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","C","D","E"]

Explanation

A. Evaluate outcomes at the end of the shift: This is an important recommendation as it allows nurses to assess the effectiveness of interventions and the overall condition of patients. Evaluating outcomes helps in identifying areas for improvement, ensuring that patient care meets safety and quality standards. This practice fosters accountability and continuous improvement in patient-centered care.
B. Evaluate outcomes at the start of the shift: While evaluating outcomes at the beginning of the shift can provide valuable information, it is more effective to evaluate outcomes after care has been provided. Starting the shift with a review of previous outcomes can guide care planning, but the actual evaluation of interventions should occur after implementation to assess their effectiveness.
C. Plan and report outcomes: Planning and reporting outcomes are essential components of providing safe, quality, patient-centered care. This involves setting clear goals for patient care and documenting the expected results, which allows for effective communication among the healthcare team and ensures that everyone is aligned in their approach to patient care.
D. Communicate the plan: Effective communication of the care plan is critical to patient safety and quality care. Sharing the plan with all team members ensures that everyone is aware of the goals and interventions, facilitating collaboration and reducing the risk of errors. Clear communication enhances the patient's understanding of their care and promotes involvement in the decision-making process.
E. Think critically: Critical thinking is fundamental to nursing practice and promotes safe, quality, patient-centered care. It involves analyzing information, evaluating evidence, and making informed decisions based on patient needs and circumstances. Encouraging critical thinking enables nurses to assess situations thoroughly, anticipate potential problems, and implement appropriate interventions.

A. Limit oral fluids to minimize labored breathing. B. Perform pursed-lip breathing to expel trapped carbon dioxide from the alveoli C. Lie in a low Fowler's position to promote lung expansion D. Perform hourly incentive spirometry to inflate lungs and mobilize secretions.

Correct Answer is D

Explanation

A. Limit oral fluids to minimize labored breathing: This action is not appropriate, as adequate hydration is important for thinning mucus secretions, making it easier for the client to expectorate them. Limiting fluids could lead to thicker secretions, which may worsen the client’s respiratory distress and increase the difficulty of clearing secretions. Therefore, this approach is not suitable for a client with pneumonia and respiratory compromise.
B. Perform pursed-lip breathing to expel trapped carbon dioxide from the alveoli: While pursed-lip breathing can help with exhalation and improve oxygenation, it does not directly address the need to mobilize and clear copious secretions. This technique is beneficial in managing dyspnea and improving ventilation but is not the priority action when the client has significant secretions that need to be cleared.
C. Lie in a low Fowler's position to promote lung expansion: A low Fowler's position (30 degrees) is less effective for promoting lung expansion compared to higher Fowler's positions. Semi-Fowler's (30-45 degrees) or high Fowler's (greater than 45 degrees) positions are more beneficial for improving lung expansion and facilitating breathing in clients with respiratory distress. Therefore, this option does not provide the most effective intervention for the client's condition.
D. Perform hourly incentive spirometry to inflate lungs and mobilize secretions: This is the priority action for the nurse to encourage, as incentive spirometry is specifically designed to help inflate the lungs and improve lung function. It promotes deep breathing, which can enhance ventilation, prevent atelectasis, and facilitate the mobilization of secretions. Regular use of incentive spirometry is essential in managing pneumonia and can significantly improve respiratory outcomes for the client.

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

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse instructor is lecturing nursing students on safety, quality and patient centered care. The students should recognize that which of the following recommendations promotes safe, quality, patient-centered care? Select all that apply.

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

Explanation

A nurse is caring for a client diagnosed with pneumonia and assesses labored breathing and copious tracheobronchial secretions. What priority action should the nurse encourage with the client?

Correct Answer is D

Explanation

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