Nokea
Your patient with a diagnosis of latent tuberculosis infection needs a bronchoscopy. During transport to endoscopy, the patient will need to wear?
- A. N95 mask
- B. Surgical mask
- C. No special PPE is needed
- D. Face mask with shield
Correct Answer: B
Rationale: Patients with latent tuberculosis are not contagious and have no symptoms, but during procedures like bronchoscopy that may generate aerosols, a surgical mask is worn to prevent potential spread if the infection is active.
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A patient is admitted with rupture of the Achilles tendon. The patient was recently treated with antibiotics for pneumonia. Which of the following medications below can cause this adverse effect?
- A. Penicillin
- B. Fluroquinolones
- C. Tetracyclines
- D. Macrolides
Correct Answer: B
Rationale: Fluoroquinolones are associated with tendon rupture, including Achilles tendon, as a rare but serious side effect. Other antibiotics listed (A, C, D) are not commonly linked to this adverse effect.
The nurse suspects the client admitted with a near-drowning is developing acute respiratory distress syndrome (ARDS). Which data support the nurse's suspicion?
- A. The client's arterial blood gases are within normal limits.
- B. The client appears anxious, has dyspnea, and is tachypneic.
- C. The client has intercostal retractions and is using accessory muscles.
- D. The client has bilateral lung sounds with crackles and rhonchi.
Correct Answer: C
Rationale: Intercostal retractions and accessory muscle use (C) indicate severe respiratory distress, consistent with ARDS due to increased work of breathing from reduced lung compliance. Normal ABGs (A) contradict ARDS, which involves hypoxia. Anxiety, dyspnea, and tachypnea (B) are non-specific. Crackles and rhonchi (D) may occur but are less specific than physical signs of distress.
Which nursing measure is most helpful in reducing the client's anxiety during an asthma attack?
- A. Close the door to the examination room.
- B. Remain within the client's view.
- C. Pull the bedside privacy curtain.
- D. Notify the client when the respiratory therapist arrives.
Correct Answer: B
Rationale: Remaining within the client's view provides reassurance and reduces anxiety by ensuring the client feels supported during an asthma attack.
When the client undergoes scratch skin testing, which sign best indicates a hypersensitivity to the scratched substance?
- A. The skin at the test site feels numb.
- B. The skin at the test site feels painful.
- C. The skin at the test site looks red.
Correct Answer: C
Rationale: A positive skin test reaction is indicated by redness and swelling at the test site, showing a hypersensitivity response to the allergen.
Until the client can be examined later that morning, which advice by the nurse would be most helpful?
- A. Sucking on ice chips should help.
- B. Rest your voice.
- C. Massage your throat.
Correct Answer: B
Rationale: Resting the voice reduces strain on the vocal cords, which is beneficial for laryngitis and helps prevent further irritation.