ch 28 iggy med surg 1

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Questions and Answers

What is the primary focus of the nurse's education for a client with tuberculosis (TB)?

Educating the client on adherence to the treatment regimen (correct)

Informing the client about follow-up sputum cultures

Teaching the client ways to balance rest with activity

Encouraging the client to eat a well-balanced diet

A client has been admitted for suspected inhalation anthrax infection. Which question by the nurse is most important?

Have you traveled recently?

How long have you been ill?

What is your occupation? (correct)

Are any family members also ill?

Which of the following is the most appropriate action for the nurse to take when educating a client with tuberculosis (TB)?

Provide information on the potential side effects of the TB medications and how to manage them

Suggest the client maintain a strict vegetarian diet to support their immune system

Emphasize the importance of completing the full course of antibiotics, even if the client feels better (correct)

Recommend the client take frequent breaks and limit physical activity during treatment

A client with suspected inhalation anthrax has been admitted to the hospital. Which of the following actions should the nurse take first?

Notify the appropriate authorities about the potential bioterrorism event Signup and view all the answers

When educating a client with tuberculosis (TB), which of the following topics should the nurse prioritize?

Stressing the necessity of adhering to the full course of prescribed therapy Signup and view all the answers

A client is suspected of having inhalation anthrax. Which of the following is the most important question the nurse should ask the client?

What is your current occupation and work environment? Signup and view all the answers

When educating a client with tuberculosis (TB), which of the following should the nurse emphasize as the top priority?

Stressing the need to adhere to the full course of prescribed antibiotic therapy Signup and view all the answers

A client has been admitted with suspected inhalation anthrax. Which of the following actions should the nurse take first?

Notify the appropriate authorities about the potential bioterrorism event Signup and view all the answers

What is the best response by the nurse when questioned about the necessity of a chest x-ray?

Older people often have vague symptoms, so an x-ray is essential. Signup and view all the answers

Why is obtaining an early chest x-ray important in older adults suspected of having pneumonia?

To avoid a delay in treatment due to vague symptoms. Signup and view all the answers

What does the nurse's response suggest when stating 'Chest x-rays are always ordered when we suspect pneumonia'?

It is a routine regardless of the specific situation. Signup and view all the answers

Why does the nurse's response mention that 'The x-ray can be done and read before laboratory work is reported'?

To indicate a delay in waiting for lab results before taking action. Signup and view all the answers

What does the staff prioritize when stating 'We are testing for any possible source of infection in the client'?

Testing for any suspected disorder. Signup and view all the answers

When is it crucial to obtain a chest x-ray in older adults suspected of having pneumonia?

Before definitive manifestations are present, due to vague symptoms. Signup and view all the answers

Which statement explains why a chest x-ray is essential for older adults with vague symptoms?

To prevent unnecessary delays in appropriate treatment. Signup and view all the answers

What is the primary purpose of the nurse's role in addressing the spouse's fear of visiting the client with tuberculosis?

To decrease the spouse's stress and enable visitation, which will benefit both the client and the spouse. Signup and view all the answers

What is the primary reason the nurse should not tell the spouse that it's safe to visit the client with tuberculosis?

It would be demeaning to the spouse's feelings. Signup and view all the answers

What is the primary reason the nurse should not inform the spouse that the precautions are meant to keep other clients safe?

It would not address the spouse's specific fears about visitation. Signup and view all the answers

What is the primary reason the nurse should not recommend occupational therapy for job retraining as the most appropriate referral for a client being discharged on long-term therapy for tuberculosis?

Job retraining is not a common need for clients with tuberculosis. Signup and view all the answers

What is the primary reason the nurse should not recommend physical therapy for homebound therapy services as the most appropriate referral for a client being discharged on long-term therapy for tuberculosis?

The client should be referred to visiting nurses for directly observed therapy. Signup and view all the answers

What is the primary reason the nurse should not recommend a community social worker for Meals on Wheels as the most appropriate referral for a client being discharged on long-term therapy for tuberculosis?

The client should be referred to visiting nurses for directly observed therapy. Signup and view all the answers

Which of the following is the most accurate statement regarding the nurse's role in addressing the spouse's fear of visiting the client with tuberculosis?

