on routine assessments like capillary refill, which do not directly address the emergency.
E. Elevate the head of the bed, then apply compression stockings. Elevating the head of the bed may help ease breathing, but it is a supportive measure rather than a primary intervention. Compression stockings are used for DVT prevention, not for managing an active embolism, making them inappropriate as a priority action in this scenario.

A. Clubbing of the fingers B. Bradycardia C. Barrel chest D. Dyspnea E. Deep respirations

Correct Answer is ["A","C","D"]

Explanation

A. Clubbing of the fingers: This finding is often associated with chronic respiratory conditions, including emphysema, due to prolonged hypoxia. The chronic low oxygen levels can lead to changes in the nail beds, resulting in clubbing as the body attempts to compensate for the decreased oxygenation. Therefore, clubbing is a common assessment finding in clients with emphysema.
B. Bradycardia: Emphysema typically does not cause bradycardia; instead, clients may experience tachycardia due to increased respiratory effort and oxygen demand. While individual variations can occur, bradycardia is not a standard finding in clients with emphysema, making this option less likely to be present.
C. Barrel chest: This is a common physical assessment finding in clients with emphysema. The chronic overinflation of the lungs leads to a characteristic increase in the anteroposterior diameter of the chest, resulting in a barrel-shaped appearance. This occurs as the diaphragm becomes flattened and the rib cage is expanded from prolonged air trapping.
D. Dyspnea: Shortness of breath, or dyspnea, is a hallmark symptom of emphysema. As the disease progresses, clients may experience increased difficulty in breathing, especially during exertion, due to the destruction of alveoli and reduced lung elasticity. This finding is expected and significant in the assessment of a client with emphysema.
E. Deep respirations: In emphysema, clients often exhibit shallow, rapid breathing patterns rather than deep respirations. The loss of elasticity in the lungs leads to difficulty in full lung expansion, which can result in a more shallow and increased respiratory rate. Therefore, deep respirations are not a typical finding in clients with emphysema.

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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 caring for a client in the emergency department (ED). Exhibits Complete the following sentence by using the list of options. The nurse should first ______followed by______

Correct Answer is A

Explanation

A nurse is caring for a client who has emphysema. Which of the following findings should the nurse expect to assess in this client? (Select all that apply.)

Correct Answer is ["A","C","D"]

Explanation

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