A patient diagnosed with active tuberculosis (TB) is homeless and has a history of alcohol abuse. Which intervention by the nurse will be most effective in ensuring adherence with the treatment regimen?

Correct Answer: C

Rationale: The correct answer is C: Arrange for a daily meal and drug administration at a community center. This option is the most effective intervention as it addresses the patient's barriers to adherence, such as homelessness and potential lack of resources for meals. By providing both meals and medication administration at a community center, the nurse ensures that the patient has access to a safe and consistent environment for taking their medications. This approach also allows for directly observed therapy (DOT), which is crucial in the treatment of active TB to ensure medication compliance and reduce the risk of developing drug-resistant strains. Option A is incorrect as simply repeating warnings about infecting others does not address the patient's specific needs related to homelessness and substance abuse. Option B, giving written instructions, may not be effective for a patient who may have difficulty reading or understanding written information due to their circumstances. Option D, arranging for a friend to administer medication, may not be feasible or sustainable in the long term and does not address the underlying issues of homelessness and lack of resources. In an educational context, this question highlights the importance of considering social determinants of health and individual patient circumstances when planning interventions to promote treatment adherence. It emphasizes the need for holistic and patient-centered care, especially in vulnerable populations like the homeless with complex health needs. Nurses must be able to identify barriers to adherence and tailor interventions to address these barriers effectively to ensure optimal patient outcomes.

Correct Answer: C

Rationale: In this scenario, option C is the correct answer because cimetidine inhibits the metabolism of theophylline, leading to increased levels of theophylline in the body and potential toxicity. Therefore, consulting with the healthcare provider is essential to avoid adverse effects. Option A is incorrect because weight gain is not directly related to theophylline administration in COPD patients. Option B is incorrect as the absence of shortness of breath does not specifically impact theophylline administration. Option D is also incorrect as coughing up green mucus may indicate an infection but does not directly affect theophylline therapy. Educationally, understanding drug interactions is crucial for nurses to ensure safe and effective patient care. This question highlights the importance of recognizing potential interactions and the need for interprofessional collaboration in managing patients with complex medication regimens, such as those with COPD. Nurses must be vigilant in assessing all aspects of a patient's history to provide optimal care and prevent complications.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Self-administration of inhaled corticosteroids. Asthma management often involves the use of inhaled corticosteroids as they help reduce airway inflammation, a key component in asthma exacerbations. Educating the patient on how to properly use these medications is crucial for their effective management of the condition. Patients need to understand how to administer the medication correctly to ensure optimal drug delivery to the airways and to maximize its therapeutic effects. Option A, the use of long-acting β-adrenergic medications, is incorrect because while these medications are used in asthma management, inhaled corticosteroids are considered the first-line treatment for asthma as they target the underlying inflammation. Option B, side effects of sustained-release theophylline, is incorrect as theophylline is not commonly used in initial asthma management due to its narrow therapeutic index and potential for significant side effects. Inhaled corticosteroids are generally preferred over theophylline. Option D, complications associated with O₂ therapy, is incorrect as oxygen therapy is not typically a primary treatment for asthma. While it may be used in severe exacerbations, it is not a routine part of asthma management as inhaled corticosteroids are. Educationally, it is essential to emphasize the importance of patient education in asthma management. Proper inhaler technique, understanding medication schedules, recognizing and responding to asthma triggers, and knowing when to seek medical help are all vital components of self-management for individuals with asthma. By focusing on self-administration of inhaled corticosteroids in discharge teaching, the nurse can empower the patient to take an active role in managing their asthma effectively.

Correct Answer: C

Rationale: Fine crackles are likely to be heard in the early phase of heart failure. Fine crackles are discontinuous, high-pitched sounds of short duration heard on inspiration. Course crackles are a series of long-duration, discontinuous, low-pitched sounds during inspiration. Wheezes are continuous high-pitched musical sounds on inspiration and expiration.

Correct Answer: A

Rationale: The correct answer is option A) Alcohol and smoking history. Laryngeal cancer is strongly linked to prolonged alcohol use and smoking. These substances contain carcinogens that can damage the cells in the larynx, leading to the development of cancer. Assessing a patient's history of alcohol and smoking is crucial in identifying potential risk factors for laryngeal cancer. Option B) Family history of cancer is incorrect because laryngeal cancer is not typically associated with genetic factors or family history. While a family history of cancer may increase overall cancer risk, it is not a specific risk factor for laryngeal cancer. Option C) Frequent antihistamine use is incorrect as it is not a known risk factor for laryngeal cancer. Antihistamines are commonly used to manage allergies and respiratory conditions but are not linked to the development of laryngeal cancer. Option D) Recent streptococcal infection is incorrect as it is not a risk factor for laryngeal cancer. Streptococcal infections are bacterial in nature and do not directly contribute to the development of cancer in the larynx. Educationally, understanding the risk factors for different types of cancer is crucial for nurses to provide holistic care to their patients. By knowing the specific risk factors for laryngeal cancer, nurses can assess patients effectively, provide appropriate education on prevention strategies, and facilitate early detection and treatment. This knowledge helps nurses advocate for their patients' health and well-being, ultimately improving patient outcomes.