Nokea
An adult is being treated with isoniazid (INH) and streptomycin for active tuberculosis. He is also receiving pyridoxine (vitamin B6). Why is this medication prescribed for him?
- A. Pyridoxine is bacteriostatic against Mycobacterium tuberculosis.
- B. To enhance his general nutritional status
- C. To prevent side effects of INH
- D. Pyridoxine acts to increase the effects of streptomycin.
Correct Answer: C
Rationale: Pyridoxine is prescribed to prevent INH-induced peripheral neuritis by supporting nerve function.
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An adult has a chest drainage system. Several hours after the chest tube was inserted, the nurse observes that there is no bubbling in the water seal chamber. What is the most likely reason for the absence of bubbling?
- A. The client's lungs have reexpanded.
- B. There is an obstruction in the tubing coming from the client.
- C. There is a mechanical problem in the pump.
- D. Air is leaking into the drainage apparatus.
Correct Answer: A
Rationale: No bubbling in the water seal chamber typically indicates lung reexpansion, as air is no longer leaking from the lung into the pleural space.
The nurse is writing a care plan for a client newly diagnosed with cancer of the larynx. Which problem is the highest priority?
- A. Wound infection.
- B. Hemorrhage.
- C. Respiratory distress.
- D. Knowledge deficit.
Correct Answer: C
Rationale: Respiratory distress (C) is life-threatening post-laryngectomy, a priority. Infection (A), hemorrhage (B), and knowledge deficit (D) are secondary.
The nurse is assessing the client diagnosed with COPD. Which data require immediate intervention by the nurse?
- A. Large amounts of thick white sputum.
- B. Oxygen flowmeter set on eight (8) liters.
- C. Use of accessory muscles during inspiration.
- D. Presence of a barrel chest and dyspnea.
Correct Answer: B
Rationale: High oxygen (8 LPM, B) risks CO2 retention in COPD, requiring immediate adjustment (2–4 LPM). Sputum (A), accessory muscles (C), and barrel chest (D) are expected but less urgent.
Which option below is considered a positive Homan's Sign for the assessment of a deep vein thrombosis (DVT)?
- A. The patient reports pain when the foot is manually dorsiflexed.
- B. The patient reports pain when the foot is manually plantarflexed.
- C. The patient experiences pain when the leg is extended.
- D. the patient experiences pain when the leg is flexed.
Correct Answer: A
Rationale: Homan's Sign is NOT reliable because of false positives, but know for exams how to elicit a response. It done by manually (forced) dorsiflexing the patient's foot (bending it up towards the shin) and if it causes the patient pain it considered a positive Homan's Sign. However, the MD must further investigate if the patient has a DVT.
Which datum requires immediate intervention by the nurse for the client diagnosed with asbestosis?
- A. The client develops an S3 heart sound.
- B. The client has clubbing of the fingers.
- C. The client is fatigued in the afternoon.
- D. The client has basilar crackles in all lobes.
Correct Answer: A
Rationale: An S3 heart sound (A) indicates heart failure, a serious complication in asbestosis due to pulmonary hypertension, requiring immediate intervention. Clubbing (B) is a chronic finding, not acute. Fatigue (C) is common but not urgent. Basilar crackles (D) are expected in asbestosis and less critical than cardiac issues.