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The nurse is working on a gerontology unit. A family member calls and tells the nurse they want to bring the family in to see one of the clients on the unit. The family member is concerned because several of the family members have colds. What instructions should the nurse provide to someone with a respiratory infection?
- A. Avoid intake of frozen foods.
- B. Avoid visiting older adults.
- C. Avoid direct sunlight.
- D. Avoid meats and other protein-rich foods.
Correct Answer: B
Rationale: The nurse should instruct anyone with respiratory infections to avoid visiting older adults until symptoms subside; older adults are more susceptible to infections because their defense mechanisms are less efficient. It is not essential for the client to avoid frozen or protein-rich foods or direct sunlight.
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A client is admitted to an acute care facility with a diagnosis of appendicitis. Which laboratory results demonstrate the client's leukocytosis?
- A. Hemoglobin of 12 mg/dL
- B. Lymphocytes 1,500
- C. Neutrophils of 3,150/mms
- D. White blood cell (WBC) count of 22,000 cells/mm
Correct Answer: D
Rationale: The body manufactures more WBCs as needed, a process referred to as leukocytosis. The WBC of 22,000 cells/mms indicates an abundance of white blood cells. Hemoglobin does not represent the presence of infection. The lymphocytes and neutrophils are within normal range and do not demonstrate leukocytosis.
A client is hospitalized for an infected decubitus ulcer of the sacral area. The physician is planning to remove the dead and damaged tissue. What type of procedure will the nurse prepare the client for?
- A. Application of a dry dressing
- B. Debridement
- C. Administration of filgrastim (Neupogen)
- D. Inject antibiotics into the wound
Correct Answer: B
Rationale: Debridement is the removal of dead and damaged tissue surgically. Application of a dry dressing will not debride the wound, nor will the administration of Neupogen or injecting antibiotics into the wound.
The nurse is caring for a client with an abscess on the back. The nurse observes purulent drainage coming from the abscess. What type of specimen does the nurse anticipate the physician will order to determine the type of bacteria present in the exudate?
- A. A sensitivity test
- B. Test for ova and parasites
- C. White blood cell (WBC) count
- D. A culture
Correct Answer: D
Rationale: A culture identifies bacteria in a specimen taken from a person with symptoms of an infection. The source of the specimen may be body fluids or wastes, such as blood, sputum, urine, or feces, or the purulent exudate, collection of pus, from an open wound. A test for ova and parasites is a stool specimen that is examined for evidence of any forms in the infecting microorganism's life cycle. A WBC count may determine that infection is present in the body but does not isolate the bacteria. A sensitivity test is done to determine which antibiotic inhibits the growth of a nonviral microorganism and will be most effective in treating the infection.
A client is admitted to the acute care facility for vomiting and diarrhea. An intravenous (IV) catheter is inserted for the delivery of IV fluids. A family member is with the client and observes the nurse enter the room and begin touching the IV site without washing hands or wearing gloves. Why should the client and family member be concerned with the nurse's actions?
- A. The client will have an allergic reaction to the IV.
- B. The nurse could develop the same symptoms.
- C. The client will develop a healthcare-associated infection.
- D. Dislodging of the IV catheter.
Correct Answer: C
Rationale: Healthcare-associated infections are infections acquired while receiving care in a healthcare agency that were not active, incubatory, or chronic at admission. They occur for many reasons. Hospitalized clients are more susceptible to infections than well people because they are exposed to pathogens in the healthcare environment; may have incisions or invasive equipment (e.g., IV lines) that compromise skin integrity; or may be immunosuppressed from poor nutrition, their disease process, or its treatment. Also, because healthcare personnel are in frequent and direct contact with many clients who harbor various microorganisms, the risk for transmitting pathogenic microorganisms between and among clients is high. Allergic reaction to the IV, the nurse developing the same symptoms, and dislodging of the IV catheter are not the priority concerns.
A client is diagnosed with a viral illness and requests an antibiotic to 'cure' the illness. When the request is refused by the physician, the client states to the nurse, 'I will never get better.' What is the best response by the nurse?
- A. I will speak with the physician again. You will only get better while taking an antibiotic.'
- B. Prescribing antibiotics for a viral infection may result in drug-resistant bacteria.'
- C. You need to think positively, and you will get better soon.'
- D. Taking antibiotics when you don't need them will make you sick.'
Correct Answer: B
Rationale: Causes of antibiotic resistance, a consequence of bacterial mutations that interfere with the mechanism of antibiotic action, are related to inappropriate prescription of antibiotics for viral (rather than bacterial) infection. Because viral infections are often self-limiting, with symptoms control, the client will get better. Indicating that the client is not thinking positively is a nontherapeutic comment. Informing the client that taking unnecessary antibiotics will cause illness is not detailed enough to be an informative response.