Quiz 2- chp. 23,24,25,26

The nurse is caring for a patient with an alteration in airway clearance. What nursing actions would be a priority to promote airway clearance. Select all that apply 1. Maintain adequate fluid intake 2. Maintain a 30-degree elevation 3. Splint the chest when coughing 4. maintain a semi-fowlers position 5. Instruct patient to cough at end of inhalation

1,3,5

The nurse is performing a respiratory assessment for a patient admitted with pneumonia. Which clinical manifestation should the nurse expect. 1. hyper resonance on percussion 2. vesicular breath sounds in all lobes 3. increased vocal fremitus on palpation 4. fine crackles in all lobes on auscultation

3

On auscultation of a patient in respiratory distress, you hear a high-pitched, harsh sound that is monophonic and is present only during inspiration. This is known as: A. Stridor B. Vesicular C. Rales D. Rhonchi

A

The nurse is caring for a patient with a theophylline level of 14 mcg/mL. What is the priority nursing intervention? A.Continue to assess the patient's oxygenation. B. Monitor the patient for toxicity. C. Stop the IV for an hour, then restart at lower rate. D. Increase the IV drip rate.

A

In discharge teaching, the nurse will emphasize to a patient receiving a beta-agonist bronchodilator the importance of reporting which side effect? A. Tachycardia B. Nonproductive cough C. Sedation D. Hypoglycemia

A- A beta-agonist bronchodilator stimulates the beta receptors of the sympathetic nervous system, resulting in tachycardia, bronchodilation, hyperglycemia (if severe), and alertness.

What over-the-counter product will the nurse instruct the patient to avoid when taking montelukast? A. St. John's wort B. Diphenhydramine(Benadryl) C. Echinacea D. Acetaminophen

A- St. John's wort has been shown to decrease serum montelukast levels. The other substances do not interact with montelukast

You note your patient's sweat and urine is orange. You reassure the patient and educate him that which medication below is causing this finding? A. Ethambutol B. Streptomycin C. Isoniazid D. Rifampin

D

The health care provider indicates that the patient will be ordered an expectorant. Which medication does the nurse anticipate the provider will order? Brompheniramine maleate Dexchlorpheniramine maleate Guaifenesin Chlorpheniramine maleate

Guaifenesin

Which of the following is NOT a treatment for chronic bronchitis or emphysema? A. Albuterol B. Spirvia C. Theophylline D. Metoprolol

The answer is D. Metoprolol is a beta blocker used to treat heart conditions. Albuterol, Spirvia, and Theophylline are types of bronchodilators which are used to treat chronic bronchitis & emphysema.

The nurse is caring for a patient in the clinic who states that he is afraid of taking antihistamines because he is a truck driver. What is the best information for the nurse to give this patient? "Take the medication only when you are not driving." "You are correct; you should not take antihistamines." "You may be able to safely take a second-generation antihistamine." "Take a lower dose than normal when you have to drive."

"You may be able to safely take a second-generation antihistamine."

. The client is admitted to the emergency department with an apical pulse rate of 134, respiration rate of 28, BP of 92/56, and the skin is pale and clammy. What action should the nurse perform first? 1. Type and crossmatch the client for PRBCs. 2. Start two IVs with large-bore catheters. 3. Obtain the client's history and physical. 4. Check the client's allergies to medications.

answer 2. The client is exhibiting symptoms of shock. The nurse should start IV lines to prevent the client from progressing to circulatory collapse.

primary progressive TB

develops in a very small percentage of individuals who have been exposed to the bacterium. Initial symptoms are relatively nonspecific and consist of fatigue, weight loss, and night sweats. A cough develops eventually and produces a rusty-colored or blood-streaked sputum. As the disease progresses, dyspnea, orthopnea, and rales become evident.

normal hematocrit levels

Male: 42-52% Female: 37-47%

The nurse is teaching a patient about the use of an expectorant. What is the most important instruction for the nurse to include in the patient teaching? "Increase your fiber and fluid intake to prevent constipation." "Increase your fluid intake in order to decrease viscosity of secretions." "Restrict your fluids in order to decrease mucus production." "Take the medication once a day only, at bedtime."

"Increase your fluid intake in order to decrease viscosity of secretions."

