TB Quiz 2 PDF

TB Quiz \#2 **Pathophysiology & Epidemiology** 1. **Which microorganism is responsible for causing tuberculosis?** - A\) Staphylococcus aureus - B\) Mycobacterium tuberculosis - C\) Streptococcus pneumoniae - D\) Pseudomonas aeruginosa - **Answer:** B) Mycobacte...

TB Quiz \#2 **Pathophysiology & Epidemiology** 1. **Which microorganism is responsible for causing tuberculosis?** - A\) Staphylococcus aureus - B\) Mycobacterium tuberculosis - C\) Streptococcus pneumoniae - D\) Pseudomonas aeruginosa - **Answer:** B) Mycobacterium tuberculosis - **Rationale:** Tuberculosis is caused by *Mycobacterium tuberculosis*, an acid-fast bacillus with a waxy outer capsule that resists destruction. 2. **A client is diagnosed with latent TB. Which of the following is true about this condition?** - A\) The client is infectious and has active symptoms. - B\) The client has been exposed but is not infectious. - C\) The client requires immediate airborne precautions. - D\) The client will develop active TB within 3 months. - **Answer:** B) The client has been exposed but is not infectious. - **Rationale:** Latent TB means the bacteria are present but inactive. The person is not contagious and does not show symptoms. 3. **A nurse is educating a patient on TB transmission. Which statement indicates the need for further teaching?** - A\) \"TB is spread through airborne droplets when an infected person coughs or sneezes.\" - B\) \"I can contract TB by touching the skin of an infected person.\" - C\) \"People in close contact with TB-positive individuals are at higher risk of contracting the disease.\" - D\) \"TB can be prevented with proper precautions and treatment adherence.\" - **Answer:** B) \"I can contract TB by touching the skin of an infected person.\" - **Rationale:** TB is spread through airborne droplets, not direct skin contact. **Risk Factors** 4. **Which of the following patients is at the highest risk for developing active TB?** - A\) A 45-year-old teacher who smokes. - B\) A 30-year-old nurse working in a hospital. - C\) A 60-year-old patient receiving chemotherapy. - D\) A 28-year-old pregnant woman. - **Answer:** C) A 60-year-old patient receiving chemotherapy. - **Rationale:** Immunocompromised individuals, such as those undergoing chemotherapy, are at higher risk of developing active TB. 5. **A homeless client presents with a persistent cough, night sweats, and weight loss. The nurse understands that which risk factor is associated with TB?** - A\) Smoking - B\) Poor nutrition and overcrowded living conditions - C\) Family history of asthma - D\) Recent antibiotic use - **Answer:** B) Poor nutrition and overcrowded living conditions - **Rationale:** TB is more prevalent in populations with poor living conditions and limited healthcare access. **Clinical Manifestations** 6. **Which symptom is most characteristic of active TB?** - A\) Productive cough with blood-tinged sputum - B\) Chest pain relieved by rest - C\) Sudden onset of high fever and chills - D\) Severe wheezing and nasal congestion - **Answer:** A) Productive cough with blood-tinged sputum - **Rationale:** Hemoptysis (coughing up blood), night sweats, fever, and weight loss are classic TB symptoms. 7. **A patient with active TB reports fatigue and weight loss. The nurse understands these symptoms occur due to:** - A\) Increased metabolic demand from the infection - B\) Side effects of TB medications - C\) Dehydration from excessive sweating - D\) Reduced lung function - **Answer:** A) Increased metabolic demand from the infection - **Rationale:** The chronic inflammatory process in TB leads to weight loss and fatigue. **Diagnostic Testing** 8. **Which diagnostic test is considered the gold standard for confirming tuberculosis?** - A\) Chest X-ray - B\) Sputum culture - C\) PPD skin test - D\) Nucleic acid amplification test (NAAT) - **Answer:** B) Sputum culture - **Rationale:** A sputum culture definitively confirms *Mycobacterium tuberculosis*, though results take several weeks. 9. **A client has a positive Mantoux (PPD) test. What is the next step?