Respiratory System | Pneumonia & Tuberculosis NCLEX Quiz 43

1. The Causative agent of Tuberculosis is said to be:

Mycobacterium Tuberculosis

Hansen’s Bacilli

Bacillus Anthracis

Group A Beta Hemolytic Streptococcus

The correct answer is Mycobacterium Tuberculosis. Tuberculosis is caused by the bacteria Mycobacterium tuberculosis, which primarily affects the lungs but can also affect other parts of the body. Hansen's Bacilli is another term for Mycobacterium leprae, the bacteria that causes leprosy. Bacillus anthracis is the causative agent of anthrax. Group A Beta Hemolytic Streptococcus is responsible for various infections such as strep throat and skin infections, but it is not the causative agent of tuberculosis.

Explanation

The correct answer is Mycobacterium Tuberculosis. Tuberculosis is caused by the bacteria Mycobacterium tuberculosis, which primarily affects the lungs but can also affect other parts of the body. Hansen's Bacilli is another term for Mycobacterium leprae, the bacteria that causes leprosy. Bacillus anthracis is the causative agent of anthrax. Group A Beta Hemolytic Streptococcus is responsible for various infections such as strep throat and skin infections, but it is not the causative agent of tuberculosis.

2. The nurse obtains a sputum specimen from a client with suspected TB for laboratory study. Which of the following laboratory techniques is most commonly used to identify tubercle bacilli in sputum?

Acid-fast staining

Sensitivity testing

Agglutination testing

Dark-field illumination

The most commonly used technique to identify tubercle bacilli is acid-fast staining. The bacilli have a waxy surface. which makes them difficult to stain in the lab. However. once they are stained. the stain is resistant to removal. even with acids. Therefore. tubercle bacilli are often called acid-fast bacilli.

Explanation

The most commonly used technique to identify tubercle bacilli is acid-fast staining. The bacilli have a waxy surface. which makes them difficult to stain in the lab. However. once they are stained. the stain is resistant to removal. even with acids. Therefore. tubercle bacilli are often called acid-fast bacilli.

3. Which of the following family members exposed to TB would be at highest risk for contracting the disease?

45-year-old mother

17-year-old daughter

8-year-old son

76-year-old grandmother

Elderly persons are believed to be at higher risk for contracting TB because of decreased immunocompetence. Other high-risk populations in the US include the urban poor. AIDS. and minority groups.

Explanation

Elderly persons are believed to be at higher risk for contracting TB because of decreased immunocompetence. Other high-risk populations in the US include the urban poor. AIDS. and minority groups.

4. INH treatment is associated with the development of peripheral neuropathies. Which of the following interventions would the nurse teach the client to help prevent this complication?

Adhere to a low cholesterol diet

Supplement the diet with pyridoxine (vitamin B6)

Get extra rest

Avoid excessive sun exposure.

INH competes with the available vitamin B6 in the body and leaves the client at risk for development of neuropathies related to vitamin deficiency. Supplemental vitamin B6 is routinely prescribed.

Explanation

INH competes with the available vitamin B6 in the body and leaves the client at risk for development of neuropathies related to vitamin deficiency. Supplemental vitamin B6 is routinely prescribed.

5. The client experiencing eighth cranial nerve damage will most likely report which of the following symptoms?

Vertigo

Facial paralysis

Impaired vision

Difficulty swallowing

The eighth cranial nerve is the vestibulocochlear nerve. which is responsible for hearing and equilibrium. Streptomycin can damage this nerve.

Explanation

The eighth cranial nerve is the vestibulocochlear nerve. which is responsible for hearing and equilibrium. Streptomycin can damage this nerve.

6. The nurse should include which of the following instructions when developing a teaching plan for clients receiving INH and rifampin for treatment for TB?

