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Exam (elaborations)

Respiratory Quiz- EVOLVE

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A client arrives at a health clinic stating, "I am here to have my tuberculin skin test read."m The nurse notes that there is a 7-mm indurated area at the injection site. Which statement made by the nurse correctly describes the result? A. "The result indicates that you have active tuberculosis." B. "The result indicates that you are infected with the tuberculosis organism." C. "The result Indicates that there are no tuberculin antibodies in your system." D. "The result indicates that you have a secondary infection related to the tuberculin organism." - ANS: B Rationale: An indurated area 5 mm or larger noted 48 to 72 hours after the tuberculin test indicates that the person is infected with the tuberculin organism. A positive tuberculin skin test accompanied by fever, coughing, weakness, and positive chest x-ray are manifestations of active tuberculosis. The other choices are incorrect. A client is being admitted to a medical unit with a diagnosis of pulmonary tuberculosis. Which type of room would the nurse assign this client? A. Private room B. Semiprivate room C. Room with windows that can be opened D. Negative-airflow room - ANS: D Rationale: Tuberculosis is an airborne contagious disease that is best contained in a negative-airflow room. Negative-airflow rooms are always private. A private room, semiprivate room, and a room with windows that can be opened are not appropriate for the standard of care for a client diagnosed with tuberculosis. Additionally, opening windows would present a possible safety hazard in a client's room. A client is prescribed rifampin after being exposed to active tuberculosis. Which finding would the nurse immediately report to the HCP? Select all that apply. A. Reddish-orange color urine B. Yellow-colored teeth stains C. Orange-colored sweat and tears D. Small, red, pinpoint areas on the arms E. Numbness, tingling, and burning of extremities - ANS: D Rationale: Pinpoint red areas that appear on the arms, legs, or trunk of the body are known as petechiae. The petechiae are tiny hemorrhages that occur under the skin as a result of a low circulating platelet count (thrombocytopenia). Thrombocytopenia occurs with liver stress or damage. As hepatotoxicity is a possible adverse reaction to rifampin, the HCP must be notified of the appearane of petechiae. A client who had thoracic surgery is admitted to the postanesthesia care unit. The nurse notes that a chest tube is in place and is attached to a disposable plastic, water-seal drainage system. To provide appropriate care of the chest tube and drainage unit, which step would the nurse take next? A. Ensure the security of the connections from the client to the drainage unit. B. Empty the drainage container and measure and record the amount. C. Verify that there is vigorous bubbling in the wet suction control compartment. D. Check that the fluid level in the water-seal compartment increases with expiration. - ANS: A Rationale: The system must remain airtight (closed) to prevent collapse of the lung. B- The system is kept closed; a record of drainage is kept by marking the outside of the container or chamber.

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Institution
Respiratory
Course
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Uploaded on
November 18, 2023
Number of pages
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Written in
2023/2024
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R146,08
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