A nurse is reinforcing discharge teaching with a client who has tuberculosis. Which of the following statements by the client indicates an understanding of the teaching?

"My family will need to wear a mask when around me at home."

"I will need to take medication for this condition for the rest of my life."

"I should throw away my used tissues in a closed plastic bag."

"I will no longer be infectious after 30 days of treatment."

Answer and Explanation

The Correct Answer is C

A. Wearing a mask by family members is not typically necessary at home once the client is on effective treatment for tuberculosis and the infectious period has passed. The client should avoid public places and limit contact with vulnerable individuals, but family members do not need to wear masks at home after the initial treatment phase.

B. Long-term medication is required for tuberculosis, but not for the rest of the client’s life. Treatment usually lasts for 6-9 months, not a lifetime. Adherence to the medication regimen is crucial to prevent relapse or resistance.

C. Throwing away used tissues in a closed plastic bag is correct. This is a key infection control measure to prevent the spread of tuberculosis through respiratory droplets. Used tissues should be discarded in a closed, lined container, and the client should practice good hygiene.

D. No longer infectious after 30 days of treatment is incorrect. A client with tuberculosis may remain infectious until they have completed several weeks of treatment and show improvement. Typically, a negative sputum culture is used to confirm the client is no longer infectious.

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Correct Answer is C

Explanation

A. The client's heart rate has increased to 110/min is incorrect. While an increased heart rate can indicate pain, it can also be caused by other factors such as anxiety, dehydration, or fever. Heart rate alone is not the most specific or reliable indicator for the need for analgesia.

B. The client grimaces when changing positions is a possible sign of discomfort, but the level of pain cannot be accurately assessed from facial expressions alone. This may suggest mild to moderate pain but does not provide a clear numerical indication of the client's pain level.

C. The client reports pain as 7 on a scale of 0 to 10 is correct. The pain scale is a more direct and reliable measure of the client's pain experience. A rating of 7 indicates moderate to severe pain, which justifies the need for analgesic intervention.

D. The client demonstrates a decreased attention span could be related to pain or discomfort, but it may also result from other causes, such as fatigue, emotional stress, or medication side effects. This is not as definitive as a self-reported pain level.

A. A nurse discusses a client's postoperative complications during shift report. B. A facility risk manager includes information from a client's medical record in a when report. C. A nurse tells the chaplain that a client has a new diagnosis of cancer. D. A social worker reads a client's chart as a follow-up to a requested consultation.

Correct Answer is C

Explanation

A. "A nurse discusses a client's postoperative complications during shift report.": This is not a breach of confidentiality if the information is shared within the context of a healthcare team for the purpose of providing care. Confidentiality is maintained as long as the information is shared appropriately.

B. "A facility risk manager includes information from a client's medical record in a when report.": This is also not necessarily a breach of confidentiality if the report is used for quality improvement, risk management, or other institutional purposes where confidentiality protocols are followed.

C. "A nurse tells the chaplain that a client has a new diagnosis of cancer.": This is a breach of confidentiality. Information should only be shared with others involved in the patient's care or if the patient has given explicit consent. Discussing a client's diagnosis with a chaplain or anyone not directly involved in the care plan is an unauthorized disclosure.

D. "A social worker reads a client's chart as a follow-up to a requested consultation.": This is not a breach of confidentiality if the social worker is following established protocols for patient care and is authorized to access the client's medical records for consultation purposes.

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A nurse is reinforcing discharge teaching with a client who has tuberculosis. Which of the following statements by the client indicates an understanding of the teaching?

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