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Which of the ff precautions must a nurse take while caring for clients with HIV/AIDS to reduce occupational risks?
- A. Transport specimens of body fluid in leakproof containers
- B. Seek prescription for a fusion inhibitor to reduce risk of infection
- C. Avoid administering IV drugs
- D. Avoid cleaning the clients room, esp cleaning urine, stool, or vomit
Correct Answer: A
Rationale: When caring for clients with HIV/AIDS to reduce occupational risks, a nurse must take precautions to minimize the risk of exposure to body fluids that may contain the HIV virus. Transporting specimens of body fluid in leakproof containers helps prevent accidental spills or leakages that could lead to exposure. Proper handling and containment of body fluids are essential to reducing the risk of transmission of HIV to healthcare workers. This precaution is in line with standard infection control practices to ensure the safety of healthcare providers and minimize the risk of occupational exposure to bloodborne pathogens like HIV.
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Immunization of children with Haemophilus influenzae type B (Hib) vaccine decreases the incidence of which of the following conditions?
- A. Bronchiolitis
- B. Laryngotracheobronchitis (LTB)
- C. Epiglottitis
- D. Pneumonia
Correct Answer: C
Rationale: Immunization of children with Haemophilus influenzae type B (Hib) vaccine decreases the incidence of severe infections caused by Haemophilus influenzae type B bacteria, including epiglottitis. Epiglottitis is a serious condition where the epiglottis, a flap of tissue that sits at the base of the tongue, becomes inflamed and can swell, potentially blocking the airway and leading to respiratory distress and even death. By vaccinating children against Hib, the risk of developing epiglottitis is significantly reduced. The Hib vaccine is a crucial component of childhood immunization programs to prevent life-threatening diseases caused by Hib bacteria, including epiglottitis.
The nurse is teaching parents about prevention of urinary tract infections in children. Which factor predisposes the urinary tract to infection?
- A. Increased fluid intake
- B. Short urethra in young girls
- C. Prostatic secretions in males
- D. Frequent emptying of the bladder
Correct Answer: B
Rationale: One of the factors that predisposes the urinary tract to infection is a short urethra in young girls. The shorter urethra compared to boys makes it easier for bacteria to travel up the urinary tract and cause infections. This anatomical difference in young girls increases their susceptibility to urinary tract infections compared to boys. In boys, the longer length of the urethra provides a natural barrier for bacteria to enter the bladder, reducing the risk of infection.
A patient is hemorrhaging from multiple trauma sites. The nurse expects that compensatory mechanisms associated with hypovolemia would cause all of the following symptoms except:
- A. Hypertension
- B. Tachycardia
- C. Oliguria
- D. Tachypnea
Correct Answer: A
Rationale: In a patient experiencing hemorrhage from multiple trauma sites leading to hypovolemia, compensatory mechanisms typically include an increase in heart rate (tachycardia), a decrease in urine output (oliguria), and an increase in respiratory rate (tachypnea). These mechanisms are the body's way of trying to maintain vital organ perfusion in the setting of decreased blood volume. However, hypertension is not typically seen in the setting of hypovolemia. In fact, blood pressure tends to decrease as a result of reduced circulating volume.
The nurse is caring for a client in the emergency room diagnosed with Bell's palsy. The client has been taking acetaminophen (Tylenol), and acetaminophen overdose is suspected. The nurse anticipates that the antidote to be prescribed is:
- A. Pentostatin (Nipent)
- B. Fludarabine (Fludara)
- C. Auranofin (Ridaura)
- D. Acetylcysteine Mucomyst)
Correct Answer: D
Rationale: Acetylcysteine (Mucomyst) is the antidote for acetaminophen (Tylenol) overdose. If an overdose of acetaminincophen is suspected, acetylcysteine should be administered within 8-10 hours of ingestion to prevent liver damage and failure. Pentostatin, Fludarabine, and Auranofin are not antidotes for acetaminophen overdose and are used for other medical conditions.
The nurse is caring for a client who is receiving antibiotics to treat a gram-negative bacterial infection. Because antibiotics destroy the body's normal flora, the nurse must monitor the client for:
- A. Platelet dysfunction
- B. Stomatitis
- C. Oliguria and dysuria
- D. Diarrhea
Correct Answer: D
Rationale: When a client is receiving antibiotics to treat an infection, especially a gram-negative bacterial infection, the antibiotics may disrupt the balance of normal flora in the gastrointestinal tract. This disruption can lead to an overgrowth of pathogenic bacteria, resulting in diarrhea. Clostridium difficile-associated diarrhea is a common complication of antibiotic therapy due to the disruption of normal gut flora. Therefore, the nurse must monitor the client for signs and symptoms of diarrhea and intervene promptly to prevent complications such as dehydration and electrolyte imbalances. Platelet dysfunction, stomatitis, and oliguria/dysuria are not typically associated with the destruction of normal flora due to antibiotic therapy for a gram-negative bacterial infection.