Nokea
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.
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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.
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.
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 has educated a client on isoniazid (INH). What statement by the client indicates teaching has been effective?
- A. I need to take extra vitamin C while on INH.
- B. I should take this medicine with milk or juice.
- C. I should take this medication on an empty stomach.
- D. My contact lenses will be permanently stained.
Correct Answer: C
Rationale: INH needs to be taken on an empty stomach, either 1 hour before or 2 hours after meals. This statement indicates the client understands the correct administration of the medication.
A client has been diagnosed with an empyema. What interventions should the nurse anticipate providing to this client? (Select all that apply.)
- A. Assisting with chest tube insertion.
- B. Facilitating pleural fluid sampling.
- C. Performing frequent respiratory assessment.
- D. Providing antibiotics as needed.
- E. Suctioning deeply every 4 hours.
Correct Answer: A,B,C,D
Rationale: The client with an empyema is often treated with chest tube insertion, which facilitates obtaining samples of the pleural fluid for analysis and expands the lungs. The nurse should perform frequent respiratory assessments and provide antibiotics as needed. Suctioning is not routinely done deeply to prevent tissue injury.