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Clinic employees were taught to recognize the hazards of various chemicals using the National Fire Protection Association's (NFPA) diamond label and coding system. What should the nurse determine about the substance that has the label illustrated?
- A. It is extremely flammable.
- B. It can become explosive if mixed with water.
- C. It has no special hazard.
- D. It could cause a serious health injury.
Correct Answer: D
Rationale: The blue diamond with a 3 indicates a serious health hazard, capable of causing significant injury.
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Which task could be safely delegated by the nurse to an unlicensed assistive personnel (UAP)?
- A. Be with a client who self-administers insulin
- B. Cleanse and dress a small decubitus ulcer
- C. Monitor a client's response to passive range of motion exercises
- D. Apply and care for a client's rectal pouch
Correct Answer: D
Rationale: The RN may delegate the application and care of rectal pouches to a UAP. This is an uncomplicated, routine task that does not require clinical judgment or advanced skills.
Which of these actions is the primary nursing intervention designed to limit transmission of a client's Salmonella infection?
- A. Wash hands thoroughly before and after client contact
- B. Wear gloves when in contact with body secretions
- C. Double glove when in contact with feces or vomitus
- D. Wear gloves when disposing of contaminated linens
Correct Answer: A
Rationale: Gram-negative bacilli cause Salmonella infection, and lack of sanitation is the primary means of contamination. Thorough handwashing can prevent the spread of salmonella.
A client has been placed in isolation because he is diagnosed with a contagious illness. The nurse should be aware that:
- A. Linens from the client's bed should be double-bagged.
- B. Meals should be served on washable dishes.
- C. Extensive isolation rarely causes psychological problems.
- D. Paper trays and plastic utensils prevent disease transmission.
Correct Answer: A
Rationale: Linens should be double-bagged. Isolation refers to techniques used to prevent or to limit the spread of infection. Some form of isolation has been used for centuries, whether to protect a high-risk person from exposure to pathogens or to prevent the transmission of pathogens from an infected person to others. Special handling of articles and linen soiled by any body fluid is indicated. These articles should be placed in impervious bags before they are removed from the client's bedside. Bagging in watertight containers is indicated to prevent exposure of personnel and contamination of the environment. The outside of the bag should not be contaminated when placing articles inside it. Each hospital and community agency has procedures for labeling and decontaminating exposed articles. Items that are visibly soiled with body substances should be rinsed and placed in plastic bags or clearly marked containers, often labeled 'Contaminated.' If the outside of the bag becomes contaminated, placing that bag in another bag (double-bagging) is required.
After working with a client, an unlicensed assistive personnel (UAP) tells the nurse, "I have had it with that demanding client. I just can't do anything that pleases him. I'm not going in there again." The nurse should respond by saying
- A. He has a lot of problems. You need to have patience with him.
- B. I will talk with him and try to figure out what to do.
- C. He may be scared and taking it out on you. Let's talk to figure out what to do.
- D. Ignore him and get the rest of your work done. Someone else can take care of him for the rest of the day.
Correct Answer: C
Rationale: This response explains the client's behavior without belittling the UAP's feelings. The UAP is encouraged to contribute to the plan of care to help solve the problem.
A client with congestive heart failure is newly admitted to home health care. The nurse discovers that the client has not been following the prescribed diet. What would be the most appropriate nursing action?
- A. Discharge the client from home health care because of noncompliance
- B. Notify the provider of the client's failure to follow prescribed diet
- C. Discuss diet with the client to learn the reasons for not following the diet
- D. Make a referral to Meals-on-Wheels
Correct Answer: C
Rationale: Discuss diet with the client to learn the reasons for not following the diet. When new problems are identified, it is important for the nurse to collect accurate assessment data. Before reporting findings to the provider, it is best to have a complete understanding of the client's behavior and feelings as a basis for future teaching and intervention.