A charge nurse is observing a newly licensed nurse who is caring for a client who has pulmonary tuberculosis. The charge nurse should expect the newly licensed nurse to take which of the following actions?
Place the client on droplet precautions.
Place the client in a room with positive-pressure airflow.
Wear a surgical mask when taking the client out of the room.
Wear an N95 respirator mask when in the client's room.
The Correct Answer is D
Answer is: Wear an N95 respirator mask when in the client’s room.
Explanation: Pulmonary tuberculosis (TB) is a contagious disease caused by bacteria that can spread through the air. The most common way of transmission is through respiratory droplets that are expelled when a person with active TB coughs, sneezes, or speaks1. Therefore, the charge nurse should expect the newly licensed nurse to take precautions to protect themselves and the client from exposure to TB. One of these precautions is to wear an N95 respirator mask when in the client’s room2. An N95 respirator mask is a type of personal protective equipment (PPE) that filters out at least 95% of airborne particles, including bacteria and viruses3. It can prevent the nurse from inhaling or spreading TB to others.
The other options are incorrect because:
Place the client on droplet precautions: Droplet precautions are not enough to prevent transmission of TB, as they only protect against respiratory droplets that are less than 5 micrometers in diameter1. However, TB bacteria can be found in larger droplets that can travel farther and infect people who are not in direct contact with the source1.
Place the client in a room with positive-pressure airflow: Positive-pressure airflow is not effective against TB, as it does not reduce the concentration of airborne particles or prevent them from escaping through cracks and gaps in doors and windows. Moreover, positive-pressure airflow can create negative pressure in other areas of the facility, which can increase the risk of cross-contamination.
Wear a surgical mask when taking the client out of the room: A surgical mask is not sufficient to protect against TB, as it only filters out particles that are larger than 5 micrometers in diameter3. It also does not fit properly on the face and may allow some particles to pass through3.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
The correct answer isChoice A: Place the client in a dorsal recumbent position for the examination.
Choice A rationale:
The dorsal recumbent position, where the client lies on their back with knees bent and feet flat on the bed, is ideal for abdominal assessments.This position helps relax the abdominal muscles, making it easier to palpate and auscultate the abdomen.
Choice B rationale:
Auscultating for vascular bruits should be done with the bell of the stethoscope, not the diaphragm.The bell is more sensitive to low-frequency sounds like bruits.
Choice C rationale:
The assessment should begin with inspection and auscultation before palpation.Palpation can alter bowel sounds, leading to inaccurate findings.
Choice D rationale:
The client should have an empty bladder before the assessment to avoid discomfort and ensure accurate findings.
Correct Answer is A
Explanation
The correct answer is choice A: Compare data from clients' records regarding skin integrity with established criteria.
Choice A rationale:
Comparing data from clients' records regarding skin integrity with established criteria (Choice A) is essential for evaluating the effectiveness of the plan to decrease pressure injuries. This action helps identify trends, improvements, or areas that still need attention.
Choice B rationale:
Measuring staff attendance at an educational program on managing pressure injuries (Choice B) assesses staff participation but does not directly evaluate the plan's impact on pressure injury rates. Attendance does not necessarily translate to improved implementation.
Choice C rationale:
Interviewing clients regarding their satisfaction with their care (Choice C) focuses on client satisfaction rather than evaluating the effectiveness of the plan in reducing pressure injuries. While satisfaction is important, it does not directly measure the plan's success.
Choice D rationale:
Monitoring use of supplies used to prevent pressure injuries (Choice D) provides information on resource utilization but does not provide comprehensive data on the plan's effectiveness. It does not account for the effectiveness of staff adherence to pressure injury prevention protocols.
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