A nurse begins to bathe a newly admitted client who reports that they have not had anything to eat that day. The nurse interrupts the bath and obtains a healthy meal for the client. This action by the nurse is an example of which of the following?

Countertransference

Boundary crossing

Promoting trust

Veracity

Answer and Explanation

The Correct Answer is C

A.   Incorrect. Countertransference refers to the nurse's emotional reaction to the client based on the nurse's personal feelings or past experiences.
B.   Incorrect. Boundary crossing refers to the nurse's actions that blur the professional boundaries of the nurse-client relationship, and this action does not necessarily represent boundary-crossing.
C.   Correct. The nurse's action of interrupting the bath to obtain a healthy meal for the client demonstrates an immediate response to the client's need and promotes trust and rapport between the nurse and the client.
D.   Incorrect. Veracity refers to truthfulness and honesty, but it does not directly apply to the nurse obtaining a meal for the client who is hungry.

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Correct Answer is D

Explanation

The correct answer is choiced. "Soiled dressings should be placed in a biohazard trash receptacle.".

Choice A rationale:

For a client who has Clostridium difficile, hand hygiene should be performed with soap and water, not an alcohol-based rub, as alcohol does not effectively kill C. difficile spores.

Choice B rationale:

Droplet precautions typically require wearing a mask, not necessarily a gown and gloves. Gown and gloves are more commonly associated with contact precautions.

Choice C rationale:

Following a blood spill, a bleach solution with a ratio of 1 to 10 is recommended, not 1 to 20. This higher concentration ensures effective disinfection.

Choice D rationale:

Placing soiled dressings in a biohazard trash receptacle is correct. This prevents the spread of infection and ensures proper disposal of contaminated materials.

A. Elevated blood pressure B. Bounding pulse C. Fruity breath odor D. Clammy skin

Correct Answer is C

Explanation

A. Elevated blood pressure is not a specific finding associated with diabetic ketoacidosis (DKA..
B. Bounding pulse might be present due to dehydration in DKA, but it's not a defining characteristic.
C. Correct. Fruity breath odor (often described as "fruity" or "acetone-like". is a characteristic sign of DKA due to the presence of ketones in the breath?
D. Clammy skin is not a specific finding associated with DKA.

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A nurse begins to bathe a newly admitted client who reports that they have not had anything to eat that day. The nurse interrupts the bath and obtains a healthy meal for the client. This action by the nurse is an example of which of the following?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

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Correct Answer is C

Explanation

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