Take the medication with antacids

Double the dosage if a drug dose is forgotten

Increase intake of dairy products

Limit alcohol intake

INH and rifampin are hepatotoxic drugs. Clients should be warned to limit intake of alcohol during drug therapy. Both drugs should be taken on an empty stomach. If antacids are needed for GI distress. they should be taken 1 hour before or 2 hours after these drugs are administered. Clients should not double the dosage of these drugs because of their potential toxicity. Clients taking INH should avoid foods that are rich in tyramine. such as cheese and dairy products. or they may develop hypertension.

Explanation

INH and rifampin are hepatotoxic drugs. Clients should be warned to limit intake of alcohol during drug therapy. Both drugs should be taken on an empty stomach. If antacids are needed for GI distress. they should be taken 1 hour before or 2 hours after these drugs are administered. Clients should not double the dosage of these drugs because of their potential toxicity. Clients taking INH should avoid foods that are rich in tyramine. such as cheese and dairy products. or they may develop hypertension.

7. Which of the following antituberculous drugs can cause damage to the eighth cranial nerve?

Streptomycin

Isoniazid

Para-aminosalicylic acid

Ethambutol hydrochloride

Streptomycin is an aminoglycoside. and eight cranial nerve damage (ototoxicity) is a common side effect from aminoglycosides.

Explanation

Streptomycin is an aminoglycoside. and eight cranial nerve damage (ototoxicity) is a common side effect from aminoglycosides.

8. A client has a positive reaction to the PPD test. The nurse correctly interprets this reaction to mean that the client has:

Active TB

Had contact with Mycobacterium tuberculosis

Developed a resistance to tubercle bacilli

Developed passive immunity to TB.

A positive PPD test indicates that the client has been exposed to tubercle bacilli. Exposure does not necessarily mean that active disease exists.

Explanation

A positive PPD test indicates that the client has been exposed to tubercle bacilli. Exposure does not necessarily mean that active disease exists.

9. The public health nurse is providing follow-up care to a client with TB who does not regularly take his medication. Which nursing action would be most appropriate for this client?

Ask the client’s spouse to supervise the daily administration of the medications.

Visit the clinic weekly to ask him whether he is taking his medications regularly.

Notify the physician of the client’s non-compliance and request a different prescription.

Remind the client that TB can be fatal if not taken properly.

Directly observed therapy (DOT) can be implemented with clients who are not compliant with drug therapy. In DOT. a responsible person. who may be a family member or a health care provider. observes the client taking the medication. Visiting the client. changing the prescription. or threatening the client will not ensure compliance if the client will not or cannot follow the prescribed treatment.

Explanation

Directly observed therapy (DOT) can be implemented with clients who are not compliant with drug therapy. In DOT. a responsible person. who may be a family member or a health care provider. observes the client taking the medication. Visiting the client. changing the prescription. or threatening the client will not ensure compliance if the client will not or cannot follow the prescribed treatment.

10. The nurse is teaching a client who has been diagnosed with TB how to avoid spreading the disease to family members. Which statement(s) by the client indicate(s) that he has understood the nurses instructions? Select all that apply.

“I will need to dispose of my old clothing when I return home.”

“I should always cover my mouth and nose when sneezing.”

“It is important that I isolate myself from family when possible.”

“I should use paper tissues to cough in and dispose of them properly.”

“I can use regular plate and utensils whenever I eat.”

The client's statement "I should always cover my mouth and nose when sneezing" indicates that he understands the importance of practicing respiratory hygiene to prevent the spread of TB. The statement "I should use paper tissues to cough in and dispose of them properly" shows that the client is aware of the need to contain respiratory secretions and dispose of them appropriately. The statement "I can use regular plate and utensils whenever I eat" suggests that the client understands that TB is not transmitted through food or utensils, indicating a good understanding of how the disease spreads.

Explanation

The client's statement "I should always cover my mouth and nose when sneezing" indicates that he understands the importance of practicing respiratory hygiene to prevent the spread of TB. The statement "I should use paper tissues to cough in and dispose of them properly" shows that the client is aware of the need to contain respiratory secretions and dispose of them appropriately. The statement "I can use regular plate and utensils whenever I eat" suggests that the client understands that TB is not transmitted through food or utensils, indicating a good understanding of how the disease spreads.

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