A nurse is assisting with the admission of a client who has varicella zoster. Which of the following interventions should the nurse plan to implement?
Administer aspirin if the client develops a fever.
Initiate contact precautions for the client.
Assign the client to a negative-pressure airflow room.
Have visitors remain at least 0.91 m (3 feet. away from the client.
The Correct Answer is C
The correct answer is choice c. Assign the client to a negative-pressure airflow room.
Choice A rationale:
Administering aspirin to a client with varicella zoster is not recommended due to the risk of Reye’s syndrome, a serious condition that can cause swelling in the liver and brain.
Choice B rationale:
While contact precautions are important, varicella zoster also requires airborne precautions due to its highly contagious nature. This means that simply initiating contact precautions is not sufficient.
Choice C rationale:
Assigning the client to a negative-pressure airflow room is crucial because it helps contain the airborne virus and prevents it from spreading to other areas of the hospital.
Choice D rationale:
Having visitors remain at least 0.91 m (3 feet) away from the client is a good practice, but it is not sufficient on its own to prevent the spread of the virus. Airborne precautions, including a negative-pressure room, are necessary.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
The correct answer is choice b. “I will stop what I am doing and lie down.”
Choice A rationale:
Taking two 325 milligram aspirin tablets at the same time is not the recommended immediate action for chest pain. Aspirin can help in preventing blood clots, but it is not the first step in managing acute angina.
Choice B rationale:
Stopping activity and lying down is the correct initial response to chest pain. This helps reduce the heart’s workload and can alleviate the pain.
Choice C rationale:
Calling the provider after taking one dose of nitroglycerin is important, but it is not the first step. The client should first stop activity and lie down, then take nitroglycerin if prescribed.
Choice D rationale:
Holding the breath and bearing down (Valsalva maneuver) is not appropriate for managing chest pain and can actually increase the heart’s workload, potentially worsening the situation.
Correct Answer is {"dropdown-group-1":"C","dropdown-group-2":"A"}
Explanation
After notifying the provider about the client's condition, the immediate actions should focus on managing the client's chest pain and potential cardiac event.
Administering oxygen at 2 L/min via nasal cannula helps ensure adequate oxygenation, while administering sublingual nitroglycerin helps alleviate chest pain and improve blood flow to the heart. The incorrect options do not address the immediate needs of a client experiencing chest pain and potential myocardial ischemia.
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