A patient complains of worsening nasal congestion despite the use of oxymetazoline nasal spray every 2 hours. What is the nurse's most appropriate response? "Oxymetazoline should be administered every hour for severe congestion." "Overuse of nasal decongestants results in rebound congestion." "Oxymetazoline is not an effective nasal decongestant." "You are probably displaying an unexpected reaction to oxymetazoline."

"Overuse of nasal decongestants results in rebound congestion."

A patient is prescribed an antitussive medication. What is the most important instruction for the nurse to include in the patient teaching? "Watch for diarrhea and abdominal cramping." "Headache and hypertension are common side effects." "This medication may cause drowsiness and dizziness." "This medication may cause tremors and anxiety."

"This medication may cause drowsiness and dizziness."

The nurse is teaching the patient on the use of beclomethasone. Which statement by the patient indicates an understanding of the teaching? "I will need to taper off the medication to prevent acute adrenal crisis." "I will need to monitor my blood sugar more closely because it may increase." "This medication will help prevent the inflammatory response of my allergies." "I need to take this medication only when my symptoms get bad."

"This medication will help prevent the inflammatory response of my allergies."

The nurse will include which information regarding the use of antileukotriene agents such as zafirlukast in the patient teaching? - "It will take about 3 weeks before you notice a therapeutic effect." - "Take the medication as soon as you begin wheezing." - "This medication will prevent the inflammation that causes your asthma attack." - "Increase fiber and fluid in your diet to prevent the side effect of constipation."

"This medication will prevent the inflammation that causes your asthma attack." Antileukotriene agents block the inflammatory response of leukotrienes and thus the trigger for asthma attacks. Response to these drugs is usually noticed within 1 week. They are not used to treat an acute asthma attack.

TB treatment

A basic four-drug combination is recommended for the treatment of TB and should continue for 9 to 12 months (Table 24.8). The basic recommended treatment for TB is broadly applicable, but modifications may be necessary in special circumstances, such as HIV+, pregnancy, drug resistance, and children.

The patient tells the nurse that she has a cold, is coughing, and feels like she has fluid in her lungs. What action will the nurse anticipate performing first? Encourage the patient to drink fluids hourly. Administer guaifenesin. Administer dextromethorphan. Administer fluticasone (Flonase).

Administer guaifenesin.

You're providing education to a patient about how to take their prescribed iron supplement. Which statement by the patient requires you to re-educate the patient on how to take this supplement? A. "I will take this medication on an empty stomach." B. "I will avoid taking this medication with orange juice." C. "I will wait and take my calcium supplements 2 hours after I take my iron supplement." D. "This medication can cause constipation. So, I will drink plenty of fluids and take a stool softer as needed."

Answer: B The patient should be encouraged to take their iron supplement with Vitamin C (hence orange juice) because Vitamin C increases the absorption of iron. All the other statements are correct in how to take an iron supplement.

The physician orders a patient with suspected iron-deficiency anemia a blood smear test to assess the quality of the red blood cells. How would the red blood cells appear if the patient had iron- deficiency anemia? A. Hyperchromic and macrocytic B. Hypochromic and microcytic C. Hyperchromic and macrocytic D. Hypochromic and macrocytic

Answer: B. The RBCs would appear pale (hypochromic) and small (microcytic).

A patient, with a history of gastric bypass surgery 6 months ago, reports feeling very fatigued and is having food cravings for clay and dirt. On assessment, you note the patient has nail changes that look "spoon-shaped". This spoon-shaped appearance of the nails is called? A. Terry's Nails B. Onychoschizia C. Koilonychias D. Leukonychia

Answer: C Koilonychias is the medial term for a spoon-shaped appearance of nails found in iron-deficiency anemia.

A patient is admitted with iron- deficiency anemia and has been receiving iron supplementation. The patient voices concern about how their stool is dark black. As the nurse, you would? A. Notify the doctor B. Hold the next dose of iron C. Reassure the patient this is a normal side effect of iron supplementation D. None of the options are correct

Answer: C This is a normal side effect of iron supplementation and demonstrates the body is absorbing the iron.

Select all the patients who are at MOST risk for iron-deficiency anemia: A. A 55 year old male who reports taking Ferrous Sulfate regularly. B. A 25 year old female who was recently diagnosed with Celiac Disease. C. A 35 year old female who is 36 weeks pregnant that reports craving ice. D. A 67 year old female with a Hemoglobin level of 14

Answers: B&C Rationale: Patients who have GI issues, such as Celiac Disease, are at risk for iron-deficiency anemia due to damage to the intestines, which play a huge role in absorbing iron. In addition, females who are pregnant are at risk for this condition because of fetal demands on the body for iron. Also, this patient is craving ice which is a sign that the body is low on iron. Option A is wrong because Ferrous Sulfate is an iron supplement, therefore decreasing the patient's chances of developing this condition, and option D is wrong because the patient's hemoglobin level is normal (normal Hgb level for a female is 12 to 15.5 women & 13.5-17.5 for men.

