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The nurse is caring for a client who is receiving antibiotic therapy and develops Clostridioides difficile colitis. Which of the following infection-control precautions should the nurse implement? Select all that apply.
- A. Disinfect surfaces using a diluted bleach solution
- B. Perform hand hygiene using an alcohol-based hand sanitizer
- C. Wear a face mask
- D. Wear a protective gown
- E. Wear nonsterile gloves
Correct Answer: A,D,E
Rationale: Bleach disinfection (A), gowns (D), and gloves (E) are required for C. difficile, which is spore-forming. Alcohol sanitizers (B) are ineffective against spores, and masks (C) are not routinely needed.
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An 86-year-old client with diabetes and gastroparesis has had repeated hospitalizations for aspiration pneumonia following a stroke and is now hospitalized with altered level of consciousness. Which nursing action is most appropriate to decrease the client's risk for developing aspiration pneumonia?
- A. Assessing client's breath sounds every 2 hours
- B. Placing client in the side lying position in bed
- C. Titrating client's oxygen to maintain saturation 93%
- D. Turning and repositioning the client every 2 hours
Correct Answer: B
Rationale: The side-lying position (B) reduces aspiration risk by preventing reflux into the airway, especially in clients with altered consciousness. Assessing breath sounds (A), oxygen titration (C), and repositioning (D) are supportive but less effective for prevention.
An adult comes to the physician's office with a history of headache yesterday and today and pain in the back. The nurse observes a horizontal band of pustular rash on the back extending from the spine to midline in the front. The client describes it as very painful. What would the nurse expect to be prescribed for this client?
- A. Antiviral
- B. Antibiotics
- C. Topical hydrocortisone
- D. Benadryl
Correct Answer: A
Rationale: The painful, unilateral, dermatomal pustular rash suggests herpes zoster (shingles), treated with antivirals like acyclovir.
The practical nurse (PN) is assisting with a client who is undergoing labor induction with misoprostol. The PN notes late decelerations and minimal variability on the fetal heart rate monitor. After notifying the registered nurse, what should the PN do first?
- A. Administer 10 L/min oxygen by face mask
- B. Examine the perineum to check for bloody show
- C. Palpate the client's abdomen
- D. Reposition the client to a side-lying position
Correct Answer: D
Rationale: Repositioning to a side-lying position (D) improves placental perfusion, addressing late decelerations. Oxygen (A) may follow, but repositioning is first. Perineal exam (B) and palpation (C) are less urgent.
The nurse is changing a dressing. Which event indicates a break in sterile technique?
- A. The nurse opens the sterile dressing set by opening the first flap away from herself.
- B. The nurse turns around when answering a question asked by the client in the other bed.
- C. The nurse opens the dressing set on the overbed table.
- D. The nurse pours sterile saline into the container in the dressing set.
Correct Answer: B
Rationale: Turning around risks contaminating the sterile field by passing non-sterile areas over it. Opening flaps away, using the table, or pouring saline maintain sterility.
The nurse preparing an educational seminar on sexually transmitted infections for female college students should advise that which 2 infections are leading causes of pelvic inflammatory disease and infertility?
- A. Genital herpes and HIV
- B. Gonorrhea and chlamydia
- C. Human papillomavirus and syphilis
- D. Yeast and trichomoniasis
Correct Answer: B
Rationale: Gonorrhea and chlamydia (B) are bacterial infections that commonly cause pelvic inflammatory disease and infertility if untreated. Other options are less associated with these outcomes.