The nurse should obtain further information about the spouse's specific fears so they can be addressed. Signup and view all the answers

What is the primary reason the nurse should recommend visiting nurses for directly observed therapy as the most appropriate referral for a client being discharged on long-term therapy for tuberculosis?

All of the above reasons are correct. Signup and view all the answers

Based on the information provided, what is the most likely diagnosis for the client seen in the emergency department?

Inhalation anthrax Signup and view all the answers

What is the appropriate duration of oral antibiotic treatment for inhalation anthrax after completing intravenous antibiotics?

60 days Signup and view all the answers

Why is sputum culture not recommended for the client with suspected inhalation anthrax?

Sputum culture is not reliable for diagnosing inhalation anthrax Signup and view all the answers

What type of precautions should be implemented for a client with inhalation anthrax?

Standard Precautions Signup and view all the answers

Why is directly observed therapy (DOT) not recommended for the client with inhalation anthrax?

DOT is only used for monitoring treatment adherence in tuberculosis Signup and view all the answers

What is the most appropriate action for the nurse when the spouse of a client with tuberculosis (TB) refuses to visit due to fear?

Explain that TB is not transmissible through casual contact Signup and view all the answers

What type of precautions should be implemented for a client with active tuberculosis (TB)?

Airborne Precautions Signup and view all the answers

What is the purpose of directly observed therapy (DOT) in the treatment of tuberculosis (TB)?

To ensure adherence to the complete course of anti-TB treatment Signup and view all the answers

What is the primary nursing action that should be taken based on the positive tuberculosis test result?

Place the client on Airborne Precautions immediately Signup and view all the answers

Which statement accurately describes the significance of the positive tuberculosis test result?

It indicates a previous exposure to tuberculosis, but not necessarily active disease Signup and view all the answers

If the client is confirmed to have active tuberculosis, which additional nursing action would be appropriate?

Recommend isolation in a negative pressure room Signup and view all the answers

Which of the following statements accurately describes the potential consequences of a delayed or missed tuberculosis diagnosis?

All of the above Signup and view all the answers

If the client is confirmed to have active tuberculosis, which additional nursing intervention would be appropriate?

Provide education on the importance of treatment adherence Signup and view all the answers

Which of the following statements accurately describes the mode of transmission for tuberculosis?

Tuberculosis is transmitted through airborne droplet nuclei Signup and view all the answers

Which nursing action would be appropriate if the client is confirmed to have latent tuberculosis infection?

Recommend prophylactic antibiotic therapy Signup and view all the answers

Which of the following statements accurately describes the risk factors for tuberculosis transmission in healthcare settings?

Tuberculosis transmission risk increases with prolonged exposure to infected individuals Signup and view all the answers

Study Notes

Infection Control and Management

A client with fever, fatigue, and dry cough, and mediastinal widening on chest x-ray, may have early inhalation anthrax, requiring oral antibiotics for at least 60 days after IV antibiotics are finished.
Anthrax is not transmissible from person to person, so Standard Precautions are adequate, and directly observed therapy is not necessary.

Tuberculosis Management

Clients with tuberculosis (TB) require a treatment regimen for 6 to 12 months, making adherence problematic, and the nurse should stress the importance of following the treatment plan for the entire duration.
The nurse should educate the client on the importance of adherence to the treatment regimen, and encourage the client to eat a well-balanced diet and balance rest with activity.
Directly observed therapy is often used for managing clients with TB in the community.

Communication and Education

When a client is fearful of visiting a spouse with TB, the nurse should educate the client on the importance of following the treatment plan, and teach the client ways to balance rest with activity.
The nurse should address the spouse's specific fears and concerns to decrease stress and permit visitation.
When a client is being discharged on long-term therapy for TB, the nurse should refer the client to Visiting Nurses for directly observed therapy.

Respiratory Assessment and Infection

A client with suspected pneumonia should have an early chest x-ray, especially in older adults, as symptoms may be vague.
A positive tuberculosis test requires immediate placement on Airborne Precautions to prevent the spread of the disease.

Nursing Process and Implementation

When a client is admitted with suspected pneumonia, the nurse should immediately place the client on Airborne Precautions if the client has a positive tuberculosis test.
The nurse should prioritize preventing the spread of the disease over other actions.

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Description

This quiz presents a situation where a family member questions the necessity of a chest x-ray for a patient with vague symptoms. Test your knowledge on the best nursing response in such a scenario.