"I have gained 5 pounds since I started taking the medication."
Weight loss is a symptom of TB. Gaining weight indicates the client is able to eat and is having minimal GI upset due to the medications.
"I cover my nose and mouth when I cough or sneeze."
Covering the mouth and nose when coughing or sneezing is good hygiene and prevents the spread of disease.
"I drink a glass of wine with dinner each night." (Correct Answer)
An adverse reaction of isoniazid is hepatitis. Instruct a client to avoid ingesting alcohol when taking the medication.
"I have stopped eating tuna salad sandwiches."
A client taking these medications should avoid tuna, aged cheese, red wine, and yeast extracts, as they may cause the adverse effects of flushing, hypotension, palpitations, and diaphoresis.
Decision Tree:
This walk-through provides test-taking strategies to determine the correct answer for the different types of questions you will encounter on the NCLEX-RN exam. These strategies are based on the Kaplan Decision Tree (DT) algorithm, a technique that provides a process to determine the correct answer for NCLEX-style questions.
This is an Evaluation Question.
For this type of question, you are looking for something correct/incorrect, right/wrong, safe/unsafe, or true/false. Use these steps, based on the Kaplan Decision Tree, to determine the correct answer.
STEP 1: Can you identify the topic of the question?
- Looking for something wrong regarding the client's tuberculosis care.
STEPS 2-4: These steps are not relevant to this type of question because you do not need to use the rules for Evaluation questions. Move to Step 5.
STEP 5: What is the outcome of each of the remaining answer choices?
Evaluate the outcome(s)
1. "I have gained 5 pounds since I started taking the medication." Active tuberculosis symptoms include unexplained weight loss, fatigue, and night sweats. The fact that the client is gaining weight suggests that the client has not been suffering gastric distress and is tolerating the tuberculosis medications well. Eliminate.
2. "I cover my nose and mouth when I cough or sneeze." Tuberculosis is spread by airborne transmission. It is not wrong to cover when coughing or sneezing. This can reduce the risk of the client infecting others. Eliminate.
3. "I drink a glass of wine with dinner each night." Isoniazid can be hepatotoxic. It would not be advisable for the client to drink alcohol while on this medication; doing so could cause the client to develop medication-related hepatitis. The client should be educated about this concern.
4. "I have stopped eating tuna salad sandwiches." It is not recommended to ingest certain foods while taking TB medications. Foods such as aged cheese, red wine, and tuna ? taken in conjunction with TB medications ? can induce symptoms such as sweating, hypotension, heart palpitations, and flushing. The client is correct to avoid such foods. Eliminate.
Select the best choice:
Is #3 the correct answer? Yes. The nurse should educate the client on the risks of ingesting alcohol while on this medication regimen.
Does #3 make sense? Yes. Avoiding alcohol can promote client safety, producing a better outcome for the client.
