A nurse in the Medical-Surgical unit is caring for a client who has had an allogeneic hematopoietic stem-cell transplant. Which of the following infection-control precautions should the nurse use while caring for this client?
Airborne.
Contact.
Droplet.
Protective.
The Correct Answer is B
The correct answer is: d. Protective. Protective precautions are crucial for clients who have had an allogeneic hematopoietic stem-cell transplant due to their severely weakened immune systems.
Choice A reason:
Airborne precautions are used for infections that spread through the air, such as tuberculosis and measles. These infections require special ventilation and respiratory protection, which is not the primary concern for stem-cell transplant patients.
Choice B reason:
Contact precautions are used for infections spread by direct contact, like MRSA or C. difficile. These precautions involve wearing gloves and gowns but do not address the airborne or droplet risks that immunocompromised patients face.
Choice C reason:
Droplet precautions are for infections spread by large respiratory droplets, such as influenza or pertussis. While important, they do not provide the comprehensive protection needed for stem-cell transplant recipients.
Choice D reason:
Protective precautions involve placing the patient in a room with HEPA filtration and limiting visitors to minimize infection risk. This is essential for patients with compromised immune systems, such as those who have undergone allogeneic hematopoietic stem-cell transplants.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale:
This situation represents an example of assault. Assault is the threat of bodily harm or unwanted physical contact, which creates an apprehension of fear in the victim. In this case, the laboratory technician's actions of restraining the client's arm against their will for blood drawing without consent is a form of assault as it involves an intentional act causing fear of harm.
Choice B rationale:
While telling a client that the nurse "does not know anything" is unprofessional and disrespectful, it doesn't constitute assault. This scenario is more related to issues of communication and respect rather than a direct threat of physical harm.
Choice C rationale:
Restraining a client at bedtime to prevent wandering is not assault. This scenario might involve ethical considerations and the appropriate use of restraints, but it doesn't meet the legal definition of assault, which involves a threat of physical harm.
Choice D rationale:
Threatening to tie down a client if they try to get up from the chair is an example of assault. This action creates an apprehension of fear in the client by implying a physically harmful act. It's a direct threat that falls under the category of assault.
Correct Answer is A
Explanation
Choice A rationale:
Applying a moisture barrier ointment helps protect the skin from the effects of moisture exposure due to urinary incontinence. Prolonged exposure to urine can lead to skin breakdown, irritation, and infection. A moisture barrier ointment creates a protective barrier, reducing the risk of skin damage.
Choice B rationale:
Requesting a prescription for an indwelling urinary catheter is not typically the first intervention to prevent skin breakdown in clients with urinary incontinence. Catheters carry their own set of risks, including infection, and should be considered after other interventions have been explored.
Choice C rationale:
Repositioning the client every 8 hours is important for preventing pressure ulcers but may not be sufficient to prevent skin breakdown due to urinary incontinence. Clients with urinary incontinence should be repositioned more frequently to address the effects of moisture.
Choice D rationale:
Checking the client's skin every 8 hours is an important step, but it alone may not effectively prevent skin breakdown. Incontinence-associated dermatitis can develop quickly, so it's essential to implement protective measures like using a moisture barrier ointment.
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