Nokea
A client in the emergency department is taking rifampin (Rifadin) for tuberculosis. The client reports yellowing of the sclera and skin and bleeding after minor trauma. What laboratory results correlate to this condition? (Select all that apply.)
- A. Blood urea nitrogen (BUN): 19 mg/dL.
- B. International normalized ratio (INR): 6.3.
- C. Prothrombin time: 35 seconds.
- D. Serum sodium: 120 mEq/L.
- E. White blood cell (WBC) count: 72,000/mm³.
Correct Answer: B,C
Rationale: Rifampin can cause liver damage, evidenced by the client's high INR and prothrombin time, which indicate coagulopathy due to liver dysfunction. The BUN, WBC count, and sodium levels are not directly related to this condition.
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A nurse is providing pneumonia vaccinations in a community setting. Due to limited finances, the event organizers must limit giving the vaccination to priority groups. What clients would be considered a priority? (Select all that apply.)
- A. 22-year-old client with asthma.
- B. Client who had a cholecystectomy last year.
- C. Client with well-controlled diabetes.
- D. Healthy 72-year-old client.
- E. Client who is taking medication for hypertension.
Correct Answer: A,C,D,E
Rationale: Clients over 65 years of age and any client with a chronic health condition (e.g., asthma, diabetes, hypertension) are considered a priority for a pneumonia vaccination. A cholecystectomy does not qualify as a chronic health condition.
A client is being discharged on long-term therapy for tuberculosis (TB). What referral by the nurse is most appropriate?
- A. Community social worker for Meals on Wheels.
- B. Occupational therapy for job retraining.
- C. Physical therapy for homebound therapy.
- D. Visiting Nurses for directly observed therapy.
Correct Answer: D
Rationale: Directly observed therapy is often utilized for managing clients with TB in the community to ensure adherence to the treatment regimen, which is critical for successful treatment.
A nurse working in a geriatric clinic sees clients with cold symptoms and rhinitis. Which drug would be appropriate to teach these clients to take for their symptoms?
- A. Chlorphenamine (Chlor-Trimeton)
- B. Diphenhydramine (Benadryl)
- C. Fexofenadine (Allegra)
- D. Hydroxyzine (Vistaril)
Correct Answer: C
Rationale: First-generation antihistamines are not appropriate for use in the older population. These drugs include chlorphenamine, diphenhydramine, and hydroxyzine. Fexofenadine is a second-generation antihistamine, which is safer and more suitable for older adults.
A client has been hospitalized with tuberculosis (TB). The client's spouse is fearful of entering the room where the client is in isolation and refuses to visit. What action by the nurse is best?
- A. Ask the spouse to explain the fear of visiting in further detail.
- B. Inform the spouse the precautions are meant to keep other clients safe.
- C. Show the spouse how to follow the isolation precautions to avoid illness.
- D. Tell the spouse that he or she has already been exposed, so it's safe to visit.
Correct Answer: A
Rationale: The nurse needs to obtain further information about the spouse's specific fears so they can be addressed. This will decrease stress and permit visitation, which will be beneficial for both client and spouse.
Which teaching point is most important for the client with bacterial pharyngitis?
- A. Gargle with warm salt water.
- B. Take all antibiotics as directed.
- C. Use a humidifier in the bedroom.
- D. Wash hands frequently.
Correct Answer: B
Rationale: Any client on antibiotics must be instructed to complete the entire course of antibiotics. Not completing them can lead to complications or drug-resistant strains of bacteria. This is the most critical teaching point to prevent treatment failure.