Nokea
An older adult patient has been diagnosed with Legionella infection. When planning this patients care, the nurse should prioritize which of the following nursing actions?
- A. Monitoring for evidence of skin breakdown
- B. Emotional support and promotion of coping
- C. Assessment for signs of internal hemorrhage
- D. Vigilant monitoring of respiratory status
Correct Answer: D
Rationale: Legionella primarily affects the lungs, causing cough, dyspnea, and chest pain, so respiratory monitoring is critical. Skin breakdown, hemorrhage, and emotional support are secondary.
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A patient on the medical unit is found to have pulmonary tuberculosis (TB). What is the most appropriate precaution for the staff to take to prevent transmission of this disease?
- A. Standard precautions only
- B. Droplet precautions
- C. Standard and contact precautions
- D. Standard and airborne precautions
Correct Answer: D
Rationale: Pulmonary TB requires airborne precautions with standard precautions to prevent droplet transmission. Droplet or contact precautions alone are insufficient.
What is the best rationale for health care providers receiving the influenza vaccination on a yearly basis?
- A. To decreased nurses susceptibility to health care-associated infections
- B. To decrease risk of transmission to vulnerable patients
- C. To eventually eradicate the influenza virus in the United States
- D. To prevent the emergence of drug-resistant strains of the influenza virus
Correct Answer: B
Rationale: Annual influenza vaccination reduces transmission to vulnerable patients. It does not prevent healthcare-associated infections, eradicate influenza, or stop drug-resistant strains.
The nurse who provides care at a wilderness camp is teaching staff members about measures that reduce campers and workers risks of developing Giardia infections. The nurse should emphasize which of the following practices?
- A. Making sure not to drink water that has not been purified
- B. Avoiding the consumption of wild berries
- C. Removing ticks safely and promptly
- D. Using mosquito repellant consistently
Correct Answer: A
Rationale: Giardia is transmitted through contaminated water, so avoiding unpurified water is key. Berries, ticks, and mosquitoes are not associated with Giardia transmission.
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.
The nurse is caring for a patient who is colonized with methicillin-resistant Staphylococcus aureus (MRSA). What infection control measure has the greatest potential to reduce transmission of MRSA and other nosocomial pathogens in a health care setting?
- A. Using antibacterial soap when bathing patients with MRSA
- B. Conducting culture surveys on a regularly scheduled basis
- C. Performing hand hygiene before and after contact with every patient
- D. Using aseptic housekeeping practices for environmental cleaning
Correct Answer: C
Rationale: Hand hygiene is the most effective measure to prevent MRSA and nosocomial pathogen transmission. Antibacterial soap, culture surveys, and housekeeping are less impactful.