A nurse is admitting a client who has hepatitis C. Which of the following precautions should the nurse implement?

Standard

Airborne

Droplet

Contact

Answer and Explanation

The Correct Answer is A

Choice A reason : Standard precautions are the primary strategy for the prevention and control of hepatitis C virus (HCV) transmission. According to the Centers for Disease Control and Prevention (CDC), standard precautions include hand hygiene and the use of personal protective equipment to prevent contact with blood and other potentially infectious materials¹. Since HCV is primarily transmitted through blood-to-blood contact, standard precautions are sufficient for routine care of patients with hepatitis C².

Choice B reason : Airborne precautions are not necessary for hepatitis C as it is not spread through the air. These precautions are used for diseases that are transmitted through airborne droplet nuclei or dust particles containing the infectious agent, such as tuberculosis, measles, or chickenpox¹.

Choice C reason : Droplet precautions are also not required for hepatitis C because it is not spread through droplets in the air. Droplet precautions are used for infections that can be transmitted through large droplets expelled during coughing, sneezing, talking, or during procedures such as suctioning and bronchoscopy¹.

Choice D reason : Contact precautions are not specifically required for hepatitis C unless there is a risk of blood contamination. Contact precautions are typically used for infections that are spread by direct or indirect contact with the patient or the patient's environment, such as gastrointestinal, respiratory, skin, or wound infections¹.

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Correct Answer is C

Explanation

Choice A reason : This statement is misleading. While heparin does need to reach a therapeutic level to be effective, it does not directly dissolve existing clots. Heparin's primary action is to prevent the formation of new clots and the extension of existing clots by inhibiting certain factors in the coagulation cascade.

Choice B reason : While a pharmacist can provide detailed information about medications, it is the nurse's responsibility to educate and inform the client about the effects of their treatment. Therefore, this response would not be appropriate.

Choice C reason : This is the most accurate response. Heparin works by inhibiting the formation of fibrin, which is essential for clot formation. It does not have the ability to dissolve existing clots but can prevent new ones from forming and existing ones from getting larger.

Choice D reason : Oral medications such as warfarin or direct oral anticoagulants (DOACs) may be used after heparin to maintain anticoagulation; however, they also do not dissolve clots. The body's natural fibrinolytic system is responsible for breaking down clots over time.

A. Tetany and complaints of stiffness of the hands. B. Exophthalmos and complaints of nervousness. C. Reports of extreme fatigue and hair loss. D. Reports of profuse sweating and flushed skin.

Correct Answer is C

Explanation

Choice A reason : Tetany and stiffness of the hands are not typical symptoms of hypothyroidism. Tetany is usually associated with hypocalcemia, which is not a direct result of hypothyroidism⁶.

Choice B reason : Exophthalmos and nervousness are symptoms associated with hyperthyroidism, not hypothyroidism. Exophthalmos, the bulging of the eyes, is particularly associated with Graves' disease, a type of hyperthyroidism⁶.

Choice C reason : Extreme fatigue and hair loss are common symptoms of hypothyroidism. The condition can lead to a slowing down of the body's metabolic processes, resulting in fatigue. Hair loss is also a frequent complaint due to the effects of reduced thyroid hormone levels on hair follicles⁶⁷⁸.

Choice D reason : Profuse sweating and flushed skin are more indicative of hyperthyroidism or other conditions, not hypothyroidism. Hypothyroidism typically leads to cold intolerance and dry skin⁶.

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A nurse is admitting a client who has hepatitis C. Which of the following precautions should the nurse implement?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has thrombophlebitis and is receiving heparin by continuous IV infusion. The client asks the nurse how long it will take for the heparin to dissolve the clot. Which of the following responses should the nurse give?

Correct Answer is C

Explanation

A client is diagnosed with hypothyroidism. Which signs/symptoms should the nurse expect the client to exhibit?

Correct Answer is C

Explanation

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