Nokea
Which health measure is most important to emphasize when instructing the client on ways to prevent transmitting tuberculosis?
- A. Eat a nutritious diet.
- B. Get adequate sleep.
- C. Cover your nose and mouth when coughing.
- D. Wash your hands before and after meals.
Correct Answer: C
Rationale: Covering the nose and mouth when coughing prevents the spread of tuberculosis, an airborne disease, to others.
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The client diagnosed with tuberculosis has been treated with antitubercular medications for six (6) weeks. Which data would indicate the medications have been effective?
- A. A decrease in the white blood cells in the sputum.
- B. The client's symptoms are improving.
- C. No change in the chest X-ray.
- D. The skin test is now negative.
Correct Answer: B
Rationale: Improved symptoms (B) after six weeks of TB treatment (e.g., reduced cough, fever) indicate medication efficacy. WBCs in sputum (A) are not a standard measure. Chest X-ray changes (C) lag behind clinical improvement. The skin test (D) remains positive post-exposure, regardless of treatment.
Your patient has a deep vein thrombosis in the left lower extremity. The patient is prescribed continuous IV Heparin. Select all the nursing interventions that are appropriate for this patient:
- A. Apply cool compresses to affected extremity
- B. Measure leg circumference
- C. Massage affected extremity
- D. Elevate affected extremity above heart level
- E. Encourage frequent ambulation
- F. Monitor the patient's INR level
- G. Monitor the patient's aPTT level
Correct Answer: B,D,G
Rationale: Nursing interventions for this patient include: measuring leg circumference, elevating affected extremity above heart level, and monitoring aPTT level (for Heparin therapy). Why are the other options wrong? Option A: WARM compresses should be used, NOT cool (this will help with pain and circulation), Option C: this could dislodge the clot (NEVER massage or rub the site), Option E: the patient needs bed rest...ambulation could dislodge the clot, Option F: INR level is used to monitor Warfarin NOT Heparin, Option H: SCDs are NOT applied to an extremity with a clot because it could dislodge the clot...they are used to PREVENT blood clots.
The client diagnosed with a community-acquired pneumonia is being admitted to the medical unit. Which nursing intervention has the highest priority?
- A. Administer the ordered oral antibiotic immediately (STAT).
- B. Order the meal tray to be delivered as soon as possible.
- C. Obtain a sputum specimen for culture and sensitivity.
- D. Have the unlicensed assistive personnel weigh the client.
Correct Answer: C
Rationale: Obtaining sputum culture (C) before antibiotics ensures accurate pathogen identification, a priority. Antibiotics (A) follow, meals (B) and weight (D) are less urgent.
Which statement by the client diagnosed with a pulmonary embolus indicates the discharge teaching is effective?
- A. I am going to use a regular-bristle toothbrush.
- B. I will take antibiotics prior to having my teeth cleaned.
- C. I can take enteric-coated aspirin for my headache.
- D. I will wear a Medic Alert band at all times.
Correct Answer: D
Rationale: A Medic Alert band (D) ensures emergency awareness of PE/anticoagulation. Multiple Choice toothbrushes (A) risk bleeding, antibiotics (B) are for endocarditis, and aspirin (C) increases bleeding.
The nurse is preparing the client for a polysomnography to confirm sleep apnea. Which preprocedure instruction should the nurse include?
- A. The client should not eat or drink past midnight.
- B. The client will receive a sedative for relaxation.
- C. The client will sleep in a laboratory for evaluation.
- D. The client will wear a monitor at home for this test.
Correct Answer: C
Rationale: Polysomnography involves overnight monitoring in a sleep lab (C) to assess sleep patterns and confirm sleep apnea. Fasting (A) is unnecessary. Sedatives (B) are avoided to ensure natural sleep. Home monitors (D) are used for different tests, not polysomnography.