A nurse is assisting with the care of a client who is placed on droplet precautions. Which of the following actions should the nurse take?
Wear a surgical mask when within 0.6 m (2 ft) of the client.
Place a surgical mask on the client when they leave their room.
Move the client to a positive airflow room.
Remove fresh flowers from the client's room.
The Correct Answer is A
A. The nurse should wear a surgical mask when within 0.6 m (2 ft) of the client to prevent the spread of infection. This is one of the key precautions for droplet isolation.
B. Clients who are placed on droplet precautions should wear a surgical mask when they leave their room to prevent the spread of infection to others. However, it is not necessary for the nurse to place a mask on the client.
C. Clients who are placed on droplet precautions should be isolated in a private room or in a room with other clients who have the same infection. A positive airflow room is typically used for clients who are immunocompromised or have airborne infections.
D. Fresh flowers do not pose a significant risk of infection transmission and can be kept in the client's room.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. While water temperature can be a matter of personal preference, it is not necessary to use hot water. In fact, the temperature of the water (whether warm or cold) does not significantly impact the effectiveness of handwashing. The most important factor is to use soap and rub the hands thoroughly for at least 20 seconds.
B. This statement is partially correct but requires clarification. Alcohol-based hand sanitizers should be rubbed on all surfaces of the hands until they are dry, which typically takes about 20 seconds. Ten seconds is insufficient for effective sanitization, so this instruction should be revised.
C. This statement is correct and should definitely be included. When hands are visibly soiled, washing them with soap and water is the most effective way to remove dirt, bacteria, and viruses. Alcohol-based hand sanitizers are not effective when hands are dirty or greasy.
D. Clostridium difficile (C. diff) infections require soap and water for handwashing, as alcohol-based hand sanitizers are ineffective against the spores of C. diff. Therefore, this instruction should not be included.
Correct Answer is ["D","E"]
Explanation
A. If a client has just consumed ice water, it can lower the oral temperature and lead to inaccurate readings. It's generally recommended to wait at least 15-30 minutes after eating or drinking before taking an oral temperature.
B. A client who has had oral surgery may have swelling, pain, or open wounds, which could make taking an oral temperature uncomfortable and could also lead to inaccurate results. Alternative sites, such as axillary or tympanic, might be preferred.
C. Clients who primarily breathe through their mouth may have a lower oral temperature reading due to airflow affecting the measurement. Additionally, mouth breathing can lead to inaccuracies in the reading.
D. While hemorrhoids themselves do not affect the ability to take an oral temperature, this client is suitable for oral temperature measurement since it does not interfere with the method.
E. A client with a coagulation disorder can typically have their oral temperature taken. There are no contraindications to taking an oral temperature in this case, as long as the client does not have any other conditions affecting their ability to do so.
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