A client with tuberculosis is starting medication therapy with isoniazid, rifampin, and pyrazinamide. Which of the following instructions should the nurse include?
- A. Take isoniazid with an antacid.
- B. Provide a sputum specimen every 2 weeks to the clinic for testing.
- C. Expect your sputum cultures to be negative after 6 months of therapy.
- D. Drink at least 8 ounces of water when you take the pyrazinamide tablet.
Correct Answer: D
Rationale: Rationale:
Taking pyrazinamide on an empty stomach can cause stomach upset. Drinking water helps prevent this.
A: Isoniazid should be taken on an empty stomach, not with an antacid.
B: Sputum specimens are usually collected at the beginning of treatment, not every 2 weeks.
C: Negative sputum cultures might not be achieved until later in treatment, not after 6 months.
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Expected age-related changes of the pulmonary system include:
- A. Significant airway obstruction
- B. Shortness of breath
- C. Development of emphysema
- D. A modest,gradual decline in pulmonary function
Correct Answer: D
Rationale: While lung capacity decreases with age, it typically results in a gradual decline rather than significant obstruction or diseases like emphysema unless other factors (e.g., smoking) are present.
What would be the best response by the nurse to a quiet and uncommunicative client?
- A. Think over the following questions.
- B. Discuss them with your instructor or peers.
- C. Acknowledge their feelings and encourage expression.
- D. Offer silence and wait patiently.
Correct Answer: D
Rationale: Silence can provide the client with space to open up when they feel ready, fostering trust and rapport.
To do an effective breast self-examination, when should the woman examine her breasts?
- A. During the fourth to the seventh menstrual cycle day
- B. Every other month
- C. While standing up
- D. 1 week before the menstrual cycle
Correct Answer: A
Rationale: The correct answer is A: During the fourth to the seventh menstrual cycle day. This is because breasts are least likely to be swollen or tender during this time, allowing for a more accurate examination. Choice B is incorrect as regular monthly examinations are recommended. Choice C can be done while standing up or lying down. Choice D is incorrect as breasts may be more tender and swollen closer to the menstrual cycle, making it harder to detect abnormalities.
A patient with a breast biopsy positive for cancer tells the nurse that she has been using information from the Internet to try to make a decision about her treatment choices. In counseling the patient, the nurse knows that (select all that apply)
- A. the patient should be taught how to identify reliable and accurate information available online.
- B. all sites used by the patient should be evaluated by the nurse for accuracy and appropriateness of the information.
- C. most information from the Internet is incomplete and inaccurate and should not be used to make important decisions regarding treatment.
- D. the Internet is an excellent source of health information, and online education programs can provide patients with better instruction than is available at clinics.
Correct Answer: A
Rationale: The correct answers are 'the patient should be taught how to identify reliable and accurate information available online' and 'the patient should be encouraged to use sites established by universities, the government, or reputable health organizations, such as the American Cancer Society, to access reliable information.' These options promote the use of credible sources while discouraging reliance on potentially unreliable information.
While caring for a client receiving positive-pressure mechanical ventilation, which intervention should the nurse NOT implement to prevent complications?
- A. Elevate the head of the bed to at least 30°.
- B. Verify the prescribed ventilator settings daily.
- C. Administer pantoprazole as prescribed.
- D. Reposition the endotracheal tube to the opposite side of the mouth daily.
Correct Answer: D
Rationale: The correct answer is D. Repositioning the endotracheal tube to the opposite side of the mouth daily is not necessary and could potentially lead to complications such as accidental extubation or damage to the airway. A: Elevating the head of the bed helps prevent aspiration. B: Verifying ventilator settings daily ensures proper functioning. C: Administering pantoprazole helps prevent stress ulcers. In summary, D is incorrect because it is unnecessary and poses risks, while A, B, and C are important interventions to prevent complications associated with positive-pressure mechanical ventilation.