Nokea
The home care nurse is instructing a client recently diagnosed with tuberculosis.
- A. What is the most important instruction for a client with tuberculosis?
- B. During the first two weeks of treatment, the client should cover his mouth and nose when he coughs or sneezes.
- C. It is necessary for the client to wear a mask at all times to prevent transmission of the disease.
- D. The family should support the client to help reduce feeling of low self-esteem and isolation.
- E. The client will be required to take prescribed medication for a duration of 6-9 months.
Correct Answer: D
Rationale: Adherence to a 6-9 month medication regimen is critical to cure tuberculosis and prevent drug resistance. While respiratory precautions, family support, and masks are important, long-term medication compliance is the most essential for treatment success.
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A client with a necrotizing spider bite is to perform his own dressing changes at home.
The nurse is aware that which of the following statements, if made by the client, indicates a correct understanding of aseptic technique?
- A. I need to buy sterile gloves to redress this wound.'
- B. I should wash my hands before redressing my wound.'
- C. I should keep the wound covered at all times.'
- D. I should use an over-the-counter antimicrobial ointment.'
Correct Answer: B
Rationale: Strategy: Answers are implementations. Determine the outcome of each answer choice. Is it desired? (1) not most important (2) correct-indicates understanding of asepsis, whose hallmark is handwashing (3) is not possible to carry out (4) should use only the prescribed medications on the wound
The nurse is teaching a client with a new diagnosis of hypertension about lisinopril (Prinivil). Which of the following instructions should the nurse include?
- A. Take the medication at bedtime.
- B. Report a persistent dry cough.
- C. Stop the medication if blood pressure is normal.
- D. Avoid regular blood pressure checks.
Correct Answer: B
Rationale: A persistent dry cough is a common lisinopril side effect, requiring reporting. Options A, C, and D are incorrect.
During the first 72 hours post CVA, the nurse should position the client:
- A. Supine
- B. Semi-Fowler
- C. Left Sim's
- D. Prone
Correct Answer: B
Rationale: Semi-Fowler's position (30-45 degrees) reduces intracranial pressure and promotes venous drainage in the acute phase post-stroke.
The client is taking streptomycin, isoniazid, and rifampin (Rimactane). Which statement indicates toxicity to isoniazid?
- A. My ears ring all the time.
- B. I have sharp pains in my legs.
- C. My urine is orange-colored.
- D. I'm having trouble at traffic lights.
Correct Answer: B
Rationale: Isoniazid can cause peripheral neuropathy, manifesting as sharp leg pains. Tinnitus is linked to streptomycin, orange urine to rifampin, and color vision issues are unrelated.
The nurse is caring for a client with a history of cirrhosis who is receiving lactulose (Chronulac) 30 mL PO tid. Which of the following findings would be of GREATest concern to the nurse?
- A. Ammonia level of 40 mcg/dL.
- B. Potassium of 3.5 mEq/L.
- C. Diarrhea with 4 stools per day.
- D. Sodium of 140 mEq/L.
Correct Answer: C
Rationale: Diarrhea with 4 stools per day suggests lactulose overdose, risking dehydration and electrolyte imbalance in cirrhosis. Options A, B, and D are normal or expected: ammonia 40 mcg/dL is controlled, potassium 3.5 mEq/L is normal, and sodium 140 mEq/L is normal.