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A nurse manager is reviewing isolation guidelines with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates understanding of isolation guidelines?
- A. I will instruct visitors to wear a mask when visiting a client who is on contact precautions.
- B. I will have a client who is on airborne precautions wear a mask when out of her room.
- C. I will wear an N95 respirator mask when caring for a client who is on droplet precautions.
- D. I will place a client who has compromised immunity in a negative-pressure airflow room.
Correct Answer: B
Rationale: The correct answer is B because it demonstrates understanding of airborne precautions. Airborne precautions require clients to wear a mask when leaving their room to prevent the spread of infectious agents through the air. This statement aligns with the principle of protecting others from exposure.
Explanation for other choices:
A - Incorrect: Visitors, not clients, should wear masks on contact precautions to prevent the spread of infection to the client.
C - Incorrect: N95 respirator masks are used for airborne precautions, not droplet precautions.
D - Incorrect: Negative-pressure airflow rooms are used for clients on airborne precautions, not those with compromised immunity.
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A nurse is serving on a committee whose task is to plan cost-effective care at the facility. Which of the following client care tasks should the nurse recommend?
- A. Change total parenteral nutrition IV tubing every 48 hr.
- B. Replace total parenteral nutrition solution bags every 48 hr.
- C. Replace peripheral IV solution bags every 96 hr.
- D. Change peripheral IV primary tubing every 96 hr.
Correct Answer: D
Rationale: The correct answer is D: Change peripheral IV primary tubing every 96 hr. This recommendation aligns with evidence-based practice guidelines for preventing infection risk associated with IV therapy. Changing the peripheral IV tubing every 96 hours helps reduce the risk of contamination and infection. Choice A is incorrect because changing total parenteral nutrition IV tubing every 48 hours is not necessary unless there is a specific indication. Choice B is incorrect as replacing total parenteral nutrition solution bags every 48 hours is not a standard practice and can lead to wastage. Choice C is incorrect because changing peripheral IV solution bags every 96 hours is less critical than changing the primary tubing.
A nurse preceptor is observing a newly hired nurse perform a sterile dressing change. Which of the following actions should the nurse preceptor identify as maintaining sterile technique?
- A. Uses a sterile-gloved hand to adjust the back of the sterile gown
- B. Uses sterile forceps to pack sterile gauze into the wound
- C. Places sterile gauze 1.3 cm (0.5 in) away from the edge of a sterile drape
- D. Sets up the sterile field 30 min prior to performing the dressing change
Correct Answer: B
Rationale: Using sterile forceps to pack gauze maintains sterility, reducing infection risk, unlike actions that breach sterile field integrity.
The family members of an older adult client are expressing conflict over whether the client should have surgery that is recommended by the provider. The oldest adult child has durable power of attorney for health care for the client. The client is oriented to person, place, and time. Which of the following people has the legal authority to make this health care decision?
- A. The client
- B. The partner
- C. The provider
- D. The oldest adult child
Correct Answer: A
Rationale: A mentally competent client retains legal authority to make healthcare decisions, despite a durable power of attorney, which only applies when the client is incapacitated.
A nurse witnesses a coworker not following facility procedure when discarding the unused portion of a controlled substance. Which of the following actions should the nurse take?
- A. Request that the coworker complete an incident report.
- B. File an anonymous report of the incident to the nurse manager.
- C. Identify all witnesses to the incident.
- D. Document a factual account of the incident.
- E. Submit an incident report to the risk manager.
Correct Answer: B,C,D,E
Rationale: Filing an anonymous report, identifying witnesses, documenting the incident, and submitting a report ensure accountability and prevent recurrence without workplace tension.
A nurse is caring for a client who has a new diagnosis of Crohn's disease and is interested in learning more about their condition. Which of the following actions should the nurse take?
- A. Encourage the client to research Crohn's disease on websites that have a gov address.
- B. Ask a licensed practical nurse to explain Crohn's disease to the client.
- C. Recommend podcasts that discuss Crohn's disease to the client.
- D. Suggest that the client read articles that recommend specific treatments for Crohn's disease.
Correct Answer: A
Rationale: The correct answer is A: Encourage the client to research Crohn's disease on websites that have a gov address. This option is the most appropriate because government websites provide reliable and evidence-based information on medical conditions. The client can access accurate and up-to-date information to better understand their condition.
Choice B is incorrect because a licensed practical nurse may not have the same level of expertise and resources as a government website. Choice C is incorrect as podcasts may not always provide detailed and accurate information. Choice D is incorrect because reading articles recommending specific treatments may not provide a comprehensive understanding of the disease itself. It is important for the client to have a solid foundation of knowledge about Crohn's disease before delving into treatment options.