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The intensive care unit nurse is caring for a client with a transmissible spongiform encephalopathy. The nurse knows that this type of encephalopathy is caused by what type of infectious agent?
- A. Prion
- B. Protozoa
- C. Helminth
- D. Rickettsia
Correct Answer: A
Rationale: A prion is a protein that does not contain nucleic acid. Research suggests that normal prions present in brain cells protect against dementia. When a prion mutates, however, it is capable of becoming an infectious agent and altering other normal prion proteins into similar mutant copies. The mutant prions, which can be formed by genetic predisposition or acquired by transmission between the same or similar infected animal species, cause transmissible spongiform encephalopathies. Transmissible spongiform encephalopathies are not caused by protozoa, helminths, or rickettsias.
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The nurse is caring for a client with a stage IV leg ulcer. The nurse is closely monitoring the client for sepsis. What would indicate that sepsis has occurred and that the nurse should notify the physician of immediately?
- A. The client feels restless and hungry.
- B. The client exhibits an increased urinary output.
- C. The client's heart rate is greater than 90 beats/minute.
- D. The client's respiratory rate is less than 20 breaths/minute.
Correct Answer: C
Rationale: A heart rate greater than 90 beats/minute or a respiratory rate greater than 20 breaths/minute will indicate that sepsis has occurred. Sepsis does not increase the client's appetite or affect the client's urinary output.
A nurse on the unit sustains a needlestick injury while caring for a client whose infectious status is unknown. What would be the best course of action for the nurse to follow?
- A. Avoid notifying the supervisor of the injury until the client's infectious status is confirmed.
- B. Avoid revealing the identity of the client or source of blood.
- C. Be tested for disease antibodies at appropriate intervals.
- D. Document the injury in writing after the client's infectious status is confirmed.
Correct Answer: C
Rationale: If a needlestick injury has occurred, the nurse should be tested for disease antibodies immediately and at appropriate intervals thereafter. The nurse should document the injury in writing immediately and should not wait until the client's infectious status is confirmed. The nurse should also notify the supervisor of the injury immediately and identify the person or source of blood, if possible.
A client visits the clinic reporting a circular rash on the upper right arm. The rash is diagnosed as tinea corporis. For what type of infection does the nurse anticipate the client will be treated?
- A. Rickettsiae
- B. Protozoans
- C. Mycoplasma
- D. Fungus
Correct Answer: D
Rationale: One type of fungal infection is superficial (dermatophytoses), which affect the skin, hair, and nails; examples include tinea corporis, or ringworm, and tinea pedis, also known as athlete's foot. Rickettsiae, protozoans, and mycoplasma have different characteristics and transmission than fungus.
The nurse gave a client an injection and, when attempting to recap the needle, sustained a needlestick injury to the finger. What is the priority action by the nurse?
- A. Report the injury or exposure to the supervisor.
- B. Document the injury in writing.
- C. Receive instructions on monitoring potential symptoms and medical follow-up.
- D. Receive the most appropriate postexposure prophylaxis.
Correct Answer: A
Rationale: Should needlestick injury or other exposure to a potential blood-borne pathogen occur, healthcare workers are advised to follow postexposure recommendations; report the injury or exposure to one's supervisor immediately; document the injury in writing; identify the person or source of blood; obtain the HIV and HBV statuses of the source of blood, if it is legal to do so. Unless the client gives permission, testing and revealing HIV status are prohibited. Obtain counseling on the potential for infection. Receive the most appropriate postexposure prophylaxis; be tested for disease antibodies at appropriate intervals. Receive instructions on monitoring potential symptoms and medical follow-up.
The nursing instructor is teaching beginning nursing students about infection. Toward the end of class, the instructor gives the students a scenario of a client with an infection who has developed fever and diarrhea. What should the student nurse instruct the client to avoid?
- A. Tea and coffee
- B. Ice water and broth
- C. Fruit juices
- D. Milk and gelatin
Correct Answer: A
Rationale: A client with fever and diarrhea should avoid tea, coffee, and carbonated beverages containing caffeine because these promote diuresis. The intake of ice water, broth, fruit juices, gelatin, and milk should be encouraged to add proteins and calories.