Nokea
The sputum of a client remains positive for the tubercle bacillus even though the client has been taking Laniazid (isoniazid). The nurse recognizes that the client should have a negative sputum culture within:
- A. 2 weeks
- B. 6 weeks
- C. 8 weeks
- D. 12 weeks
Correct Answer: D
Rationale: With effective treatment, sputum cultures for tuberculosis typically become negative within 2-3 months (approximately 12 weeks), depending on the regimen and adherence.
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A student in a cardiac unit is performing auscultation of a client's heart. The nurse recognizes that the student is performing pulmonic auscultation correctly when the stethoscope is placed:
- A. Between the apex and the sternum
- B. At the fifth intercostal space at the left midclavicular line
- C. At the second intercostal space, left of the sternum
- D. At the manubrium
Correct Answer: C
Rationale: The pulmonic area is auscultated at the second intercostal space, left of the sternum, where the pulmonary valve sounds are best heard.
The nurse is caring for a client who has just returned from surgery for an ascending colostomy. The nurse plans to include reinforcement teaching for the client and spouse. Which statements should the nurse include in the teaching? Select all that apply.
- A. The colostomy will begin functioning within 24 hours.
- B. A large amount of bleeding may be present at the stoma site.
- C. The first stools will be liquid and will gradually become more formed.
- D. A healthy stoma is reddish-pink and moist and protrudes about 2 cm from the abdominal wall.
Correct Answer: C,D
Rationale: A healthy stoma is reddish-pink, moist, and protrudes slightly (D). Initial stools are liquid, becoming formed over time (C). Function typically starts in 2-5 days, not 24 hours (A), and significant bleeding (B) is abnormal.
A transient homeless client with a history of mental illness and substance abuse is to be discharged. Which of the following support systems are most likely to provide social support for the client? Select all that apply.
- A. Self-help programs.
- B. Internet-based programs.
- C. Community agencies.
- D. Governmental agencies.
- E. Friends.
- F. Family.
Correct Answer: A,C,D
Rationale: Community agencies (C), governmental agencies (D), and self-help programs (A) are likely to provide social support for a homeless client with mental illness and substance abuse. Internet-based programs (B), friends (E), and family (F) may be less accessible or reliable.
An elderly client's wife tells a nurse she is concerned because her husband insists on talking about past events. The nurse assesses the client and finds him alert, oriented, and responsive to questions. Which statement should the nurse make to the client's wife?
- A. Your husband is choosing to live in a happier time in his life.
- B. Redirect your husband to speak about current events when he begins regressing into the past.
- C. If he were my husband, I would call our minister to speak to him.
- D. Your husband is reflecting on his life. This is normal at his age.
Correct Answer: D
Rationale: Reflecting on past events is a normal part of aging, especially in older adults, and this response reassures the wife while providing accurate information.
In caring for a critically ill client with a nasogastric tube (NGT) for enteral feeding, which action by the nurse demonstrates competency in NGT care? Select all that apply.
- A. The nurse checks gastric residual every 4 hours for continuous feedings.
- B. The nurse maintains the client in a low Fowler's position during feeding.
- C. The nurse checks gastric residual before each bolus or intermittent feeding.
- D. The tubing is changed every 48 hours or when the bag appears visibly soiled.
- E. The nurse returns the residual to the stomach unless the volume is greater than 250 mL.
Correct Answer: A, C, E
Rationale: Checking residuals for continuous and bolus feedings and returning residuals (unless >250 mL) are standard. Low Fowler’s increases aspiration risk, and tubing change frequency varies by policy.