A nurse is caring for a 2-year-old child who has Clostridium difficile.
Which of the following actions should the nurse take?
Instruct the parents to avoid bringing fresh flowers into the room.
Initiate contact precautions.
Place the child in a room that has a HEPA filtration system.
Use an N95 respirator.
The Correct Answer is B
Choice A rationale:
Instructing parents to avoid bringing fresh flowers into the room is not the primary intervention for a child with Clostridium difficile. While it is essential to maintain a clean environment, the most critical action is to implement proper infection control measures.
Choice B rationale:
This is the correct answer. Initiating contact precautions is crucial when caring for a child with Clostridium difficile. This includes using gloves and gowns to prevent the spread of the bacteria to others.
Choice C rationale:
Using a HEPA filtration system in the room is not the first-line intervention for managing Clostridium difficile. While it can help maintain air quality, it does not directly address the transmission of the bacteria.
Choice D rationale:
Using an N95 respirator is not the primary action in caring for a child with Clostridium difficile. Contact precautions, such as gloves and gowns, are more critical to prevent the spread of infection.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is {"A":{"answers":"A"},"B":{"answers":"B"},"C":{"answers":"A"},"D":{"answers":"B"},"E":{"answers":"A,B,C"}}
Explanation
Wheezes: This finding may indicate a latex allergy, as wheezing is a sign of respiratory distress caused by an allergic reaction to latex proteins. Wheezes are not typical of malignant hyperthermia or hypovolemic shock.
Muscle rigidity: This finding is a hallmark of malignant hyperthermia, as it reflects the excessive calcium release and muscle contraction triggered by certain anesthetic agents. Muscle rigidity is not a feature of latex allergy or hypovolemic shock.
Urticaria: This finding is a common manifestation of latex allergy, as urticaria (hives) is a type of skin rash caused by an allergic reaction to latex proteins. Urticaria is not associated with malignant hyperthermia or hypovolemic shock.
Hypercapnia: This finding is indicative of malignant hyperthermia, as hypercapnia (high carbon dioxide levels in the blood) is a result of increased metabolism and oxygen consumption due to muscle rigidity and fever. Hypercapnia is not usually seen in latex allergy or hypovolemic shock, unless there is severe respiratory compromise.
Tachycardia: This finding can be present in all three disease processes, as tachycardia (fast heart rate) is a nonspecific response to stress, fever, pain, hypoxia, or hypovolemia. However, tachycardia is more pronounced and persistent in malignant hyperthermia and hypovolemic shock than in latex allergy.
Correct Answer is C
Explanation
The correct answer is ChoiceC.
Choice A rationale:Restricting fluid intake to 1 L per day is not recommended for a client with a urinary tract infection (UTI). Adequate hydration is essential for flushing out bacteria from the urinary tract and preventing further infections. Therefore, this choice is incorrect.
Choice B rationale:Taking the prescribed antibiotic until manifestations are gone is partially correct. It’s crucial for the client to complete the entire course of antibiotics, even if symptoms improve or disappear before the medication is finished. Stopping antibiotics early can lead to recurrent infections or antibiotic resistance. Therefore, this choice ispartially correct, but the instruction should be clarified to ensure the client understands the importance of completing the full course of antibiotics.
Choice C rationale:Wearing cotton underwear is recommended for clients with a UTI. Cotton is a breathable fabric that can help keep the area around the urethra dry, reducing the likelihood of bacterial growth. Therefore, this choice is correct.
Choice D rationale:Drinking orange juice daily for 3 to 4 weeks is not specifically recommended for a client with a UTI. While vitamin C can help inhibit bacterial growth, orange juice is high in sugar, which can promote bacterial growth. It’s more beneficial to drink water and other unsweetened fluids to help flush out the bacteria from the urinary tract. Therefore, this choice is incorrect.
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