Nokea
The nurse is providing discharge teaching for a client diagnosed and treated for tuberculosis (TB). Which statement by the client indicates that teaching has been effective? Select all that apply.
- A. All used dishes should be sterilized.
- B. My close contacts should be tested for TB.
- C. Soiled tissues should be disposed of properly.
- D. House isolation is required for at least 8 months.
- E. The mouth should always be covered when coughing.
Correct Answer: B,C,E
Rationale: Tuberculosis is a communicable disease, and the nurse must teach the client measures to prevent its spread. Any close contacts with the client must be tested and treated if the results of the screening test are positive. Because it is an airborne disease, the client must properly dispose of used tissues and needs to cover the mouth when coughing. There is no evidence to suggest that sterilizing dishes would break the chain of infection with pulmonary TB. It is not necessary for the client to isolate herself or himself to the house. Once the client is treated and results of three sputum cultures are negative, the client will not spread the infection.
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The nurse has provided home care instructions to a client with prostate cancer who has been hospitalized for a transurethral resection of the prostate (TURP). Which statement by the client indicates the need for further teaching?
- A. Prune juice needs to be included in my diet.
- B. I need to avoid strenuous activity for 4 to 6 weeks.
- C. My intake of water needs to be at least 6 to 8 glasses daily.
- D. I can't lift or push objects that weigh more than 30 pounds.
Correct Answer: D
Rationale: The client needs to be advised to avoid strenuous activity for 4 to 6 weeks and avoid lifting items that weigh more than 20 pounds. Straining during defecation is avoided to prevent bleeding. Prune juice is a satisfactory bowel stimulant. The client needs to consume a daily intake of at least 6 to 8 glasses of nonalcoholic fluids to minimize clot formation.
The nurse is giving dietary instructions to a client who has been prescribed cyclosporine. Which statement by the client indicates the need for further teaching?
- A. Red meats are alright to eat.
- B. Orange juice is a great choice for breakfast.
- C. Grapefruit juice will not interfere with the medication.
- D. Green leafy vegetables should be eaten as often as possible.
Correct Answer: C
Rationale: A compound in grapefruit juice inhibits the metabolism of cyclosporine. Thus, drinking grapefruit juice can raise cyclosporine levels by 50% to 100%, greatly increasing the risk of toxicity. The foods in options 1, 2, and 4 are acceptable to consume.
The nurse provides instructions to a client about applying a nitroglycerin patch. What statement indicates that the client is using correct technique?
- A. A second patch will be applied if chest pain occurs.
- B. I will apply the patch to a nonhairy area of the body.
- C. I will remove the patch when bathing and reapply it after the bath.
- D. I will remove the patch after gently rubbing the area to activate the medication.
Correct Answer: B
Rationale: Topical nitroglycerin is applied to a nonhairy part of the body. It is used on a scheduled basis and is not prescribed specifically for the occurrence of chest pain. The ointment is not rubbed into the skin; it is reapplied only as directed.
Cholestyramine is prescribed, and the nurse provides instructions to the client about the medication. Which client statement indicates a need for further teaching?
- A. I should take this medication with meals.
- B. I need to mix the medication with juice or applesauce.
- C. I should increase my fluid intake while taking this medication.
- D. I should call my primary health care provider immediately if it causes constipation.
Correct Answer: D
Rationale: Common side effects of cholestyramine include constipation, nausea, indigestion, and flatulence. Therefore, it is not necessary to contact the primary health care provider immediately if constipation occurs. Cholestyramine must be administered with food to be effective. This medication should not be taken dry, and it can be mixed in water, juice, carbonated beverages, applesauce, or soup. Increasing fluids will minimize the constipating effects of the medication.
A client has been prescribed a clonidine patch, and the nurse has instructed the client regarding the use of the patch. Which client statement indicates a need for further teaching?
- A. I intend to change the patch every 7 days.
- B. I need to trim the patch if an edge becomes loose.
- C. It's important to put the patch on a hairless site on my torso.
- D. It's alright to leave the patch in place during bathing or showering.
Correct Answer: B
Rationale: The clonidine patch should not be trimmed because it will alter the medication dose. If it becomes slightly loose, it should be covered with an adhesive overlay from the medication package. If it becomes very loose or falls off, it should be replaced. It is changed every 7 days, and is left in place when bathing or showering. The clonidine patch should be applied to a hairless site on the torso or the upper arm. The patch is discarded by folding it in half with the adhesive sides together.