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A nurse is contributing to the plan of care for a client who is being admitted to the facility w/a suspected diagnosis of pertussis. Which of the following should the nurse include in the plan of care? Select all.
- A. Place the client in a room that has negative air pressure of at least 6 exchanges/hr
- B. Wear a mask when providing care within 3 ft of the client
- C. Place a surgical mask on the client if transportation to another dept is unavoidable
- D. Use sterile gloves when handling soiled linens
- E. Wear a gown when performing care that may result in contamination from secretions
Correct Answer: B, C, E
Rationale: The correct answers are B, C, and E.
B: Wearing a mask within 3 ft of the client helps prevent the transmission of pertussis through respiratory droplets.
C: Placing a surgical mask on the client during transportation reduces the spread of the infection to others.
E: Wearing a gown when handling secretions helps prevent contamination and spread of the infection.
Incorrect choices:
A: Negative air pressure is not necessary for the care of a pertussis patient.
D: Sterile gloves are not required for handling soiled linens in pertussis cases.
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A nurse educator is teaching a module on pharmacokinetics to a group of newly licensed nurses. Which of the following statements by a newly licensed nurse indicates an understanding of the 1st-pass effect?
- A. Some meds block normal receptor activity regulated by endogenous compounds or receptor activity caused by other meds.
- B. Some meds may have to be administered by a nonenteral route to avoid inactivation as they travel through the liver.
- C. Some meds leave the body more slowly & therefore have a greater risk of accumulation & toxicity.
- D. Some meds have a wide safety margin, so there is no need for routine serum medication level monitoring.
Correct Answer: B
Rationale: Correct Answer: B
Rationale:
1. The 1st-pass effect refers to the metabolism of a drug in the liver before it reaches systemic circulation.
2. Medications administered orally undergo first-pass metabolism in the liver, leading to potential inactivation.
3. Administering such meds through nonenteral routes (e.g., intravenous) bypasses the liver, avoiding inactivation.
4. Choice A discusses receptor activity, not related to the first-pass effect.
5. Choice C refers to drug elimination rate, not specific to the first-pass effect.
6. Choice D discusses safety margin and monitoring, not directly related to drug metabolism.
A client who is postop following a knee arthroplasty is concerned about the adverse effects of the medication he is receiving for pain management. Which of the following members of the interprofessional care team may assist the client in understanding the medication's effects? Select all.
- A. Provider
- B. CNA
- C. Pharmacist
- D. RN
- E. Respiratory therapist
Correct Answer: A, C, D
Rationale: The correct answer is A, C, and D. The provider, pharmacist, and RN are key members of the interprofessional care team who can assist the client in understanding the medication's effects. The provider can explain the rationale for prescribing the medication and address any concerns the client may have. The pharmacist can provide detailed information about the medication, including potential side effects and interactions. The RN can monitor the client's response to the medication, educate them on how to take it properly, and address any immediate concerns. Choices B, E, and F are incorrect because CNAs and respiratory therapists typically do not have the expertise to provide in-depth medication counseling to clients.
A nurse is assessing the pain level of a client who has come to the ER reporting severe abdominal pain. The nurse asks the client whether he has nausea & has been vomiting. The nurse is assessing which of the following?
- A. Presence of associated symptoms
- B. Location of the pain
- C. Pain quality
- D. Aggravating & relieving factors
Correct Answer: A
Rationale: The correct answer is A: Presence of associated symptoms. By asking about nausea and vomiting, the nurse is assessing for other symptoms that may accompany the abdominal pain, providing crucial information for a comprehensive assessment. This helps in identifying potential causes, such as gastrointestinal issues. Other choices are incorrect because B: Location of the pain, C: Pain quality, and D: Aggravating & relieving factors focus solely on the characteristics of pain itself and not on associated symptoms.
An RN is making assignments for client care to an LPN at the beginning of the shift. Which of the following assignments should the LPN question?
- A. Assisting a client who is 24hr postop to use an incentive spirometer
- B. Collecting a clean-catch urine specimen from a client who was admitted on the previous shift
- C. Providing nasopharyngeal suctioning for a client who has pneumonia
- D. Replacing the cartridge and tubing on a PCA pump
Correct Answer: D
Rationale: The LPN should question assignment D (replacing the cartridge and tubing on a PCA pump) because this task involves medication administration and intravenous therapy, which are typically outside the LPN's scope of practice. LPNs are not trained to handle complex medication delivery systems like PCA pumps, as this requires specialized knowledge and skills that are within the RN's scope of practice. It is crucial for patient safety that tasks are assigned to healthcare providers based on their education, training, and scope of practice to prevent errors and ensure quality care. Assignments A, B, and C are within the LPN's scope of practice and can be safely performed without questioning.
A nurse is reviewing the CDC's immunization recommendations with a young adult client. Which of the following recommendations should the nurse include in this discussion? Select all.
- A. Human papillomavirus
- B. Measles, mumps, rubella
- C. Varicella
- D. Haemophilus influenzae type b
- E. Polio
Correct Answer: A, B, C
Rationale: The correct answer includes Human papillomavirus (HPV), Measles, mumps, rubella (MMR), and Varicella vaccines. These vaccines are recommended by the CDC for young adults to prevent serious diseases. HPV vaccine helps prevent certain types of cancers, MMR protects against highly contagious viral infections, and Varicella prevents chickenpox. The incorrect choices, Haemophilus influenzae type b (Hib) and Polio, are typically given during infancy and are not part of routine vaccinations for young adults. In summary, the correct recommendations focus on preventing common infections in this age group, while the incorrect choices are either not relevant or administered at a different life stage.