Nokea
A patient receiving medical treatment for an active tuberculosis infection asks when she can starting going out in public again. You respond that she is no longer contagious when:
- A. She has 3 negative sputum cultures
- B. Her signs and symptoms improve
- C. She has completed the full medication regime
- D. Her chest x-ray is normal
- E. She has been on tuberculosis medications for about 3 weeks
Correct Answer: A,B,E
Rationale: These are all criteria for when a patient with active TB can return to public life (school, work, running errands). Until then they are still contagious and must stay home in isolation.
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You're educating a patient how to use a peak flow meter to help monitor the status of their asthma. Which statement by the patient demonstrates they understand how to use the device?
- A. This device will help keep my lungs strong so I don't have another asthma attack.
- B. I will inhale as hard as I can while using the device.
- C. I will use this device at the same time, either in the morning or before bedtime, and compare the readings with my personal best reading.
- D. I will notify the doctor if my peak flow rating is 90% or more than my personal best peak flow.
Correct Answer: C
Rationale: Correct use involves measuring peak flow at consistent times and comparing to personal best to monitor asthma control. Inhaling is incorrect, and a high reading is not a concern.
You are providing care to a patient with COPD who is receiving medical treatment for exacerbation. The patient has a history of diabetes, hypertension, and hyperlipidemia. The patient is experiencing extreme hyperglycemia and bruising. Which medication ordered for this patient can cause hyperglycemia and bruising?
- A. Prednisone
- B. Atrovent
- C. Flagyl
- D. Levaquin
Correct Answer: A
Rationale: Prednisone , a corticosteroid, commonly causes hyperglycemia and easy bruising as side effects. Atrovent , Flagyl , and Levaquin are not typically associated with these effects.
The nurse is preparing the plan of care for the client who had a pleurodesis. Which collaborative intervention should the nurse include?
- A. Monitor the amount and color of drainage from the chest tube.
- B. Perform a complete respiratory assessment every two (2) hours.
- C. Administer morphine sulfate, an opioid analgesic, intravenously.
- D. Keep a sterile dressing and bottle of sterile normal saline at the bedside.
Correct Answer: A
Rationale: Pleurodesis involves sclerosing the pleural space to prevent fluid reaccumulation, often requiring a chest tube. Monitoring drainage amount and color (A) is a collaborative intervention to assess procedure success and detect complications. Respiratory assessment (B) and morphine administration (C) are nursing or medical orders, not collaborative. Keeping sterile supplies (D) is preparatory, not a primary intervention.
A client comes to the clinic with a bloody nose. Which instruction is most appropriate?
- A. Sit up with your head tilted forward. Grasp the soft part of your nose firmly between your thumb and forefinger.'
- B. Lay down and tilt your head backward. Grasp the end of your nose between your fingers.'
- C. Sit up and lean backwards. Put pressure on the side of your nose with your hand.'
- D. Lie down with your head lower than your feet. Grasp as much of your nose as possible between your fingers.'
Correct Answer: A
Rationale: Sitting with the head tilted forward and grasping the soft part of the nose prevents aspiration of blood and effectively stops bleeding.
Which assessment data indicate to the nurse the chest tubes inserted three (3) days ago have been effective in treating the client with a hemothorax?
- A. Gentle bubbling in the suction compartment.
- B. No fluctuation (tidaling) in the water-seal compartment.
- C. The drainage compartment has 250 mL of blood.
- D. The client is able to deep breathe without any pain.
Correct Answer: B
Rationale: No tidaling (B) indicates lung re-expansion, showing effective hemothorax treatment. Bubbling (A) suggests air leak, drainage (C) is expected, and pain-free breathing (D) is secondary.