A nurse is teaching a client who has tuberculosis and is to start medication therapy with isoniazid, rifampin, and pyrazinamide. Which of the following instructions should the nurse include?
"Expect your sputum cultures to be negative after 6 months of therapy."
"Drink at least 8 ounces of water when you take the pyrazinamide tablet."
"Provide a sputum specimen every 2 weeks to the clinic for testing."
"Take isoniazid with an antacid."
The Correct Answer is B
Answer: B
Rationale:
A) "Expect your sputum cultures to be negative after 6 months of therapy":
While sputum cultures may become negative after a period of effective therapy, it is not always guaranteed to happen within exactly 6 months. Tuberculosis (TB) treatment usually involves several months of medication, and sputum cultures are monitored periodically to assess treatment efficacy, not solely at the 6-month mark.
B) "Drink at least 8 ounces of water when you take the pyrazinamide tablet":
Drinking plenty of water with pyrazinamide is important to prevent dehydration and to help minimize potential side effects, such as hyperuricemia or gout. Adequate hydration can also aid in the effective elimination of the medication from the body, thus reducing the risk of adverse effects.
C) "Provide a sputum specimen every 2 weeks to the clinic for testing":
Sputum specimens are typically provided less frequently than every 2 weeks, usually monthly, to monitor the progress of TB treatment. Testing frequency may vary depending on the client's condition and the healthcare provider's recommendations.
D) "Take isoniazid with an antacid":
Isoniazid should not be taken with antacids, as antacids can interfere with the absorption of isoniazid. It is usually advised to take isoniazid on an empty stomach, and clients should be instructed to wait at least 1 hour after taking isoniazid before consuming antacids.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Increasing fluid intake helps to hydrate the mucous membranes and thin the respiratory secretions, which facilitates expectoration and improves gas exchange.
- Encourage coughing and deep breathing. This is beneficial for clearing the airways and preventing atelectasis, but it does not directly affect the viscosity of the secretions.
- Encourage regular use of the incentive spirometer. This is helpful for expanding the lungs and preventing complications such as pneumonia or pleural effusion, but it does not influence the consistency of the secretions.
- Encourage the client to ambulate frequently. This is important for promoting circulation and mobility, but it does not have a significant effect on the thinning of the secretions.
Correct Answer is ["A","D"]
Explanation
These responses are correct and explain how albuterol helps the client's breathing. Albuterol is a short- acting beta2-agonist that causes bronchodilation and relieves bronchospasm, which are the main causes of wheezing and dyspnea in clients who have asthma or COPD. By opening the airways, albuterol improves gas exchange and oxygenation.
b) The medication will decrease coughing episodes. This response is incorrect and does not explain how albuterol helps the client's breathing. Albuterol does not have a direct effect on coughing, which is a reflex response to irritation or obstruction of the airways. Coughing may be beneficial for clearing secretions and mucus from the lungs, but it may also cause bronchoconstriction and inflammation. The nurse should advise the client to use other measures to decrease coughing, such as drinking fluids, using a humidifier, or taking an expectorant.
c) The medication will reduce inflammation. This response is incorrect and does not explain how albuterol helps the client's breathing. Albuterol does not have an anti-inflammatory effect on the airways, which are often inflamed and swollen in clients who have asthma or COPD. Inflammation can contribute to airway obstruction and mucus production, which impair gas exchange and oxygenation. The nurse should inform the client that albuterol is used for quick relief of acute symptoms, but not for long-term control or prevention of inflammation. The client may need to use another medication, such as an inhaled corticosteroid, to reduce inflammation.
e) The medication will stimulate flow of mucus. This response is incorrect and does not explain how albuterol helps the client's breathing. Albuterol does not have a direct effect on mucus production or clearance, which are often increased in clients who have asthma or COPD. Mucus can cause airway obstruction and infection, which impair gas exchange and oxygenation. The nurse should advise the client to use other measures to stimulate flow of mucus, such as drinking fluids, using a humidifier, or taking an expectorant.
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