The nurse is caring for a patient who is taking a first-generation antihistamine. What is the most important information for the nurse to teach the patient? "Do not drive after taking this medication." "Make sure you drink a lot of liquids while on this medication." "Take this medication on an empty stomach." "Do not take this medication for more than 2 days."

Do not drive

This lung sound is continuous, high-pitched with musical instrument sound that is polyphonic and occurs mainly during expiration but can be present with inspiration as well? A. Stridor B. Fine crackles C. High-pitched wheeze D. High-pitched crackles

C

You are providing diet teaching to a patient with low iron levels. Which foods would you encourage the patient to eat regularly? A. Herbal tea, apples, and watermelon B. Sweet potatoes, artichokes, and packaged meat C. Egg yolks, beef, and legumes D. Chocolate, cornbread, and cabbage

C Of all the options, foods in option C contain the most iron.

The health care provider indicates that the patient will be ordered an opioid antitussive. Which medication does the nurse anticipate the provider will order? Codeine Promethazine with dextromethorphan Benzonatate Levocetirizine

Codeine

Which tasks are appropriate to assign to the unlicensed assistive personnel (UAP)? Select all that apply. 1. Perform mouth care on the client diagnosed with pneumonia. 2. Apply oxygen via nasal cannula to the client. 3. Empty the trash cans in the clients' rooms. 4. Take the empty blood bag back to the laboratory. 5. Show the client how to ambulate on the walker.

Correct answers are 1 and 4. The nurse should not delegate assessment, teaching, evaluation, medications, or an unstable client to the UAP.

The RN staff nurse is working with a licensed practical nurse (LPN) and an unlicensed assistive personnel (UAP) to care for a group of clients. Which nursing tasks can the RN delegate or assign? Select all that apply. 1. The routine oral medications for the clients 2. The bed baths and oral care 3. Evaluating the client's progress 4. Transporting a client to dialysis 5. Administering scheduled vaccinations

Correct answers are 1, 2, 4, and 5.

Primary TB

Primary TB infection is often asymptomatic and is confirmed only by positive sputum cultures and a positive skin test. This person is not infectious.

What should the nurse expect to find that would indicate a therapeutic effect of acetylcysteine? - Decreased nasal secretions - Relief of bronchospasms - Decreased cough reflex - Liquefying and loosening of bronchial secretions

Liquefying and loosening of bronchial secretions - Acetylcysteine is a mucolytic drug used to liquefy and loosen bronchial secretions in order to enhance their expectoration.

What is the most important thing for the nurse to teach a patient who is switching allergy medications from diphenhydramine to loratadine? Loratadine has fewer sedative effects. Loratadine has increased bronchodilating effects. Loratadine causes less gastrointestinal upset. Loratadine can potentially cause dysrhythmias.

Loratadine has fewer sedative effects

normal hemoglobin levels

Male 14-17.3 g/dL Female 11.7-15.5 g/dL

A patient has taken metaproterenol. What is the nurse's priority action? - Monitoring for sedation -Monitoring for heart rate >100 beats/min -Assessing for elevated blood pressure -Telling the patient not to drive for 2 h

Monitoring for heart rate >100 beats/min The beta1 properties of this drug can cause increased heart rate and palpitations. The drug should not cause sedation or elevated blood pressure.

Nursing management for laryngeal trauma

Patients who have experienced neck trauma are at high risk for airway occlusion or obstruction. Have an emergency tracheostomy insertion set at the bedside, and closely observe the patient for changes in respiratory rate, respiratory effort, and the development of adventitious breath sounds.

Latent TB

Patients with LTBI have no symptoms, do not feel ill, and are not contagious. It is only when the immune system becomes compromised that the disease can become reactivated. The most common factors associated with reactivation are HIV infection, long-term diabetes, chronic renal disease, long-term steroid administration, sepsis, and malnutrition.

