The nurse is interpreting a tuberculin skin test (TST) for a 58-year-old female patient with end-stage kidney disease secondary to diabetes mellitus. Which finding would indicate a positive reaction?
A. Acid-fast bacilli cultured at the injection site
B. 15-mm area of redness at the TST injecti...
Respiratory Exam Med-Surg Accurate &
graded A+
The nurse is interpreting a tuberculin skin test (TST) for a 58-year-old female patient with end-stage
kidney disease secondary to diabetes mellitus. Which finding would indicate a positive reaction?
A. Acid-fast bacilli cultured at the injection site
B. 15-mm area of redness at the TST injection site
C. 11-mm area of induration at the TST injection site
D. Wheal formed immediately after intradermal injection
C. 11-mm area of induration at the TST injection site
An area of induration ≥ 10 mm would be a positive reaction in a person with end-stage kidney disease.
Reddened, flat areas do not indicate a positive reaction. A wheal appears when the TST is administered
that indicates correct administration of the intradermal antigen. Presence of acid-fast bacilli in the
sputum indicates active tuberculosis.
The nurse is preparing the patient for a diagnostic procedure to remove pleural fluid for analysis. The
nurse would prepare the patient for which test?
A. Thoracentesis
B. Bronchoscopy
C. Pulmonary angiography
D. Sputum culture and sensitivity
A. Thoracentesis
Thoracentesis is the insertion of a large-bore needle through the chest wall into the pleural space to
obtain specimens for diagnostic evaluation, remove pleural fluid, or instill medication into the pleural
space.
, Respiratory Exam Med-Surg Accurate &
graded A+
2. The nurse plans to teach a patient how to manage allergic rhinitis. Which information should the
nurse include in the teaching plan?
a. Hand washing is the primary way to prevent spreading the condition to others.
b. Use of oral antihistamines for 2 weeks before the allergy season may prevent reactions.
c. Corticosteroid nasal sprays will reduce inflammation, but systemic effects limit their use.
d. Identification and avoidance of environmental triggers are the best way to avoid symptoms.
ANS: D
The most important intervention is to assist the patient in identifying and avoiding potential allergens.
Intranasal corticosteroids (not oral antihistamines) should be started several weeks before the allergy
season. Corticosteroid nasal sprays have minimal systemic absorption. Acute viral rhinitis (the common
cold) can be prevented by washing hands.
After obtaining blood for an arterial blood gas measurement, the nurse should hold pressure on the
puncture site for 5 minutes by the clock to be sure that bleeding has stopped. An artery is an elastic
vessel under much higher pressure than veins, and significant blood loss or hematoma formation could
occur if the time is insufficient.
A patient with a recent history of a dry cough has had a chest x-ray that revealed the presence of
nodules. In an effort to determine whether the nodules are malignant or benign, what is the primary
care provider likely to order?
A. Thoracentesis
B. Pulmonary angiogram
C. CT scan of the patient's chest
D. Positron emission tomography (PET)
D. Positron emission tomography (PET)
PET is used to distinguish benign and malignant pulmonary nodules. Because malignant lung cells have
an increased uptake of glucose, the PET scan (which uses an IV radioactive glucose preparation) can
demonstrate increased uptake of glucose in malignant lung cells. This differentiation cannot be made
using CT, a pulmonary angiogram, or thoracentesis.
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