A nurse is admitting a client who has active tuberculosis. Which of the following nursing interventions is appropriate?
Place the client in a room that is ventilated to the outside.
Wear a gown when delivering the client's food tray.
Prohibit visitors while the client's infection is active.
Administer a tuberculin skin test prior to discharge.
The Correct Answer is A
A nurse admitting a client who has active tuberculosis should place the client in a room that is ventilated to
the outside. This is an appropriate nursing intervention to prevent the spread of tuberculosis to others.
The other options are not correct.
b) The nurse does not need to wear a gown when delivering the client's food tray but should wear a mask and gloves.
c) Visitors are not prohibited while the client's infection is active but should be limited and should wear masks.
d) A tuberculin skin test is not necessary prior to discharge as the client has already been diagnosed with active tuberculosis.
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Related Questions
Correct Answer is C
Explanation
c. Hallucination
In the scenario described, the client's experience of receiving special audible messages from the Central Intelligence Agency that no one else can hear indicates a hallucination. Hallucinations are perceptual disturbances in which a person experiences sensory perceptions without any external stimuli. They can occur in any sensory modality, such as hearing (auditory hallucinations), seeing (visual hallucinations), smelling (olfactory hallucinations), tasting (gustatory hallucinations), or feeling (tactile hallucinations).
In this case, the client is experiencing auditory hallucinations, as he is perceiving auditory stimuli (audible messages) that are not present in the external environment. Auditory hallucinations are most commonly associated with schizophrenia, although they can occur in other psychiatric disorders as well.
Derealization (option a) refers to a subjective feeling of unreality or detachment from the environment. It involves a perception that the external world is strange, distorted, or unreal. This is not the primary alteration in perception described in the scenario.
Illusion (option b) is a misinterpretation or misperception of a real sensory stimulus. It occurs when a person's perception of an actual stimulus is distorted or misunderstood. There is no indication of a misperception of a real stimulus in the scenario.
Depersonalization (option d) is a subjective experience of being detached from one's own body, thoughts, or emotions. It involves a feeling of being outside of oneself or observing oneself from a distance. This is not the primary alteration in perception described in the scenario.
Therefore, the correct answer is c. Hallucination, as the client's experience of receiving special audible messages that no one else can hear represents an auditory hallucination.
Correct Answer is B
Explanation
Answer: B. You can take a shower 1 day after your procedure.
Rationale:
A. You can resume a regular diet 3 days after your procedure:
There is typically no need to delay resuming a regular diet for three days after a cardiac catheterization. Most clients can resume their usual diet shortly after the procedure once they are fully awake and any nausea has resolved.
B. You can take a shower 1 day after your procedure:
It is generally safe to shower the day after a cardiac catheterization as long as the insertion site remains protected. Clients should avoid soaking in a bath or swimming until the site is fully healed to prevent infection.
C. You can begin exercising 2 days after your procedure:
Strenuous activities, including exercise, should generally be avoided for a few days to a week following a cardiac catheterization. This allows time for the insertion site to heal and reduces the risk of complications such as bleeding.
D. You can return to school 1 week after your procedure:
Most clients can return to school or normal activities within a few days, provided they feel well and avoid excessive physical exertion. A full week off is typically not necessary unless specified by the healthcare provider based on the individual’s recovery.
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