Nokea
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.
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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.
A client is in the family medicine clinic reporting a dry, sore throat. The provider asks the nurse to assess for odynophagia. What assessment technique is most appropriate?
- A. Ask the client what foods cause trouble swallowing.
- B. Observe the client's throat for redness.
- C. Perform a throat culture immediately.
- D. Check the client's temperature.
Correct Answer: A
Rationale: Odynophagia refers to painful swallowing. Asking the client what foods cause trouble swallowing is the most direct way to assess for this condition.
A client seen in the emergency department reports fever, fatigue, and dry cough but no other upper respiratory symptoms. A chest x-ray reveals mediastinal widening. What action by the nurse is best?
- A. Collect a sputum sample for culture by deep suctioning.
- B. Instruct the client that antibiotics will be needed for 60 days.
- C. Place the client on Airborne Precautions immediately.
- D. Tell the client that directly observed therapy is needed.
Correct Answer: B
Rationale: This client has manifestations of early inhalation anthrax. For treatment, after IV antibiotics are finished, oral antibiotics are continued for at least 60 days, making this the best action.
A client has been admitted for suspected inhalation anthrax infection. What question by the nurse is most important?
- A. Are any family members also ill?
- B. Have you traveled recently?
- C. How long have you been ill?
- D. What is your occupation?
Correct Answer: D
Rationale: Inhalation anthrax is rare and is an occupational hazard among people who work with animal wool, bone meal, hides, and such, such as tanners and veterinarians. Inhalation anthrax in someone without an occupational risk is considered a bioterrorism event and must be reported to authorities immediately.
A client has the diagnosis of valley fever accompanied by myalgias and arthralgias. What treatment should the nurse educate the client on?
- A. Intravenous amphotericin B.
- B. Long-term anti-inflammatories.
- C. No specific treatment.
- D. Oral fluconazole (Diflucan).
Correct Answer: D
Rationale: Valley fever, or coccidioidomycosis, is a fungal infection. The presence of joint and muscle pain indicates a moderate infection that needs treatment with antifungal medications like oral fluconazole.