Nokea
Your patient is diagnosed with a latent tuberculosis infection. Select all the correct statements that reflect this condition:
- A. "The patient will not need treatment unless it progresses to an active tuberculosis infection."
- B. "The patient is not contagious and will have no signs and symptoms."
- C. "The patient will have a positive tuberculin skin test or IGRA test."
- D. "The patient will have an abnormal chest x-ray."
- E. "The patient's sputum will test positive for mycobacterium tuberculosis."
Correct Answer: B,C
Rationale: The patient WILL need medical treatment to prevent this case of LBTI from developing into an active TB infection later on. The patient will NOT have an abnormal chest x-ray or a positive sputum test. This is only in active TB.
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The nurse is planning care for a client who has COPD. Which statement is the client most likely to say about activity tolerance?
- A. The most difficult time of the day for me is the first hour after waking up in the morning.'
- B. I feel best in the morning after a good night's sleep.'
- C. I seem to have more energy after eating a big meal.'
- D. I don't know why, but I get my 'second wind' at night and don't want to go to bed.'
Correct Answer: A
Rationale: Morning fatigue is common in COPD due to mucus accumulation and poor sleep, affecting activity tolerance.
The charge nurse on a surgical floor is making assignments. Which client should be assigned to the most experienced registered nurse (RN)?
- A. The 36-year-old client who has undergone an antral irrigation for sinusitis yesterday and has moderate pain.
- B. The six-(6)-year-old client scheduled for a tonsillectomy and adenoidectomy this morning who will not swallow medication.
- C. The 18-year-old client who had a Caldwell-Luc procedure three (3) days ago and has purulent drainage on the drip pad.
- D. The 45-year-old client diagnosed with a peritonsillar abscess who requires IVPB antibiotic therapy four (4) times a day.
Correct Answer: C
Rationale: Purulent drainage post-Caldwell-Luc (C) suggests infection, requiring experienced assessment. Antral irrigation (A), tonsillectomy refusal (B), and antibiotics (D) are less complex.
Which clinical manifestation would the nurse assess in the client newly diagnosed with intrinsic lung cancer?
- A. Dysphagia.
- B. Foul-smelling breath.
- C. Hoarseness.
- D. Weight loss.
Correct Answer: C
Rationale: Hoarseness (C) is a common early symptom of intrinsic lung cancer due to tumor compression of the recurrent laryngeal nerve. Dysphagia (A) is more typical of esophageal involvement. Foul-smelling breath (B) is non-specific. Weight loss (D) occurs later in advanced disease.
Which laboratory tests should the client receive before prophylactic drug therapy for tuberculosis is started?
- A. Serum creatinine and blood urea nitrogen (BUN)
- B. Aspartate aminotransferase (AST; SGOT) and alanine aminotransferase (ALT; SGPT)
- C. Complete blood count (CBC) and hematocrit
- D. White blood cell (WBC) count and urinalysis
Correct Answer: B
Rationale: Liver function tests (AST and ALT) are essential before starting tuberculosis prophylaxis, as drugs like isoniazid can cause hepatotoxicity.
The client is admitted to a medical unit with a diagnosis of pneumonia. Which signs and symptoms should the nurse assess in the client?
- A. Pleuritic chest discomfort and anxiety.
- B. Asymmetrical chest expansion and pallor.
- C. Leukopenia and CRT <three (3) seconds.
- D. Substernal chest pain and diaphoresis.
Correct Answer: A
Rationale: Pneumonia causes pleuritic chest pain and anxiety (A) from inflammation/hypoxia. Asymmetry (B) suggests pneumothorax, leukopenia (C) is atypical, and substernal pain (D) suggests MI.