A client has been taking isoniazid for tuberculosis for 3 weeks. What laboratory results need to be reported to the primary health care provider immediately?

Correct Answer: B

Rationale: The correct answer is B: Alanine aminotransferase (ALT): 180 U/L. Elevated ALT levels indicate liver damage, a potential side effect of isoniazid. This is crucial to report immediately to the primary health care provider to assess liver function and adjust medication if needed. A: Albumin levels may fluctuate due to various factors but are not typically urgent in this context. C: RBC count within normal range, not directly related to isoniazid therapy. D: WBC count slightly elevated but not a priority unless there are other concerning symptoms.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Oral temperature 101.2°F. The rationale behind this choice is that an elevated temperature could indicate an infection, which is particularly concerning for a client with COPD who has not received flu or pneumonia vaccinations. Fever can be a sign of respiratory infection, which can exacerbate COPD symptoms and lead to complications. Option A) Blood pressure 152/84 is not the most relevant parameter to report in this situation. While elevated blood pressure can be a concern, it is not directly related to the client's respiratory condition and lack of vaccinations. Option B) Respiratory rate 27/minute is elevated but not as critical to report as the elevated temperature. Respiratory rate alone may not necessarily indicate an acute issue in this context. Option C) Heart rate 92/minute is within a normal range and is not as urgent to report as the elevated temperature. While heart rate can be affected by respiratory conditions, in this case, the temperature is a more immediate concern. Educationally, understanding the rationale behind choosing the correct vital sign to report is crucial for nursing assistants caring for clients with respiratory conditions. Recognizing the significance of changes in vital signs and their implications on specific health conditions is essential for providing timely and appropriate care to clients. It highlights the importance of comprehensive assessment skills and the ability to prioritize findings based on the client's individual health needs.

Correct Answer: D

Rationale: Palpation is a crucial assessment technique in examining the respiratory system. In this context, the correct answer is D) Limited chest expansion. Palpation involves using hands to feel for abnormalities or changes in the chest wall movement. Limited chest expansion can indicate conditions like pneumonia, pleural effusion, or obstructive lung diseases. Option A) Stridor is a high-pitched sound heard during inspiration and indicates upper airway obstruction, which is typically assessed through auscultation, not palpation. Option B) Finger clubbing is a physical sign where fingertips become rounded and the nail beds angle downwards due to chronic hypoxia. This is assessed visually and by palpating the fingertips, not through chest palpation. Option C) Tracheal deviation is a sign of tension pneumothorax or mass effect in the chest, which is assessed by inspection and palpation of the trachea, not chest wall palpation. Educationally, understanding the correct assessment techniques and their indications is crucial for healthcare professionals to accurately diagnose and manage respiratory conditions. Palpation skills are essential for detecting subtle changes in chest wall movement and guiding further diagnostic tests and interventions. This question reinforces the importance of differentiating assessment techniques based on the specific clinical presentation to provide optimal patient care.

Correct Answer: C

Rationale: In planning postural drainage for a patient with COPD, the nurse must include assessing the patient's tolerance for dependent (head-down) positions because this position helps to mobilize secretions in the lungs and facilitate their removal. This position allows gravity to assist in moving mucus towards the larger airways, making it easier for the patient to clear their lungs. Option A is incorrect because scheduling the procedure around meals is not directly related to the effectiveness of postural drainage. Option B is incorrect as having the patient cough before positioning is not the primary consideration when planning postural drainage. Option D is incorrect as percussion and vibration should be performed after positioning the patient to aid in mobilizing secretions, not before. From an educational perspective, understanding the rationale behind each option helps students grasp the importance of proper postural drainage techniques in managing respiratory conditions like COPD. It reinforces the significance of individualized care based on patient needs and condition-specific interventions. This question also underscores the critical thinking required in nursing practice to optimize patient outcomes.