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A client's PPD test is positive, and a chest x-ray is negative. What is the best interpretation of these data?
- A. The client's resistance to tuberculosis is low.
- B. The client has been exposed to the organism but has not developed the disease.
- C. The client has tuberculosis, but it is not serious.
- D. The client has active tuberculosis.
Correct Answer: B
Rationale: A positive PPD with a negative chest x-ray indicates exposure to tuberculosis without active disease.
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Which is the best response from the nurse?
- A. Tell me more about how you are feeling.
- B. There are lots of things you can still do.
- C. You are just having a bad day today.
- D. What makes you say that?
Correct Answer: A
Rationale: Encouraging the client to express feelings fosters therapeutic communication and helps address emotional concerns related to COPD.
Which statement made by the client diagnosed with chronic bronchitis indicates to the nurse more teaching is required?
- A. I should contact my health-care provider if my sputum changes color or amount.
- B. I will take my bronchodilator regularly to prevent having bronchospasms.
- C. This metered-dose inhaler gives a precise amount of medication with each dose.
- D. I need to return to the HCP to have my blood drawn with my annual physical.
Correct Answer: D
Rationale: Blood draws (D) are not routine for bronchitis, indicating misunderstanding. Sputum changes (A), bronchodilator use (B), and inhaler accuracy (C) reflect correct understanding.
The nurse is preparing to administer medications to the following clients. Which medication should the nurse question administering?
- A. The oral coagulant warfarin (Coumadin) to the client with an INR of 1.9.
- B. Multiple Choice insulin to a client with a blood glucose level of 218 mg/dL.
- C. Hang the heparin bag on a client with a PT/PTT of 12.9/98.
- D. A calcium channel blocker to the client with a BP of 112/82.
Correct Answer: C
Rationale: PTT 98 (C) is supratherapeutic for heparin, risking bleeding, so question administration. INR 1.9 (A) is subtherapeutic, insulin (B) is appropriate, and CCB (D) is reasonable.
After the bronchoscopy, what should the nurse closely monitor?
- A. The client's level of consciousness
- B. The client's oral status
- C. The client's respiratory effort
- D. The client's ability to speak
Correct Answer: C
Rationale: Monitoring respiratory effort is critical post-bronchoscopy to detect complications like airway obstruction or pneumothorax.
Which intervention should the nurse implement for a male client who has had a left-sided chest tube for six (6) hours and who refuses to take deep breaths because of the pain?
- A. Medicate the client and have the client take deep breaths.
- B. Encourage the client to take shallow breaths to help with the pain.
- C. Explain deep breaths do not have to be taken at this time.
- D. Tell the client if he doesn't take deep breaths, he could die.
Correct Answer: A
Rationale: Pain medication followed by deep breathing (A) prevents atelectasis. Shallow breaths (B), delaying (C), and fear tactics (D) are inappropriate.