Your patient with asthma is taking Theophylline. Which product below should the patient avoid consuming? A. Caffeine B. Dairy C. Wheat D. Shellfish

The answer is A. Caffeine has the same properties as Theophylline and can increase the effects the drug

You are providing care to a patient with COPD who is receiving medical treatment for exacerbation. The patient has a history of diabetes, hypertension, and hyperlipidemia. The patient is experiencing extreme hyperglycemia. In addition, the patient has multiple areas of bruising on the arms and legs. Which medication ordered for this patient can cause hyperglycemia and bruising? A. Prednisone B. Atrovent C. Flagyl D. Levaquin

The answer is A. Prednisone is a corticosterioid and can cause hyperglycemia and brusing.

A patient with asthma is prescribed to take inhaled Salmeterol and Fluticasone for long-term management of asthma. You observe the patient taking these medications. Which option below best describes the correct order in how to take these medications? A. The patient inhales the Salmeterol first and then waits 5 minutes before inhaling the Fluticasone. B. The patient inhales the Fluticasone first and then waits 5 minutes before inhaling the Salmeterol. C. The patient inhales the Salmeterol first and then waits 1 minute before inhaling the Fluticasone. D. The patient inhales the Fluticasone and immediately inhales the Salmeterol.

The answer is A. The bronchodilator inhaler (Salmeterol) is administered first to open up the airways. Then the patient is to wait five minutes and then administer the corticosteroid (Fluticasone). The bronchodilator will open the airways so the corticosteroid can easily enter the airways to decrease inflammation.

A patient is newly diagnosed with COPD due to chronic bronchitis. You're providing education to the patient about this disease process. Which statement by the patient indicates they understood your teaching about this condition? A. "If I stop smoking, it will cure my condition." B. "Complications from this condition can lead to pulmonary hypertension and right-sided heart failure." C. "I'm at risk for low levels of red blood cells due to hypoxia and may require blood transfusions during acute illnesses." D. "My respiratory system is stimulated to breathe due to high carbon dioxide levels rather than low oxygen levels.

The answer is B. Option A is wrong because smoking cessation will NOT cure the condition but it may slow down the progress of it. Option C is wrong because the patient may develop HIGH LEVELS of red blood cells due to the body trying to compensate for hypoxia. Option D is wrong because patients with COPD are stimulated to breathe due to LOW OXYGEN LEVELS rather than high carbon dioxide levels.

While assessing a patient's lung sounds you note bronchial breath sounds in the peripheral lung fields. What could this finding represent? A. This is a normal finding. B. Pulmonary emboli C. Lung consolidation like with pneumonia D. Pleuritis

The answer is C. Bronhical breath sounds should only be heard in the trachael area. It is ABNORMAL to hear them in the perpherial lung fields. If this happens, it could represent lung consolidation like with pnemonia

You assist your patient with using their inhaler. The inhaler contains the medication Budesonide. Before administering the inhaler, you will want to connect what device to the inhaler to help decrease the patient from developing ________? A. Peak flow meter; pneumonia B. Incentive spirometer; thrush C. Spacer; thrush D. Peak flow meter; mouth sores

The answer is C. Budesonide is a corticosteroid. Inhaled corticosteroids can cause thrush. Therefore, it is important to connect a spacer to the inhaler before usage to help prevent the patient from developing thrush and for the patient to gargle and rinse the mouth with water.

A patient taking Isoniazid (INH) should be monitored for what deficiency? A. Vitamin C B. Calcium C. Vitamin B6 D. Potassium

The answer is C. This medication can lead to low Vitamin B6 levels. Most patients will take a supplement of B6 while taking this medication.

A patient with asthma is receiving a nebulizer of Cromolyn. The patient reports a burning sensation in the nose along with a horrible taste in their mouth. As the nurse you will? A. Immediately stop the nebulizer B. Re-adjust the nebulizer C. Call a rapid response because the patient is having a potential anaphylactic reaction to the medication. D. Reassure the patient this is a temporary side effect of this medication.

The answer is D. Cromolyn can temporarily cause the following side effects during administration: sneezing, burning in nose, itchy/watery eyes, bad taste in mouth. Reassure the patient that these are temporary side effects of this medication.

