Nokea
An immunosuppressed patient is receiving chemotherapy treatment at home. What infection-control measure should the nurse recommend to the family?
- A. Family members should avoid receiving vaccinations until the patient has recovered from his or her illness.
- B. Wipe down hard surfaces with a dilute bleach solution once per day.
- C. Maintain cleanliness in the home, but recognize that the home does not need to be sterile.
- D. Avoid physical contact with the patient unless absolutely necessary.
Correct Answer: C
Rationale: A clean but non-sterile home environment is sufficient for immunosuppressed patients, as intrinsic bacteria pose greater risks than environmental ones. Avoiding vaccinations or contact is unnecessary, and daily bleach cleaning is excessive.
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A nurse is caring for a child who was admitted to the pediatric unit with infectious diarrhea. The nurse should be alert to what assessment finding as an indicator of dehydration?
- A. Labile BP
- B. Weak pulse
- C. Fever
- D. Diaphoresis
Correct Answer: B
Rationale: Weak pulse is a key sign of dehydration in children, along with thirst, dry mucous membranes, and poor skin turgor. Labile BP, fever, and diaphoresis are not specific to dehydration.
A 2-year-old is brought to the clinic by her mother who tells the nurse her daughter has diarrhea and the child is complaining of pain in her stomach. The mother says that the little girl had not eaten anything unusual, consuming homemade chicken strips and carrot sticks the evening prior. Which bacterial infection would the nurse suspect this little girl of contracting?
- A. Escherichia coli
- B. Salmonella
- C. Shigella
- D. Giardia lamblia
Correct Answer: B
Rationale: Salmonella is commonly associated with poultry, causing diarrhea and abdominal pain. E. coli is linked to undercooked beef, Shigella to fecal-oral transmission, and Giardia to contaminated water.
During a health education session, a participant asks the nurse how a vaccine can protect from future exposures to diseases against which she is vaccinated. What would be the nurses best response?
- A. The vaccine causes an antibody response in the body.
- B. The vaccine responds to an infection in the body after it occurs.
- C. The vaccine is similar to an antibiotic that is used to treat an infection.
- D. The vaccine actively attacks the microorganism.
Correct Answer: A
Rationale: Vaccines stimulate an antibody response to provide immunity against future exposures. They do not treat active infections or directly attack pathogens.
A public health nurse is teaching a mother about vaccinations prior to obtaining informed consent for her childs vaccination. What should the nurse cite as the most common adverse effect of vaccinations?
- A. Temporary sensitivity to the sun
- B. Allergic reactions to the antigen or carrier solution
- C. Nausea and vomiting
- D. Joint pain near the injection site
Correct Answer: B
Rationale: Allergic reactions to vaccine components are the most common adverse effects. Sun sensitivity, nausea, and joint pain are not typical.
A patients diagnostic testing revealed that he is colonized with vancomycin-resistant enterococcus (VRE). What change in the patients health status could precipitate an infection?
- A. Use of a narrow-spectrum antibiotic
- B. Treatment of a concurrent infection using vancomycin
- C. Development of a skin break
- D. Persistent contact of the bacteria with skin surfaces
Correct Answer: C
Rationale: A skin break provides a portal for VRE to cause infection from colonization. Antibiotics or prolonged skin contact are less likely to trigger infection.