Page 1610 - Saunders Comprehensive Review For NCLEX-RN

Test-Taking Strategy: Focus on the subject, manifestations of COPD. Think about
the pathophysiology associated with this disorder. Remember that hypercapnia, a
hyperinflated chest, a flat diaphragm, oxygen desaturation on exercise, and
decreased vital capacity are manifestations.
Level of Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Assessment
Content Area: Adult Health: Respiratory
Health Problem: Adult Health: Respiratory: Obstructive Pulmonary Disease
Priority Concepts: Gas Exchange; Perfusion
Reference: Ignatavicius, Workman, Rebar (2018), p. 574.

568. Answer: 1, 3, 4, 5

Rationale: The nurse should provide the client and family with information about
tuberculosis and allay concerns about the contagious aspect of the infection. The
client needs to follow the medication regimen exactly as prescribed and always have
a supply of the medication on hand. Side and adverse effects of the medication and
ways of minimizing them to ensure compliance should be explained. After 2 to 3
weeks of medication therapy, it is unlikely that the client will infect anyone.
Activities should be resumed gradually and a well-balanced diet that is rich in iron,
protein, and vitamin C to promote healing and prevent recurrence of infection
should be consumed. Respiratory isolation is not necessary, because family members
already have been exposed. Instruct the client about thorough hand washing, to
cover the mouth and nose when coughing or sneezing, and to put used tissues into
plastic bags. A sputum culture is needed every 2 to 4 weeks once medication therapy
is initiated. When the results of 3 sputum cultures are negative, the client is no
longer considered infectious and can usually return to former employment.
Test-Taking Strategy: Focus on the subject, home care instructions for
tuberculosis. Knowledge regarding the pathophysiology, transmission, and
treatment of tuberculosis is needed to answer this question. Read each option
carefully to answer correctly.
Level of Cognitive Ability: Analyzing
Client Needs: Safe and Effective Care Environment
Integrated Process: Teaching and Learning
Content Area: Adult Health: Respiratory
Health Problem: Adult Health: Respiratory: Tuberculosis
Priority Concepts: Client Education; Infection
Reference: Ignatavicius, Workman, Rebar (2018), p. 610.

569. Answer: 3

Rationale: If a biopsy was performed during a bronchoscopy, blood-streaked
sputum is expected for several hours. Frank blood indicates hemorrhage. A dry
cough may be expected. The client should be assessed for signs of complications,
which would include cyanosis, dyspnea, stridor, bronchospasm, hemoptysis,
hypotension, tachycardia, and dysrhythmias. Hematuria is unrelated to this

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