Nokea
A healthcare professional is preparing to admit a client suspected of having pulmonary tuberculosis. Which of the following actions should the healthcare professional plan to perform first?
- A. Implement airborne precautions.
- B. Obtain a sputum culture.
- C. Administer antituberculosis medications.
- D. Recommend a screening test for close contacts.
Correct Answer: A
Rationale: The initial priority when admitting a client suspected of having pulmonary tuberculosis is to implement airborne precautions to prevent the spread of the disease. Airborne precautions include wearing a mask and placing the client in a negative pressure room. Obtaining a sputum culture is essential for confirming the diagnosis, but ensuring infection control measures come first to protect others. Administering antituberculosis medications is important but should be initiated after implementing necessary precautions. Recommending a screening test for close contacts is relevant but is a secondary concern compared to immediate infection control measures.
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When caring for a client with diarrhea due to Shigella, which of the following precautions should the nurse take?
- A. Wash hands before and after contact with the client
- B. Wear a surgical mask
- C. Use a face shield
- D. Wear a gown and gloves only
Correct Answer: A
Rationale: The correct precaution for Shigella infection is to wash hands thoroughly before and after contact with the client. Shigella is transmitted through the fecal-oral route, so hand hygiene is crucial in preventing its spread. Wearing a surgical mask or face shield is not necessary for Shigella as it is not primarily transmitted through respiratory droplets. While wearing a gown and gloves is important for standard precautions, the key precaution specific to Shigella is proper hand hygiene.
A nurse is providing education about cultural and religious traditions and rituals related to death for the assistive personnel on the unit. Which of the following information should the nurse include?
- A. People who practice Judaism stay with the body of the deceased until burial.
- B. People who practice Islam avoid cremation of the body.
- C. People who practice Buddhism prefer to have a brief funeral service.
- D. People who practice Hinduism prefer to have the body embalmed before cremation.
Correct Answer: A
Rationale: The correct answer is A. In Judaism, it is customary for the body to be attended to by family or members of the community until burial. This practice is rooted in the belief of providing respect and care to the deceased individual. Choices B, C, and D are incorrect because they do not accurately reflect the cultural and religious traditions related to death for people who practice Islam, Buddhism, and Hinduism, respectively. People who practice Islam generally avoid cremation and opt for burial, Buddhists may have varying funeral service preferences, and Hindus often practice cremation without embalming the body.
While assisting a client with a meal, the client suddenly grabs at their neck with both hands and appears frightened. The appropriate nursing action is to:
- A. Ask the client if they are choking
- B. Perform abdominal thrusts
- C. Call for emergency help
- D. Check the client's airway
Correct Answer: A
Rationale: The correct action when a client suddenly grabs at their neck and appears frightened is to ask if they are choking. This allows the nurse to gather more information from the client directly. Performing abdominal thrusts (choice B) should only be done if the client is unable to speak, cough, or breathe. Calling for emergency help (choice C) should be done after assessing the situation and confirming choking. Checking the client's airway (choice D) is important but should come after confirming that the client is choking.
The healthcare provider is caring for a client with tuberculosis (TB). Which type of isolation precautions should the healthcare provider implement?
- A. Droplet precautions
- B. Airborne precautions
- C. Contact precautions
- D. Standard precautions
Correct Answer: B
Rationale: When caring for a client with tuberculosis (TB), airborne precautions should be implemented. Tuberculosis is spread through the air via droplet nuclei, requiring the use of airborne precautions to prevent the transmission of the infection. Droplet precautions are used for diseases spread by large respiratory droplets, such as influenza or pertussis. Contact precautions are used for diseases that spread through direct contact, such as MRSA. Standard precautions are used for all clients to prevent the transmission of infections from blood, body fluids, non-intact skin, and mucous membranes.
A client is immobile due to a cast, and a nurse is assisting in the use of a fracture bedpan. Which of the following actions should the nurse take?
- A. Place the shallow end of the fracture pan under the client's buttocks.
- B. Encourage the client to remain immobile on the fracture pan for 20 minutes.
- C. Keep the bed flat while the client is on the fracture pan.
- D. Hyperextend the client's back while the fracture pan is in place.
Correct Answer: A
Rationale: The correct action when using a fracture bedpan for an immobile client is to place the shallow end of the pan under the client's buttocks. This positioning helps in proper collection of feces without causing discomfort or injury. Encouraging the client to try to defecate for 20 minutes (Choice B) is inappropriate and unrealistic, as defecation should not be forced or timed. Keeping the bed flat (Choice C) is incorrect as elevating the head of the bed can help promote proper positioning for bedpan use. Hyperextending the client's back (Choice D) is contraindicated and can lead to discomfort and potential injury to the client.