You're providing discharge teaching to a patient who was admitted with asthma. You discussed the early warning signs of an asthma attack and ask the patient to list some of them. Select all the correct early warning signs verbalized by the patient: A. Easily fatigued with physical activity B. Reduced peak flow meter reading C. Chest retractions D. Cyanosis E. Wheezing with activity F. Nighttime coughing G. No relief with short-acting bronchodilator inhaler

The answers are A, B, E, and F. These are all early warning signs an asthma attack is imminent. Options C, D, and G are signs and symptoms of an active asthma attack that requires medical treatment.

Select all the correct options that represent the pathophysiology of an asthma attack. A. The smooth muscle surrounding the alveoli constricts, limiting oxygenation. B. The mucosa lining experiences severe inflammation. C. The goblet cells within the mucosa lining produce excessive amounts of mucous. D. Too much carbon dioxide is exhaled due to hyperventilation and the patient experiences respiratory alkalosis.

The answers are B and C. Option A is wrong because the smooth muscle surrounding the BRONCHI AND BRONCHIOLES CONSTRICTS (not alveoli), limiting oxygenation. Option D is wrong become the patient does NOT experience respiratory alkalosis but respiratory ACIDOSIS. During an asthma attack, the patient is unable to exhale fully and air trapping occurs. Therefore, gas exchange does NOT occur, leaving carbon dioxide to build up in the blood and NO oxygen to enter the bloodstream. The CO2 builds up in the system and oxygen saturations drop....hence acidosis. Remember CO2 is acidic.

You're teaching a group of long-term care health givers about the signs and symptoms of tuberculosis. What signs and symptoms will you include in your education? A. Cough for a minimum of 6 weeks B. Night sweats C. Weight gain D. Hemoptysis E. Chills F. Fever G. Chest pain

The answers are B, D, E, F, and G. Option A is wrong because a cough should be present for 3 weeks or more (NOT 6 weeks). Option C is wrong because the patient will experience weight LOSS (not gain).

You are assessing your newly admitted patients who are all presenting with atypical signs and symptoms of a possible lung infection. The physician suspects tuberculosis. So, therefore, the patients are being monitored and tested for the disease. Select all the risk factors below that increases a patient's risk for developing tuberculosis: A. Diabetes B. Liver failure C. Long-term care resident D. Inmate E. IV drug user F. HIV G. U.S. resident

The answers are C, D, E, and F. - mnemonic "TB Risk". It stands for tight living quarters (LTC resident, prison, homeless shelter etc.), below or at the poverty line (homeless), refugee (especially in high risk countries), immune system issue such as HIV, substance abusers (IV drugs or alcohol), Kids less than the age of 5....all these are risk factors.

Which client should the medical unit nurse assess first after receiving the shift report? 1. The 84-year-old client diagnosed with pneumonia who is afebrile but getting restless 2. The 25-year-old client diagnosed with influenza who is febrile and has a headache 3. The 56-year-old client diagnosed with a left-sided hemothorax with tidaling in the waterseal compartment of the chest drainage system 4. The 38-year-old client diagnosed with a sinus infection who has green drainage from the nose

answer 1. Elderly clients diagnosed with pneumonia may not present with the "normal" symptoms, such as fever. The client's increased restlessness may indicate a decrease in oxygen to the brain. This client should be seen first.

. The 50-year-old client diagnosed with an exacerbation of COPD and tobacco abuse is in respiratory distress. Which intervention should the nurse implement first? 1. Place the client in the orthopneic position. 2. Administer 6 L oxygen via nasal cannula. 3. Assess the client's pulse oximeter reading. 4. Notify the respiratory therapist.

answer 1. Placing the client in the orthopneic position will help the client breathe easier. The position assumed by clients diagnosed with orthopnea is one in which they are sitting propped up in bed by several pillows

. In the intensive care unit (ICU), the critical care nurse assesses a client diagnosed with an asthma attack who has a respiration rate of 10 and an oxygen saturation of 88%. Which intervention should the nurse implement first? 1. Call a Rapid Response Team (RRT). 2. Increase the oxygen to 10 LPM. 3. Check the client's ABG results. 4. Administer the fast-acting inhaler.

answer 2 rationale: 1. A Rapid Response Team (RRT) is called when the nurse assesses a client whose condition is deteriorating. The purpose of an RRT is to intervene to prevent a code. In the scenario described, the situation has not progressed to an arrest. The nurse should call an RRT, but administering oxygen is the first intervention. 2. The first action is to increase the client's oxygen to 100%. 3. The nurse could check the ABG results, but the client is in distress and the nurse should implement an intervention to relieve the distress. 4. A fast-acting inhaler should be used, but not until after the oxygen has been increased and an RRT called.

