A nurse is caring for a client newly diagnosed with active tuberculosis (TB) and prescribed triple antibiotic therapy. The nurse should recognize that which clinical sign indicates inadequate drug therapy after 2 months of treatment?

Non-productive cough.

Decreased shortness of breath.

Positive acid-fast bacilli in the sputum.

Poor appetite.

Answer and Explanation

The Correct Answer is C

Choice A rationale
A non-productive cough is not a definitive sign of inadequate drug therapy for tuberculosis. It could be a symptom of many other respiratory conditions.
Choice B rationale
Decreased shortness of breath is generally a positive sign indicating improvement in the patient’s condition. It does not necessarily indicate inadequate drug therapy.
Choice C rationale
The presence of positive acid-fast bacilli in the sputum after 2 months of treatment indicates that the tuberculosis bacteria are still present in the patient’s body. This suggests that the triple antibiotic therapy is not effectively eliminating the bacteria, thus indicating inadequate drug therapy.
Choice D rationale
Poor appetite is a common symptom of tuberculosis, but it does not specifically indicate the effectiveness or inadequacy of drug therapy.

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Correct Answer is D

Explanation

Choice A rationale
Reporting the absence of spontaneous respirations is important, but it is not the priority action. The patient is on mechanical ventilation, so the absence of spontaneous respirations is expected.
Choice B rationale
Encouraging the patient to attempt to breathe on their own is not the priority action. The patient is receiving mechanical ventilation, which means they are likely unable to breathe adequately on their own.
Choice C rationale
Providing passive range-of-motion exercises is important for overall patient mobility and prevention of complications such as deep vein thrombosis, but it is not the priority action in this case.
Choice D rationale
Responding to ventilator alarms is the priority action. Alarms may indicate a change in the patient’s condition or a problem with the ventilator. Immediate response is necessary to ensure the patient’s safety.

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

Correct Answer is C

Explanation

Choice A rationale
Limiting oral fluids is not the best action for a client with pneumonia and copious tracheobronchial secretions. Adequate hydration can actually help thin and loosen pulmonary secretions, making them easier to expel.
Choice B rationale
While lying in a low Fowler’s position can aid in lung expansion, it is not the priority action in this case. The client has copious tracheobronchial secretions, and the most effective way to mobilize these secretions is through incentive spirometry.
Choice C rationale
Performing hourly incentive spirometry can help inflate the lungs and mobilize secretions, which is particularly beneficial for a client with pneumonia who has copious tracheobronchial secretions. This is the priority action as it directly addresses the client’s issue of labored breathing due to excessive secretions.
Choice D rationale
Pursed lip breathing is a technique used primarily to slow the pace of breathing and can help maintain open airways longer. However, it is not the most effective method for mobilizing tracheobronchial secretions.

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A nurse is caring for a client newly diagnosed with active tuberculosis (TB) and prescribed triple antibiotic therapy. The nurse should recognize that which clinical sign indicates inadequate drug therapy after 2 months of treatment?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a patient receiving mechanical ventilation. The nurse should prioritize which action associated with neuromuscular blockade?

Correct Answer is D

Explanation

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

Correct Answer is C

Explanation

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