A nurse is contributing to the plan of care for a client who has viral meningitis. Which of the following interventions should the nurse recommend?
Measure the client's intake and output every 8 hr.
Dim the lighting in the client's room.
Monitor the client's temperature every 6 hr.
Initiate contact precautions for the client.
The Correct Answer is B
Choice A Reason:
Measuring the client's intake and output every 8 hours is a general nursing intervention but might not be specifically pertinent to managing viral meningitis.
Choice B Reason:
Dim the lighting in the client's room is correct. Meningitis often causes sensitivity to light (photophobia) due to the inflammation of the meninges surrounding the brain and spinal cord. Dimming the lighting in the client's room helps reduce discomfort and sensitivity to light, which is a common symptom of meningitis.
Choice C Reason:
Monitoring the client's temperature every 6 hours is a routine nursing practice, but in viral meningitis, more frequent temperature monitoring might be necessary, especially if the client shows signs of fever or instability.
Choice D Reason:
Initiating contact precautions for viral meningitis is not typically necessary because it's usually transmitted through respiratory secretions. Standard precautions for infection control, including proper hand hygiene, are usually sufficient.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A Reason:
Place on airborne precautions. This is incorrect. Tinea corporis isn't transmitted through the air. Airborne precautions are specific infection control measures for diseases transmitted through airborne particles, like tuberculosis or measles, which are caused by specific bacteria or viruses.
Choice B Reason:
Avoid direct contact is correct. Direct contact is a crucial precaution to prevent the spread of tinea corporis. It's a contagious infection, often transmitted through skin-to-skin contact or by sharing contaminated items such as clothing, towels, or bedding. Encouraging precautions like not sharing personal items and avoiding direct skin contact helps prevent the spread of the infection to others.
Choice C Reason:
Isolate for 24 hr. after lesions appear is incorrect. While it's essential to take precautions to prevent spread, isolating for only 24 hours after lesions appear might not be sufficient. The infection can remain contagious until it's effectively treated and lesions have resolved. More extended isolation or precautions might be necessary until the infection is no longer transmissible.
Choice D Reason:
Administer a broad-spectrum antibiotic is incorrect. Tinea corporis is a fungal infection, not a bacterial one, so antibiotics would not be effective against it. Antifungal medications, such as topical or oral antifungals, are the primary treatment for tinea corporis. Using an antibiotic would not treat the fungal infection and might lead to inappropriate medication use.
Correct Answer is C
Explanation
Choice A Reason:
A client whose injection site is scabbed is incorrect. Scabbing at the injection site does not provide information about the presence or absence of induration. It doesn't contribute to interpreting the test result directly.
Choice B Reason:
A client whose injection site is firm and measures 3 mm (0.1 in) is incorrect. A measurement of 3 mm of induration is generally considered a negative result for most individuals, including those without any risk factors for tuberculosis (TB).
Choice C Reason:
A client whose injection site has an elevated area measuring 15 mm (0.6 is correct. An area of induration measuring 15 mm or more is considered positive in individuals with no known risk factors for TB.
Choice D Reason:
A client whose injection site is ecchymotic is incorrect. Ecchymosis (bruising) at the injection site is not relevant to the interpretation of the tuberculin skin test. It does not contribute to determining a positive or negative result.
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