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The charge nurse is preparing for an influx of clients with measles (rubeola) in the emergency department. To prevent the spread of this infection, the nurse recommends
- A. The distribution of respirator masks (N95) to nursing staff.
- B. Disposable face shields outside client rooms.
- C. The placement of bleach wipes to disinfect commonly touched surfaces.
- D. The removal of alcohol-based hand rubs.
Correct Answer: A
Rationale: Measles requires airborne precautions, including N95 respirators for staff. Face shields, bleach wipes, and removing hand rubs are not specific to airborne transmission.
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The nurse and two unlicensed assistive personnel (UAP) are preparing to reposition a client who requires log rolling. Which actions would be appropriate? Select all that apply.
- A. Place a small pillow between the client's knees.
- B. Places the client's arms at their side.
- C. Fanfold a drawsheet along the backside of the client.
- D. Instruct the client to laterally flex the neck during the turn.
- E. Roll the client as one unit in a smooth, continuous motion.
Correct Answer: A,B,C,E
Rationale: Pillow placement, arms at sides, drawsheet use, and rolling as a unit maintain spinal alignment. Neck flexion risks injury during log rolling.
Ergonomic principles are most closely associated with:
- A. Normal bodily alignment
- B. The control of infection
- C. Preventing congenital abnormalities
- D. Preventing hospital-acquired infections
Correct Answer: A
Rationale: Ergonomics focuses on optimizing bodily alignment to reduce strain. Infection control and congenital abnormalities are unrelated.
Which of the following actions is most effective at reducing the incidence of health-care-associated infections?
- A. Screen all newly admitted clients for colonization or infection with MRSA.
- B. Develop policies that automatically start antibiotic therapy for clients colonized by multi-drug resistant organisms.
- C. Ensure that dispensers for alcohol-based hand rubs are readily available in all client care areas of the hospital.
- D. Require nursing staff to wear gowns to change wound dressings for all clients.
Correct Answer: C
Rationale: Alcohol-based hand rub availability is the most effective way to reduce healthcare-associated infections by promoting frequent hand hygiene. MRSA screening, automatic antibiotics, and universal gown use are less effective or inappropriate.
The nurse is caring for a client with a jejunostomy tube receiving intermittent enteral feedings. Which intervention would reduce this client's aspiration risk?
- A. Flush tubing with 10 mL water after feeding is completed
- B. Assess the client's gag reflex prior to feeding
- C. Assess blood glucose every 6 hours
- D. Position the client in semi-Fowler's during and after the feeding
Correct Answer: D
Rationale: Positioning the client in semi-Fowler's (30-45 degrees) during and after feeding reduces aspiration risk by using gravity to prevent gastric contents from refluxing.
The nurse supervises a student nurse preparing a client for a magnetic resonance imaging (MRI) test. Which of the following actions by the student nurse would require follow-up by the nurse? The student
- A. Asks the client if they have claustrophobia.
- B. Instructs the client to apply earplugs before the exam.
- C. Moves the nitroglycerin patch from the torso to the back.
- D. Tells the client that they will not have any exposure to radiation.
Correct Answer: C
Rationale: Moving a nitroglycerin patch can disrupt medication delivery and is unnecessary for MRI. Asking about claustrophobia, using earplugs, and confirming no radiation exposure are correct.