Employee health test results reveal a tuberculosis (TB) skin test of 16-mm induration and a negative chest x-ray for a staff nurse working on the pulmonary unit. The nurse has no symptoms of TB. Which information should the occupational health nurse plan to teach the staff nurse?

Correct Answer: B

Rationale: The correct answer is B: Standard four-drug therapy for TB. In this scenario, the nurse has a positive TB skin test but no symptoms or chest x-ray findings. This suggests latent TB infection. The standard treatment for latent TB infection is a four-drug therapy regimen to prevent the progression to active TB. It is essential for the occupational health nurse to educate the staff nurse about this treatment to prevent the development of active TB disease. Choice A (Use and side effects of isoniazid) is incorrect because while isoniazid is part of the treatment regimen for latent TB infection, the nurse needs to be educated about the full four-drug therapy regimen, not just one drug. Choice C (Need for annual repeat TB skin testing) is incorrect as the positive TB skin test already indicates latent TB infection, so repeat skin testing annually is not necessary. Choice D (Reasons for annual sputum cytology testing) is incorrect because sputum cytology testing is not

Correct Answer: A

Rationale: The correct answer is A: Administer a bronchodilator. This is the priority intervention because wheezing indicates airway constriction in asthma, requiring immediate relief to improve breathing. Bronchodilators help dilate the airways, providing quick relief. Administering an inhaled corticosteroid (B) is important for long-term control, not immediate relief. Administering an IV analgesic (C) is not necessary for wheezing in asthma. Performing a neurological assessment (D) is not relevant and does not address the immediate respiratory issue.

Correct Answer: B

Rationale: The correct answer is B: Encourage the patient to sit up at the bedside in a chair and lean forward. This position, known as the orthopneic position, helps improve ventilation in COPD patients by reducing the pressure on the diaphragm and allowing for better expansion of the lungs. By sitting up and leaning forward, the patient can maximize their lung capacity and facilitate better gas exchange. A: Having the patient rest in bed with the head elevated to 15 to 20 degrees may help with breathing comfort but does not provide the same level of lung expansion as the orthopneic position. C: Resting in bed in a high-Fowler's position with the knees flexed may help with respiratory effort but does not promote optimal ventilation like sitting up in a chair and leaning forward. D: This is a duplicate of option C. In summary, option B is the best choice as it directly supports improved ventilation and gas exchange in COPD patients compared to the other options.

Correct Answer: B

Rationale: The correct answer is B: Administer a corticosteroid. The priority intervention is to address the potential cause of the severe headache, which could be due to increased intracranial pressure (ICP) resulting from the stroke. Corticosteroids, such as dexamethasone, are often used to reduce brain edema and inflammation in stroke patients. Administering analgesics (choice A) may provide temporary relief but does not address the underlying issue. Assessing respiratory status (choice C) is important but not the priority in this case. Administering beta-agonists (choice D) is not indicated for managing a severe headache in a stroke patient.

Correct Answer: A

Rationale: The correct answer is A: Administer nitroglycerin. Nitroglycerin is the priority action for chest pain in a patient with a history of hypertension as it helps dilate blood vessels, reducing cardiac workload and improving blood flow to the heart. This can help alleviate chest pain in the setting of a possible myocardial infarction. Aspirin (B) is also commonly given to patients with chest pain to prevent clot formation, but nitroglycerin takes precedence in this scenario. Sublingual nitroglycerin (C) is specifically mentioned as the correct choice, as it is a rapid-acting form of the medication. Corticosteroids (D) are not indicated for the immediate management of chest pain in this context.