Nokea
A nurse is initiating a protective environment for a client who has had an allogeneic stem cell transplant. Which of the following precautions should the nurse plan for this client?
- A. Wear an N95 respirator when giving direct care to the client.
- B. Place the client in a private room with negative-pressure airflow.
- C. Ensure the client's room has at least six air exchanges per hour.
- D. Ensure the client wears a mask when outside their room if there is construction in the area.
Correct Answer: A
Rationale: The correct answer is A: Wear an N95 respirator when giving direct care to the client. This is correct because allogeneic stem cell transplant recipients are at high risk for infection due to immunosuppression. An N95 respirator helps protect the nurse from inhaling airborne pathogens when in close contact with the client.
Choice B is incorrect because negative-pressure airflow rooms are typically used for clients with airborne infections, not for those at risk due to immunosuppression.
Choice C is incorrect because although adequate air exchanges are important for infection control, it is not the specific precaution needed for a client with an allogeneic stem cell transplant.
Choice D is incorrect because wearing a mask outside the room is not as effective in preventing transmission of infections as wearing an N95 respirator during direct care.
You may also like to solve these questions
The nurse identifies a need for additional teaching when the patient who is self-monitoring blood glucose
- A. washes the puncture site using warm water and soap
- B. chooses a puncture site in the center of the finger pad
- C. hangs the arm down for a minute before puncturing the site
- D. says the result of 120 mg indicates good blood sugar control
Correct Answer: B
Rationale: The correct answer is B because choosing a puncture site in the center of the finger pad can lead to increased pain and potential nerve damage. Washing the puncture site with warm water and soap (A) is important for hygiene. Hanging the arm down before puncturing (C) can help with blood flow. Interpreting a blood sugar level of 120 mg as good control (D) is incorrect as it is above the normal range. By selecting the center of the finger pad, the patient risks causing unnecessary pain and nerve damage.
A client is having difficulty breathing while receiving supplemental oxygen via a nasal cannula in a supine position. Which of the following interventions should the nurse take first?
- A. Suction the client's airway.
- B. Instruct the client to perform incentive spirometry every hour.
- C. Assist the client to an upright position.
- D. Humidify the client's supplemental oxygen.
Correct Answer: C
Rationale: The correct answer is C: Assist the client to an upright position. This is the priority intervention because placing the client in an upright position helps improve lung expansion and oxygenation by optimizing ventilation-perfusion matching. This position also reduces the risk of aspiration and improves overall respiratory function.
Choice A (Suction the client's airway) is not the first intervention because difficulty breathing in this scenario is more likely due to positioning rather than airway obstruction.
Choice B (Instruct the client to perform incentive spirometry every hour) is not the first intervention as it may not address the immediate issue of breathing difficulty related to supine positioning.
Choice D (Humidify the client's supplemental oxygen) is not the first intervention as lack of humidification is not likely the cause of the client's difficulty breathing in this situation.
An RN knows that sometimes, when working through an ethical dilemma, the decision makers are unable to arrive at a mutually agreed upon decision. Which of the following is a reason why an agreement cannot be reached?
- A. One or more of the parties may be able to reconcile their values.
- B. The patient’s point of view is recognized as valuable.
- C. The dilemma involves two or more equally unpleasant choices.
- D. The institution is unable to honor the patient’s request.
Correct Answer: D
Rationale: The correct answer is D because if the institution is unable to honor the patient's request, it can create a barrier to reaching an agreement in an ethical dilemma. If the institution cannot support the patient's wishes, it can lead to conflicting viewpoints and hinder consensus. In contrast, choices A, B, and C do not directly address the institutional aspect and are not as relevant to the primary reason for the inability to reach an agreement in this context. Choice A focuses on individual values, choice B emphasizes the patient's perspective, and choice C pertains to the nature of the dilemma itself rather than external factors like institutional limitations.
If a task is delegated to someone, they need to be granted the ___________ to complete the task.
- A. Authority
- B. Planning
- C. Organizing
- D. Controlling
Correct Answer: A
Rationale: The correct answer is A: Authority. When a task is delegated, the individual needs the authority to make decisions and take actions to complete it effectively. Authority grants the power to make decisions, allocate resources, and enforce actions. Planning (B) involves creating a roadmap for achieving goals, organizing (C) involves arranging resources and tasks, and controlling (D) involves monitoring and ensuring tasks are on track. However, without authority, the delegated individual may face obstacles in executing the task. Therefore, the most essential aspect for successful delegation is granting authority.
Monitoring the number of times a medication is given utilizing the 'five rights' is an example of which phase of the Six Sigma program?
- A. Measure
- B. Management
- C. Quantitative
- D. Goal
Correct Answer: A
Rationale: The correct answer is A: Measure. In the Six Sigma program, the Measure phase involves collecting data to understand the current process performance. Monitoring the number of times a medication is given using the 'five rights' aligns with this phase as it focuses on measuring the accuracy and effectiveness of medication administration. This data helps identify any deviations from the desired standards and provides insights for improvement.
Summary of why other choices are incorrect:
B: Management - This choice does not specifically address the phase related to data collection and measurement.
C: Quantitative - While data collection is quantitative in nature, this choice does not capture the specific phase of Six Sigma that focuses on measurement.
D: Goal - This choice does not directly relate to the phase involving data collection and measurement; it is more focused on setting objectives and targets.