The nurse is admitting a client diagnosed with pneumonia. Which health-care provider's order should be implemented first? 1. 1,000 mL normal saline at 125 mL/hour 2. Obtain sputum for Gram stain and culture 3. Ceftriaxone 1,000 mg IVPB every 12 hours 4. Ultrasonic nebulization treatment every 6 hours

answer 2. In order to treat the client with the most effective medication and not skew the results of a sputum culture, the specimen must be obtained before initiating antibiotics.

The client who is 1-day postoperative following chest surgery is having difficulty breathing, has bilateral rales, and is confused and restless. Which intervention should the nurse implement first? 1. Assess the client's pulse oximeter reading. 2. Notify the Rapid Response Team. 3. Place the client in the Trendelenburg position. 4. Check the client's surgical dressing.

answer 2. The Rapid Response Team was mandated by The Joint Commission. It is a team of health-care professionals who respond to clients who are breathing but who the nurse thinks are in an emergency situation. A code is called if the client is not breathing. The nurse must determine if the client is in distress; remember: if in distress do not assess. The nurse must intervene to help the client. Do not select equipment over the client's body.

Which client should the RN charge nurse assign to the new graduate (GN) on the respiratory unit? 1. The client diagnosed with lung cancer who has rust-colored sputum and chest pain of 10 on a scale of 1 to 10 2. The client diagnosed with atelectasis who is having shortness of breath and difficulty breathing 3. The client diagnosed with tuberculosis who has a nonproductive cough and orange-colored urine 4. The client diagnosed with pneumonia who has a pulse oximeter reading of 91% and has a CRT greater than 3 seconds

answer 3. The orange-colored urine is secondary to rifampin, an antitubercular medication, and a nonproductive cough is expected. Therefore, this client is stable and should be assigned to a new graduate nurse.

The client in the postanesthesia care unit (PACU) has noisy and irregular respirations with a pulse oximeter reading of 89%. Which intervention should the PACU nurse implement first? 1. Increase the client's oxygen rate via nasal cannula. 2. Notify the respiratory therapist to draw arterial blood gases. 3. Tilt the head back and push forward on the angle of the lower jaw. 4. Obtain an intubation tray and prepare for emergency intubation.

answer 3. The client is exhibiting signs or symptoms of hypopharyngeal obstruction, and this maneuver pulls the tongue forward and opens the air passage.

The RN home health nurse is visiting the client diagnosed with end-stage chronic obstructive pulmonary disease (COPD) while the unlicensed assistive personnel (UAP) is providing care. Which action by the UAP would warrant intervention by the RN home health nurse? 1. Keeping the bedroom at a warm temperature. 2. Maintaining the client's oxygen rate at 2 L/min. 3. Helping the client sit in the orthopneic position. 4. Allowing the client to sleep in the recliner.

answer: 1. The client diagnosed with end-stage COPD usually prefers a cool climate, with fans to help ease breathing. A warm area would increase the effort the client would require to breathe. This action would warrant intervention by the nurse.

The unlicensed assistive personnel (UAP) tells the RN clinic nurse that the client in Room 4 is "really breathing hard and can't seem to catch his breath." Which instruction should the nurse give to the UAP? 1. Put 4 mL oxygen on the client. 2. Sit the client upright in a chair. 3. Go with the nurse to the client's room. 4. Take the client's vital signs.

answer: 3. CLINICAL JUDGMENT GUIDE: Any time the nurse receives information from another staff member about a client who may be experiencing a new problem, complication, or life-threatening problem, the nurse must assess the client. The nurse should not make decisions about client needs based on another staff member's information.

The nurse is developing a nursing care plan for a client diagnosed with chronic obstructive pulmonary disease (COPD). What should be the client's priority nursing diagnosis? 1. Activity intolerance 2. Altered coping 3. Impaired gas exchange 4. Self-care deficit

answer: 3. Impaired gas exchange is the priority problem for this client. If the client does not have adequate gas exchange, the client will die. Remember Maslow's Hierarchy of Needs.

Drug resistant TB

can be mono-drug or poly-drug resistant. Drug-resistant TB can be caused by primary or secondary means. Primary resistance is caused by person-to-person transmission of the resistant organism. Secondary (acquired) resistant TB develops during treatment and results from an ineffective treatment regimen or an incomplete treatment regimen.