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A nurse is caring for a client who has a history of exposure to TB and symptoms of night sweats and hemoptysis. Which of the following tests should the nurse realize is the most reliable to confirm the diagnosis of active pulmonary TB?
- A. Bronchoscopy
- B. Chest X-ray
- C. TB skin test (Mantoux test)
- D. Sputum culture for acid-fast bacillus
Correct Answer: D
Rationale: The correct answer is D: Sputum culture for acid-fast bacillus. This test is the most reliable for confirming active pulmonary TB because it directly detects the presence of the Mycobacterium tuberculosis bacteria in the sputum sample. Bronchoscopy (A) may help visualize the airways but does not definitively confirm TB. Chest X-ray (B) can show characteristic findings suggestive of TB but cannot confirm the diagnosis. TB skin test (C) indicates exposure but not active disease. Sputum culture is the gold standard for diagnosing TB, as it allows for definitive identification of the bacteria.
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A nurse is preparing dietary instructions for a client who has episodes of biliary colic from chronic cholecystitis. Which of the following instructions should the nurse include in the teaching plan?
- A. Avoid foods high in fat.
- B. Avoid foods high in carbohydrates.
- C. Eat a high-protein, low-fat diet.
- D. Increase intake of high-fat foods.
Correct Answer: A
Rationale: The correct answer is A: Avoid foods high in fat. Biliary colic is caused by gallstones, and high-fat foods can trigger gallbladder contractions leading to pain. Therefore, advising the client to avoid foods high in fat can help prevent biliary colic episodes. Choice B is incorrect as carbohydrates do not directly affect biliary colic. Choice C is incorrect because while a high-protein, low-fat diet may be beneficial for some conditions, it is not specifically recommended for biliary colic. Choice D is incorrect as increasing intake of high-fat foods can worsen symptoms.
The nurse is caring for a client who has heart failure and a history of asthma. The nurse reviews the provider's orders and recognizes that clarification is needed for which of the following medications?
- A. Furosemide
- B. Carvedilol
- C. Spironolactone
- D. Lisinopril
Correct Answer: B
Rationale: The correct answer is B: Carvedilol. Carvedilol is a beta-blocker, which can exacerbate asthma symptoms in clients with a history of asthma due to its potential bronchoconstrictive effects. Furosemide (A), Spironolactone (C), and Lisinopril (D) are commonly used in heart failure management and do not pose a significant risk for clients with asthma. It is crucial to avoid medications that can worsen respiratory function in clients with a history of asthma to prevent complications.
A nurse is assessing a client who is 1 day postoperative following a lobectomy and has a chest tube drainage system in place. Which of the following findings by the nurse indicates a need for intervention?
- A. Clear breath sounds on the affected side
- B. Reduction in drainage output
- C. Development of subcutaneous emphysema
- D. Minimal pain at the surgical site
Correct Answer: C
Rationale: Subcutaneous emphysema, where air gets trapped under the skin, may indicate an underlying pneumothorax and should be reported to the provider.
A nurse teaches a client about cervical polyps. What is an expected symptom?
- A. Pelvic pain
- B. Heavy menstrual bleeding
- C. Postcoital bleeding
- D. Urinary incontinence
Correct Answer: C
Rationale: The correct answer is C: Postcoital bleeding. Cervical polyps are benign growths on the cervix that can cause postcoital bleeding due to contact with the polyp during intercourse. Pelvic pain, heavy menstrual bleeding, and urinary incontinence are not typical symptoms of cervical polyps. Pelvic pain may occur in other conditions like endometriosis. Heavy menstrual bleeding can be a symptom of fibroids or hormonal imbalances. Urinary incontinence is more commonly associated with pelvic floor disorders or urinary tract infections. Postcoital bleeding specifically points to cervical polyps as the likely cause.
A nurse is instructing a client how to decrease the nausea associated with chemotherapy and radiation. Which of the following statements indicates an understanding of the teaching?
- A. I will eat food that are served at room temperature.
- B. I will avoid drinking liquids with meals.
- C. I will eat spicy foods to improve appetite.
- D. I will drink hot liquids to settle my stomach.
Correct Answer: A
Rationale: The correct answer is A: "I will eat food that are served at room temperature." This is correct because consuming foods at room temperature helps reduce nausea associated with chemotherapy and radiation. Cold foods can worsen nausea, while hot foods can trigger vomiting. Avoiding extreme temperatures can help alleviate nausea.
Choice B is incorrect because avoiding liquids with meals can lead to dehydration and worsen nausea. Choice C is incorrect because spicy foods can exacerbate nausea rather than improve appetite. Choice D is incorrect because drinking hot liquids can aggravate nausea.