A nurse is caring for a client who has a new diagnosis of tuberculosis (TB). The client asks the nurse why she needs to take four different antituberculotic medications. Which of the following replies should the nurse make?

"The organism that causes TB becomes resistant to antituberculotic medications when you only take one medication."

Taking several antituberculotic medications will protect your liver from toxic effects."

"People who have a severe form of TB need several antituberculotic medications, but those who have less severe TB need just one medication."

"Adverse effects occur more often and are more severe when you take only one antituberculotic medication."

Answer and Explanation

The Correct Answer is A

Choice A Reason:

"The organism that causes TB becomes resistant to antituberculotic medications when you only take one medication." This statement is appropriate.

Tuberculosis bacteria tend to develop resistance to single medications when used alone. Using multiple medications simultaneously helps prevent the bacteria from becoming resistant to any single drug. This strategy, known as combination therapy, is crucial in treating TB effectively and reducing the risk of drug resistance.

When TB bacteria are exposed to just one medication, they can mutate and become resistant to that specific drug. However, using a combination of medications helps ensure that if one medication fails to eliminate some bacteria due to resistance, the other drugs can still work against the resistant strains.

Preventing drug resistance is essential for successful TB treatment and to avoid the need for more complex and less effective medications if resistance develops.

Choice B Reason:

"Taking several antituberculotic medications will protect your liver from toxic effects." This statement is incorrect. While it's true that some antituberculotic medications can have hepatotoxic effects (adverse effects on the liver), the primary reason for using multiple medications in TB treatment isn't solely to protect the liver. The main goal of using multiple medications is to prevent the development of drug-resistant strains of TB bacteria. Protecting the liver is an important consideration in medication selection and monitoring but isn't the primary rationale for multiple medications.

Choice C Reason:

"People who have a severe form of TB need several antituberculotic medications, but those who have less severe TB need just one medication." This statement is incorrect. The severity of TB doesn't determine the number of medications required. The standard treatment approach for TB involves multiple medications, regardless of the severity. This approach aims to prevent the development of drug resistance, ensure effective treatment, and reduce the risk of treatment failure. Using a combination of medications is a fundamental strategy to combat TB effectively.

Choice D Reason:

"Adverse effects occur more often and are more severe when you take only one antituberculotic medication." This statement is incorrect. While it's true that adverse effects can occur with antituberculotic medications, the primary reason for using multiple medications isn't solely to reduce adverse effects. The main concern addressed by using multiple drugs is preventing the development of drug-resistant TB strains. Using a combination of medications reduces the likelihood of resistance developing and increases the effectiveness of treatment, rather than solely minimizing adverse effects.

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Correct Answer is C

Explanation

Choice A Reason:

Discarding soiled wound care supplies in a trash receptacle outside the client's room is generally a good practice for infection control. However, this action alone might not be sufficient for managing an infectious wound. Proper disposal is essential, but placing the client in isolation is more critical to prevent the spread of infection.

Choice B Reason:

Administering antibiotic therapy before culturing the wound might interfere with accurate culture results. It's generally preferred to obtain wound cultures before starting antibiotic therapy to identify the specific pathogens causing the infection and determine the most effective treatment.

Choice C Reason:

Placing the client in a private room with a private bathroom is correct. Isolating the client in a private room with a private bathroom helps minimize the spread of potential pathogens present in the wound drainage. This measure helps contain the infection and prevents exposure to others.

Choice D Reason:

Instructing visitors to perform hand hygiene for only 5 seconds after leaving the client's room isn't thorough enough for proper infection control. Proper hand hygiene typically involves washing hands with soap and water or using alcohol-based hand sanitizer for at least 20 seconds to effectively reduce the spread of infection.

A. Isopropyl alcohol B. Bleach C. Hydrogen peroxide D. Chlorhexidine

Correct Answer is B

Explanation

Choice A Reason:
Isopropyl alcohol is the appropriate cleaning agent. While alcohol can be used as a disinfectant for some purposes, it might not be as effective as bleach against bloodborne pathogens like HIV. Bleach is generally recommended for disinfection in this context.
Choice B Reason:
Bleach is recommendable. Bleach is effective in disinfecting surfaces contaminated with bloodborne pathogens, including HIV. It's recommended for cleaning and disinfecting areas contaminated with blood as it can effectively kill many pathogens, including viruses like HIV. The standard recommendation is to create a solution of bleach and water to clean surfaces contaminated with blood.
Choice C Reason:
Hydrogen peroxide is not recommendable. Hydrogen peroxide has some disinfectant properties, but bleach is more effective against bloodborne pathogens like HIV when used to clean contaminated surfaces.
Choice D Reason:
Chlorhexidine is not appropriate. Chlorhexidine is an antiseptic commonly used for skin disinfection before procedures. While it's effective for certain purposes, it's not typically recommended for disinfecting surfaces contaminated with bloodborne pathogens like HIV. Bleach is the preferred agent in such cases.

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A nurse is caring for a client who has a new diagnosis of tuberculosis (TB). The client asks the nurse why she needs to take four different antituberculotic medications. Which of the following replies should the nurse make?

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