** - A\) Begin isolation precautions - B\) Obtain a chest X-ray - C\) Start a four-drug regimen immediately - D\) Repeat the test in one month - **Answer:** B) Obtain a chest X-ray - **Rationale:** A positive PPD test does not confirm active TB; further testing, like a chest X-ray or sputum sample, is needed. **Treatment & Management** 10. **Which of the following TB medications can cause optic neuritis?** - A\) Isoniazid - B\) Rifampin - C\) Ethambutol - D\) Pyrazinamide - **Answer:** C) Ethambutol - **Rationale:** Ethambutol can cause optic neuritis, leading to vision changes. 11. **A client taking rifampin should be educated on which side effect?** - A\) Red/orange discoloration of body fluids - B\) Severe constipation - C\) Photosensitivity - D\) Peripheral neuropathy - **Answer:** A) Red/orange discoloration of body fluids - **Rationale:** Rifampin can turn urine, tears, and sweat red-orange. 12. **Which strategy is used to improve TB medication adherence?** - A\) Administering higher doses weekly - B\) Directly Observed Therapy (DOT) - C\) Prescribing a single medication instead of combination therapy - D\) Recommending self-monitoring of symptoms - **Answer:** B) Directly Observed Therapy (DOT) - **Rationale:** DOT ensures adherence by having a healthcare worker observe the patient taking the medication. **Prevention & Infection Control** 13. **A patient with active TB is being admitted. Which of the following precautions should be implemented?** - A\) Droplet - B\) Contact - C\) Airborne - D\) Standard - **Answer:** C) Airborne - **Rationale:** TB is transmitted via airborne droplets; isolation in a negative-pressure room is required. 14. **Which statement about TB transmission requires further teaching?** - A\) \"I should wear a mask when visiting my family.\" - B\) \"I should cover my mouth when I cough.\" - C\) \"I need to take my medications until I feel better.\" - D\) \"I should stay away from crowded areas until I'm non-infectious.\" - **Answer:** C) \"I need to take my medications until I feel better.\" - **Rationale:** TB treatment requires completion of the full regimen, even if symptoms improve. **Advanced Management & Patient Education** 15. **A patient is considered non-infectious when which of the following criteria are met?** - A\) Two negative AFB sputum smears and symptom improvement - B\) Three consecutive negative AFB sputum smears, clinical improvement, and at least two weeks of treatment - C\) Negative PPD skin test after treatment initiation - D\) Negative chest X-ray after three months of therapy - **Answer:** B) Three consecutive negative AFB sputum smears, clinical improvement, and at least two weeks of treatment - **Rationale:** TB is no longer infectious when three negative sputum smears are confirmed, the patient shows clinical improvement, and treatment has been ongoing for at least two weeks. 16. **Which of the following patients should receive prophylactic treatment for TB?** - A\) A healthcare worker with a negative PPD test but exposure to an active TB patient - B\) A patient with latent TB and a history of HIV - C\) A patient with active TB who has completed three months of therapy - D\) A patient who received the Bacillus Calmette-Guérin (BCG) vaccine as a child - **Answer:** B) A patient with latent TB and a history of HIV - **Rationale:** Patients with latent TB and immunosuppression (e.g., HIV) require prophylactic treatment to prevent progression to active TB. 17. **A patient is prescribed isoniazid (INH) for latent TB. Which vitamin should be supplemented to prevent adverse effects?** - A\) Vitamin B6 (Pyridoxine) - B\) Vitamin C - C\) Vitamin D - D\) Folic acid - **Answer:** A) Vitamin B6 (Pyridoxine) - **Rationale:** Isoniazid can cause peripheral neuropathy, which can be prevented with vitamin B6 supplementation. 18. **Which laboratory value should be closely monitored in a patient receiving pyrazinamide?** - A\) White blood cell count - B\) Creatinine levels - C\) Liver function tests (LFTs) - D\) Potassium levels - **Answer:** C) Liver function tests (LFTs) - **Rationale:** Pyrazinamide can cause hepatotoxicity, so liver enzymes should be monitored. 19. **Which medication can interfere with oral contraceptives?