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 D

Explanation

Choice A Reason:

Bilirubin 1.0 mg/dL (0.3 to 1.0 mg/dL) is incorrect. Bilirubin levels within the normal range typically indicate normal liver function. The value of 1.0 mg/dL falls within the expected range, so it doesn't raise immediate concerns regarding the need for a liver biopsy.

Choice B Reason:

Aspartate aminotransferase 34 units/L (0 to 34 units/L) is incorrect. Aspartate aminotransferase (AST) is an enzyme found in various tissues, including the liver, heart, muscles, and red blood cells. While a value of 34 units/L is at the upper limit of the normal range, it's still within the expected range and doesn't typically prompt immediate concern for the need for a biopsy.

Choice C Reason:

Ammonia 55 mcg/dL (10 to 80 mcg/dL ) is incorrect. Ammonia levels can rise in cases of liver dysfunction. The level of 55 mcg/dL falls within the reference range, indicating normal or near-normal ammonia levels, which doesn't usually necessitate an urgent liver biopsy.

Choice D Reason:

Platelets 60,000/mm3 (150,000 to 400,000/mm3) is correct. Platelets are crucial for blood clotting. A significantly low platelet count, such as 60,000/mm3, termed thrombocytopenia, can indicate compromised clotting ability, which might pose a risk of bleeding during or after a liver biopsy. In the context of a liver biopsy, a low platelet count warrants attention and consideration before proceeding with the procedure to prevent excessive bleeding or complications.

A. Elevate the head of the client's bed for 1 hr. after the feeding. B. Administer the feeding solution at a cold temperature. C. Rotate the jejunostomy tube once per day. D. Flush the tube with 90 ml of sterile water before and after the feeding.

Correct Answer is A

Explanation

Choice A Reason:

Elevate the head of the client's bed for 1 hr. after the feeding is appropriate. This action helps minimize the risk of aspiration. Elevating the head of the bed (typically at least 30 to 45 degrees) can reduce the chance of reflux and aspiration of the feeding solution into the lungs. This position should ideally be maintained for about 1 hour after the feeding to aid digestion and reduce the risk of complications.

Choice B Reason:

Administering the feeding solution at a cold temperature is inappropriate. Feeding solutions are generally administered at room temperature or slightly warmed to prevent discomfort and minimize the risk of altering the client's core body temperature. Cold temperatures can cause discomfort or cramping and might affect the absorption of the nutrients. Therefore, administering the feeding solution at a cold temperature is not recommended.

Choice C Reason:

Rotating the jejunostomy tube once per day is inappropriate. Rotating the jejunostomy tube is not typically part of routine care. Tube rotation can cause discomfort, irritation, and potential injury to the gastrointestinal tract. Tubes should be secured properly to prevent movement but not rotated unless specifically instructed by a healthcare provider for a particular reason, such as checking for proper tube placement.

Choice D Reason:

Flushing the tube with 90 ml of sterile water before and after the feeding is inappropriate.

Flushing the tube with sterile water before and after the feeding helps ensure the patency of the tube and prevents clogging. It's a standard procedure to clear the tube and maintain its function.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reviewing the laboratory data of a client who is scheduled for a liver biopsy. Which of the following values should the nurse report to the provider?

Correct Answer is D

Explanation

A nurse is caring for a client who is receiving intermittent bolus enteral feedings through a jejunostomy tube. Which of the following actions should the nurse take?

Correct Answer is A

Explanation

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