A nurse is creating home instructions for a client who has immunodeficiency. Which of the following statements by the client indicates an understanding of the teaching?
I might experience harmless white patches in my mouth.
I will expect to have a mild, occasional fever.
I will avoid people who have just received a live vaccine.
I will limit the use of skin cream to once a week.
The Correct Answer is C
Choice A reason:
The statement “I might experience harmless white patches in my mouth” could indicate the presence of oral thrush, a common fungal infection in immunocompromised individuals. However, this statement does not directly reflect an understanding of preventive measures or home care instructions for someone with immunodeficiency.
Choice B reason:
Expecting to have a mild, occasional fever is not a typical understanding of immunodeficiency care. While fevers can occur, they should not be considered normal or expected. Any fever in an immunocompromised person should be promptly evaluated by a healthcare provider as it could indicate an infection.
Choice C reason:
Avoiding people who have just received a live vaccine is a crucial preventive measure for individuals with immunodeficiency. Live vaccines contain a weakened form of the virus or bacteria, which can pose a risk to immunocompromised individuals. This statement shows an understanding of the need to avoid potential sources of infection.
Choice D reason:
Limiting the use of skin cream to once a week is not a standard recommendation for immunodeficiency care. Skin care is important, but the frequency of using skin cream should be based on individual needs and the type of cream used. This statement does not reflect a specific understanding of immunodeficiency management.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason:
Washing the cord daily with mild soap and water is not recommended. The best practice is to keep the umbilical cord stump clean and dry. Cleaning it with water and mild soap can be done if it gets dirty, but it should not be a daily routine as it might delay the drying process.
Choice B reason:
Applying petroleum jelly to the cord stump is not advised. The goal is to keep the stump dry to promote natural drying and falling off. Petroleum jelly can keep the area moist, which is counterproductive to the drying process.
Choice C reason:
Covering the cord with the diaper is not recommended. Instead, the diaper should be folded down below the umbilical cord stump to keep it exposed to air and prevent irritation from urine or stool3. This helps the stump to dry out and fall off naturally.
Choice D reason:
Giving a sponge bath until the cord stump falls off is the correct instruction. Submerging the baby in water can delay the drying and falling off of the stump. Sponge baths help keep the area dry and clean, promoting faster healing.
Correct Answer is ["A","B","C","E"]
Explanation
Choice A reason: The preschooler mispronounces words can be a sign of a speech sound disorder. While some mispronunciation is normal in early speech development, persistent difficulty with articulation may indicate a need for speech therapy to improve clarity and communication skills.
Choice B reason: The preschooler speaks in three-word sentences may indicate a delay in expressive language development. By preschool age, children typically use longer sentences and more complex language structures. Limited sentence length can suggest a need for further evaluation and intervention.
Choice C reason: The preschooler stutters when speaking can be a sign of a fluency disorder. Stuttering involves disruptions in the flow of speech, such as repetitions, prolongations, or blocks. Early intervention with speech therapy can help manage and reduce stuttering.
Choice D reason: The preschooler talks to himself when reading is generally not a concern. Self-talk can be a normal part of development and learning, as children often verbalize their thoughts and actions. It does not typically indicate a need for speech therapy.
Choice E reason: The preschooler speaks in a nasally tone can indicate a resonance disorder, which affects the quality of the voice. A nasally tone may result from structural issues or improper use of the vocal tract. Speech therapy can help address these issues and improve vocal quality.
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