** - A\) Ethambutol - B\) Rifampin - C\) Isoniazid - D\) Pyrazinamide - **Answer:** B) Rifampin - **Rationale:** Rifampin induces liver enzymes, reducing the effectiveness of oral contraceptives. 20. **A patient is on rifampin therapy. What patient teaching should the nurse provide?** - A\) "Take this medication with milk to avoid stomach upset." - B\) "Your tears and urine may turn orange, which is harmless." - C\) "Avoid caffeine while on this medication." - D\) "Do not eat grapefruit while taking this drug." - **Answer:** B) "Your tears and urine may turn orange, which is harmless." - **Rationale:** Rifampin can cause red-orange discoloration of body fluids, which is benign. **Complications of TB** 21. **A major complication of untreated or poorly managed TB is:** - A\) Pulmonary fibrosis - B\) Severe allergic reaction - C\) Guillain-Barré syndrome - D\) Kidney failure - **Answer:** A) Pulmonary fibrosis - **Rationale:** Chronic TB infection can cause lung scarring and fibrosis. 22. **Which type of TB occurs when Mycobacterium tuberculosis spreads beyond the lungs?** - A\) Latent TB - B\) Pulmonary TB - C\) Miliary TB - D\) Cavitary TB - **Answer:** C) Miliary TB - **Rationale:** Miliary TB occurs when TB bacteria disseminate through the bloodstream to multiple organs. 23. **A patient with active TB develops hemoptysis and worsening dyspnea. What complication should the nurse suspect?** - A\) Pneumonia - B\) Cavitary TB - C\) Pulmonary embolism - D\) Pleural effusion - **Answer:** B) Cavitary TB - **Rationale:** Cavitary TB involves lung destruction and formation of cavities, leading to hemoptysis and respiratory distress. **Nursing Priorities & Interventions** 24. **A nurse is reviewing discharge instructions for a patient with active TB. Which statement by the patient indicates the need for further teaching?** - A\) "I should continue taking my medications until my symptoms improve." - B\) "I need to cover my mouth when I cough." - C\) "I should wear a mask when I'm around others." - D\) "I need to keep my follow-up appointments for sputum tests." - **Answer:** A) "I should continue taking my medications until my symptoms improve." - **Rationale:** TB treatment must be completed fully, even if symptoms improve. 25. **Which of the following nursing diagnoses is most appropriate for a patient with active TB?** - A\) Ineffective thermoregulation - B\) Impaired urinary elimination - C\) Ineffective airway clearance - D\) Disturbed sensory perception - **Answer:** C) Ineffective airway clearance - **Rationale:** TB leads to a chronic cough and mucus production, affecting airway clearance. 26. **A nurse is caring for a patient in airborne isolation for active TB. Which action is appropriate?** - A\) Keep the door open for ventilation - B\) Wear a surgical mask when entering the room - C\) Have visitors wear an N95 mask - D\) Transfer the patient to a standard medical floor after 24 hours of treatment - **Answer:** C) Have visitors wear an N95 mask - **Rationale:** Airborne isolation requires N95 masks for healthcare workers and visitors. **NCLEX-Style Prioritization & Delegation** 27. **The nurse is managing four patients. Which patient should be assessed first?** - A\) A patient with TB who has had three negative sputum cultures - B\) A patient with latent TB experiencing mild fatigue - C\) A patient with active TB who is experiencing hemoptysis and respiratory distress - D\) A patient starting TB treatment experiencing mild nausea - **Answer:** C) A patient with active TB who is experiencing hemoptysis and respiratory distress - **Rationale:** Hemoptysis and respiratory distress indicate possible complications and require immediate assessment. 28. **A nurse is educating a group about TB prevention. Which statement should be emphasized?** - A\) "Vaccination with BCG is mandatory in the U.S." - B\) "TB is not contagious once symptoms resolve." - C\) "Adherence to medication prevents transmission and drug resistance." - D\) "Once exposed to TB, you will always develop the disease." - **Answer:** C) "Adherence to medication prevents transmission and drug resistance." - **Rationale:** Proper adherence is critical to preventing transmission and multidrug-resistant TB.