Nokea
A family member wants to donate blood for a client who needs a blood transfusion. What information from the family member would make them ineligible for donation?
- A. The family member was serving in the military in England in 1993 for 2 years.
- B. The family member had a surgical procedure 4 years previously for an inguinal hernia.
- C. The family member received a blood transfusion 10 years previously at a hospital in Canada.
- D. The family member takes an antihypertensive medication for control of blood pressure.
Correct Answer: A
Rationale: The American Red Cross bans blood collection from anyone who has lived in the United Kingdom for a total of 6 months or longer between 1980 and 1996, lived in various countries in Europe including while serving in the military since 1980, received a blood transfusion in the United Kingdom, or lived 5 or more years in various European countries from 1980 to the present. There is a higher risk among these potential donors for BSE or 'mad cow disease.' The other answers are not exclusion criteria for donating blood.
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A nurse is having a yearly employee tuberculin skin test. Which skin test results would indicate a positive result?
- A. An induration of 12 mm
- B. An uneven erythemic area
- C. An induration of less than 1 mm
- D. An induration of 4 mm
Correct Answer: A
Rationale: The size of the induration, not including the surrounding area of erythema, is measured in millimeters. The measurement determines whether the reaction is significant. For example, a tuberculin skin test is considered positive if the induration is 10 mm or greater in persons with no known risk factors for TB; smaller measurements are significant in certain risk groups, such as immunocompromised clients. The other answers are not indicative of positive results.
A client informs the nurse of having been using a douche to cleanse the vagina on a daily basis and is now experiencing itching and burning in the vaginal area. What should the nurse explain to the client that occurs when the vaginal pH is changed?
- A. It causes destruction of the normal flora of the vagina and allows the development of vaginal infections.
- B. The bottle must be contaminated with bacteria, and when the pH is changed, it allows the bacteria to enter the vaginal area.
- C. It will cause an allergic reaction in the vaginal area.
- D. When the vaginal pH is changed, it allows cancer cells to spread from the vagina to the cervix.
Correct Answer: A
Rationale: The acid environment is unfavorable for the multiplication of pathogenic bacteria and fungi. A change in vaginal pH or destruction of the normal flora, however, can promote the development of a vaginal infection. Bacteria do not cause the vaginal pH to change; the pH change allows bacteria to grow. Change in vaginal pH does not cause an allergic reaction and does not allow the development of cancer cells.
The nurse is working on a gerontology unit. A family member calls and tells the nurse they want to bring the family in to see one of the clients on the unit. The family member is concerned because several of the family members have colds. What instructions should the nurse provide to someone with a respiratory infection?
- A. Avoid intake of frozen foods.
- B. Avoid visiting older adults.
- C. Avoid direct sunlight.
- D. Avoid meats and other protein-rich foods.
Correct Answer: B
Rationale: The nurse should instruct anyone with respiratory infections to avoid visiting older adults until symptoms subside; older adults are more susceptible to infections because their defense mechanisms are less efficient. It is not essential for the client to avoid frozen or protein-rich foods or direct sunlight.
The nurse is caring for a client with a stage IV leg ulcer. The nurse is closely monitoring the client for sepsis. What would indicate that sepsis has occurred and that the nurse should notify the physician of immediately?
- A. The client feels restless and hungry.
- B. The client exhibits an increased urinary output.
- C. The client's heart rate is greater than 90 beats/minute.
- D. The client's respiratory rate is less than 20 breaths/minute.
Correct Answer: C
Rationale: A heart rate greater than 90 beats/minute or a respiratory rate greater than 20 breaths/minute will indicate that sepsis has occurred. Sepsis does not increase the client's appetite or affect the client's urinary output.
Which of the following would be considered a mechanical defense mechanism?
- A. Cast
- B. Coughing
- C. Clothing
- D. Sunscreen
Correct Answer: B
Rationale: Mechanical defense mechanisms are physical barriers that prevent microorganisms from gaining entry or expel microorganisms before they multiply. Examples are the skin and mucous membranes, physiologic reflexes (e.g., sneezing, coughing, vomiting), and macrophages. Casts, clothing, and sunscreen do not keep microorganisms from gaining entry to the body.