Nokea
The nurse is caring for a client who has chickenpox with open lesions. Which of the following infection control precautions should the nurse implement?
- A. Place the client in a private room with monitored negative air pressure.
- B. Ensure that pregnant staff members are not assigned to care for the client.
- C. Put a surgical mask on the client during transport outside of the assigned room.
- D. Wear a protective gown, clean gloves, and an N95 respirator mask when caring for the client.
- E. Prevent visitors from entering the client's room for 24 hours from the initial appearance of symptoms.
Correct Answer: A,B,C,D
Rationale: Chickenpox requires airborne and contact precautions: negative pressure room (A), protecting pregnant staff (B), masking during transport (C), and gown, gloves, N95 (D). Visitor restriction (E) is too short; it lasts until lesions crust.
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An 81-year-old client is admitted to a rehabilitation facility 3 days after total hip replacement. The next morning, the unlicensed assistive personnel (UAP) takes the client's vital signs, but when the UAP returns to assist the client with a shower, the client curses at and tries to hit the UAP. Which is the most appropriate response by the practical nurse?
- A. I will walk to the room to observe the client's behavior.
- B. It sounds like the client is not satisfied with the care provided. I'll see if we can make the client more comfortable.
- C. Just leave the client alone now and try again later.
- D. The client probably has dementia and is under a lot of stress with the change of environment.
Correct Answer: A
Rationale: Observing the client (A) allows assessment of the behavior's cause. Assuming dissatisfaction (B) or dementia (D) is premature. Leaving the client (C) delays intervention.
During change-of-shift report, the nurse going off duty notes that the nurse coming on has an alcohol smell on the breath and slurred speech. What actions are most important for the nurse to take?
- A. Do not continue the handoff report with the oncoming nurse
- B. Document the incident according to facility policy
- C. Notify the charge nurse
- D. Say nothing but watch for impaired behavior
- E. Tell the oncoming nurse that he/she is not fit for duty
Correct Answer: B,C
Rationale: Notifying the charge nurse (C) and documenting (B) ensure patient safety and follow protocol. Stopping handoff (A) disrupts care continuity. Watching silently (D) delays action, and confronting directly (E) may escalate the situation.
The nurse at the prenatal clinic is reinforcing education to a client who is HIV positive. Which information is appropriate for the nurse to include?
- A. Prescribed antiretroviral therapy should be continued during pregnancy
- B. Tetanus-diphtheria-acellular pertussis vaccine should be avoided until after birth
- C. The infant should be exclusively breastfed for 6 months to receive maternal antibodies
- D. The infant will not require treatment for HIV after birth
Correct Answer: A
Rationale: Continuing antiretroviral therapy (A) during pregnancy reduces HIV transmission to the infant. Tdap vaccine (B) is recommended in pregnancy. Breastfeeding (C) is contraindicated in HIV-positive mothers in high-resource settings. Infants (D) require prophylaxis post-birth.
The nurse in a same-day surgery unit assigns the unlicensed assistive personnel (UAP) to provide a hernia patient with a lunch tray. Which statement by the nurse is most appropriate?
- A. Tell the family they can bring in a pizza if the patient would prefer that.
- B. Make sure the patient gets at least 2 cartons of milk
- C. Stop the IV if the patient is able to eat solid food.
- D. Encourage the patient to eat slowly to prevent gas.
Correct Answer: D
Rationale: The professional nurse can delegate tasks with an expected outcome. The UAP is given adequate information about the task and how to promote the best outcome.
The nurse prepares a 7-year-old client for an influenza injection. The nurse explains that the client will receive 'medicine under the skin,' and the client is visibly anxious. Which nursing intervention is appropriate?
- A. Ask the child to count to 10 during injection
- B. Ask the parent to hold the child's arms tightly
- C. Explain to the child that the injection will not hurt
- D. Keep the injection needle out of the child's view
Correct Answer: D
Rationale: Hiding the needle (D) reduces anxiety. Counting (A) may not distract enough, holding arms (B) can increase fear, and denying pain (C) is dishonest.