A charge nurse is creating assignments for the next shift for several nurses and one of the nurses is pregnant. Which of the following clients should the charge nurse assign to a nurse who is not pregnant?
A client who has alcoholic pancreatitis
A client who has latent tuberculosis
A client who is recovering from shingles
A client who has HIV
The Correct Answer is C
Rationale:
A. A client who has alcoholic pancreatitis: Alcoholic pancreatitis does not pose a risk of teratogenicity or infectious transmission to a pregnant nurse. Standard precautions are sufficient, making this assignment safe for a pregnant nurse.
B. A client who has latent tuberculosis: Latent TB is not contagious, as the bacteria are inactive and the client cannot transmit the infection. A pregnant nurse can safely care for this client with standard precautions without increased risk.
C. A client who is recovering from shingles: Shingles (herpes zoster) is caused by reactivation of the varicella-zoster virus and can be transmitted via direct contact with lesions. Pregnant nurses who have not had chickenpox or the varicella vaccine are at risk for serious complications, so this client should be assigned to a non-pregnant nurse.
D. A client who has HIV: HIV is transmitted through blood and body fluids, and standard precautions effectively protect healthcare workers. There is no contraindication for a pregnant nurse to care for a client with HIV using proper infection control measures.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Rationale:
A. "I will change my baby's diaper at least every 4 hours.": Frequent diaper changes help keep the circumcision site clean and dry, reducing the risk of infection and irritation from urine or stool. Keeping the area free from moisture allows proper healing and minimizes discomfort for the newborn. This reflects correct home care following a circumcision.
B. "I will wash the penis with soap and warm water until the circumcision has healed.": Using soap on the circumcision site can cause irritation and delay healing. The area should be gently cleansed with warm water only, allowing the natural healing process to occur without additional chemical irritation from soaps or wipes containing alcohol or fragrances.
C. "I will apply topical lidocaine following each diaper change.": Topical anesthetics such as lidocaine are not recommended for routine circumcision care because they may cause toxicity or be absorbed unpredictably in newborns. Pain is managed through comfort measures such as swaddling, breastfeeding, or using petroleum jelly, not through anesthetic application.
D. "I will apply an ice pack to my baby's penis twice daily to decrease swelling.": Applying ice to a newborn’s circumcision site is unsafe and can cause tissue injury due to extreme temperature sensitivity. Mild swelling is expected and resolves naturally; the recommended care involves gentle cleansing and protecting the site with petroleum jelly not cold therapy.
Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"C"}
Explanation
Rationale for Correct Choices
• opioid intoxication: The client is drowsy, difficult to arouse, and has a respiratory rate of 10/min, all of which are hallmark findings of opioid intoxication. The presence of a needle in the antecubital space and the need for naloxone also strongly support opioid involvement. The prior history also documents opioid misuse and prior treatment with buprenorphine/naloxone, further increasing the likelihood of opioid intoxication in this episode.
• pupil characteristics: Miotic (pinpoint) pupils are a classic indicator of opioid intoxication and help differentiate it from alcohol intoxication, which typically presents with normal or enlarged pupils. The pupil response directly supports the diagnosis when paired with respiratory depression and altered level of consciousness.
Rationale for Incorrect Choices
• Alcohol withdrawal: Alcohol withdrawal presents with agitation, tremors, diaphoresis, tachycardia, hypertension, and occasionally hallucinations. This client is drowsy with decreased respiratory rate and constricted pupils, which are inconsistent with alcohol withdrawal, making this diagnosis unlikely.
• Alcohol intoxication: Alcohol intoxication often presents with slurred speech, ataxia, and altered mental status, but pupils are usually normal in size and not constricted. There is also no evidence of significant alcohol consumption reported, making alcohol intoxication less likely in this scenario.
• Opioid withdrawal: Opioid withdrawal is characterized by mydriasis (dilated pupils), diaphoresis, piloerection, tachycardia, nausea, vomiting, and agitation. The client’s current presentation of drowsiness, miotic pupils, and respiratory depression is opposite of withdrawal symptoms, ruling out opioid withdrawal.
• Amount of alcohol consumed: The client reportedly had only one beer, which is insufficient to cause coma-level depression. Alcohol intoxication severe enough to cause unresponsiveness with respiratory depression would require significantly higher intake.
• Breath sounds: Clear breath sounds do not help distinguish the cause of the altered mental status. Breath sounds are more useful for identifying respiratory complications, not for differentiating intoxication types.
• Current temperature: A normal temperature does not help identify opioid intoxication versus withdrawal. Temperature fluctuations are more common in severe withdrawal states and are not diagnostic enough to determine the underlying cause in this scenario.
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