A nurse is part of a task force planning to audit a facility's nursing units concerning adherence to hand-hygiene protocols. Which of the following steps should the task force take first?

Compare the facility's data with the established criteria for hand hygiene

Establish methods for collecting data within the facility.

Determine the accepted standards for hand hygiene.

Take corrective measures to enforce hand hygiene.

Answer and Explanation

The Correct Answer is C

A. Data comparison should be done after establishing the standards and collecting data.

B. While data collection is important, the first step is to determine what the accepted hand hygiene standards are.

C. This is the correct answer. The first step in an audit process is to determine the accepted hand hygiene standards to provide a basis for evaluation.

D. Corrective measures should only be taken after data has been collected and analyzed.

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Correct Answer is C

Explanation

A. Healthy weight – A BMI between 18.5 and 24.9 is classified as healthy. Since the client's BMI is 17.2, they do not fall within this range.

B. Overweight – Overweight is defined as a BMI between 25.0 and 29.9. The client's BMI of 17.2 is far below this range.

C. Underweight – A BMI below 18.5 is classified as underweight. Since the client's BMI is 17.2, they fall into this category. Clients with Crohn’s disease often experience malabsorption and weight loss, leading to a low BMI.

D. Obesity class 1 – Obesity is categorized as a BMI of 30.0 or higher. The client’s BMI is far below this classification.

A. Weigh the client every 48 hr. B. Allow the client to eat meals in his room. C. Observe the client for 1 hr after meals D. Obtain the client's vital signs every other day.

Correct Answer is C

Explanation

A. Weigh the client every 48 hr. – Clients with anorexia nervosa should be weighed daily at the same time to monitor for fluctuations in weight and refeeding complications.

B. Allow the client to eat meals in his room. – Clients should eat meals in a monitored dining area to prevent food hoarding, purging, or avoidance of meals.

C. Observe the client for 1 hr after meals. – This is the correct answer because clients with anorexia nervosa are at risk of purging or excessive exercise after meals. Close observation helps prevent these behaviors.

D. Obtain the client’s vital signs every other day. – Vital signs should be monitored daily or more frequently if the client is medically unstable.

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A nurse is part of a task force planning to audit a facility's nursing units concerning adherence to hand-hygiene protocols. Which of the following steps should the task force take first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has Crohn's disease. The nurse calculates that the client's BMI is 17.2. The nurse should document the client's weight status as being within which of the following categories?

Correct Answer is C

Explanation

A nurse in an acute care facility is caring for a client who has anorexia nervosa. During the first week of care, which of the following actions should the nurse take?

Correct Answer is C

Explanation

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