A client is being discharged on long-term therapy for tuberculosis (TB). What referral by the nurse is most appropriate?

Correct Answer: D

Rationale: The correct answer is D: Visiting nurses for directly observed therapy. This option ensures proper administration of TB medications by healthcare professionals. Visiting nurses can monitor medication adherence, side effects, and provide education. Referring to a social worker for meals (A) is not directly related to TB treatment. Occupational therapy (B) and physical therapy (C) are not typically indicated for TB treatment.

Correct Answer: D

Rationale: In this scenario, assigning the ventilator-dependent client with COPD to the fairly new nurse from the surgical unit is the most appropriate choice. This assignment provides the nurse with an opportunity to develop critical skills in managing a client requiring ventilator support, which is a common intervention in the medical unit. It allows the nurse to gain exposure to respiratory assessment, suctioning techniques, ventilator monitoring, and oxygen therapy administration. Option A, assigning the client on airborne precautions for TB, is not suitable for the new nurse as it requires a thorough understanding of infection control measures and specific protocols related to TB management, which may be beyond the scope of a nurse with limited experience. Option B, the client post-bronchoscopy and biopsy, requires close monitoring for respiratory status changes and potential complications. This assignment demands a higher level of respiratory assessment skills and knowledge, making it unsuitable for a nurse with only two months of experience. Option C, the client needing teaching about incentive spirometry, although important for respiratory maintenance, does not provide the new nurse with the opportunity to practice critical respiratory nursing skills like ventilator management, which is crucial in a medical unit setting. Therefore, assigning the ventilator-dependent client with COPD aligns with the educational objective of providing the new nurse with hands-on experience in managing complex respiratory conditions, thereby enhancing their competence and confidence in caring for respiratory patients in the future.

Correct Answer: A

Rationale: Rationale: The correct answer is A) Aspiration. When microorganisms reach the lungs and cause pneumonia through aspiration, it means that these pathogens have been inhaled into the lungs due to the accidental entry of foreign substances, such as food or liquids, into the respiratory tract. This can lead to infection and inflammation in the lungs, resulting in pneumonia. Option B) Lymphatic spread is incorrect because microorganisms causing pneumonia typically reach the lungs directly through the respiratory tract, rather than spreading through the lymphatic system. Option C) Inhalation of microbes in the air is a plausible route for respiratory infections, but in the context of pneumonia, aspiration is a more direct mechanism. Option D) Touch contact with infectious microbes is not a common route for pneumonia-causing microorganisms to reach the lungs; it is more relevant for skin infections or gastrointestinal illnesses. Educational Context: Understanding how microorganisms cause pneumonia is crucial for healthcare professionals, especially nurses preparing for the NCLEX exam. Aspiration pneumonia is a common type of pneumonia, typically seen in patients with impaired swallowing mechanisms or altered consciousness. Knowledge of the different ways pathogens can reach the lungs helps nurses in providing appropriate care, infection control measures, and patient education to prevent respiratory infections.

Correct Answer: C

Rationale: Cystic fibrosis is a genetic disorder that affects the production of the CFTR protein, leading to the production of thick, sticky mucus. Option C is the correct answer because it correctly identifies the pathophysiological mechanism of cystic fibrosis that results in obstructive lung disease. The low levels of sodium chloride in secretions cause the mucus to become thick and difficult to clear, leading to airway obstruction, recurrent infections, and ultimately, obstructive lung disease. Option A is incorrect because fibrosis of mucous glands and destruction of bronchial walls are not the primary mechanisms of cystic fibrosis. Option B is incorrect as destruction of lung parenchyma from inflammation and scarring is more commonly seen in conditions like chronic obstructive pulmonary disease (COPD) rather than cystic fibrosis. Option D is also incorrect as increased serum levels of pancreatic enzymes do not directly contribute to obstructive lung disease in cystic fibrosis. In an educational context, understanding the pathophysiological mechanisms of cystic fibrosis is crucial for nurses and healthcare professionals caring for patients with this condition. By knowing how cystic fibrosis leads to obstructive lung disease, healthcare providers can better manage symptoms, prevent complications, and provide optimal care for these patients.