A nurse is providing discharge teaching to a client who has an impaired immune system due to chemotherapy.
Which of the following information should the nurse include in the teaching?
"Wash your perineal area two times each day with antimicrobial soap.".
"Wash your toothbrush in the dishwasher once each month.".
"Change your pet's litter box daily.".
"Change the water in your drinking glass every 4 hours.".
The Correct Answer is A
The nurse should instruct the client to wash their perineal area two times each day with antimicrobial soap.
This is important because chemotherapy can weaken the immune system, making the client more susceptible to infections.
Choice B is wrong because washing a toothbrush in a dishwasher once a month is not an effective way to prevent infection.
Choice C is wrong because changing a pet’s litter box daily could expose the client to harmful bacteria and should be avoided.
Choice D is wrong because changing the water in a drinking glass every 4 hours is not necessary for preventing infection.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
“The client’s capillary refill in the left toe is 6 seconds.” Capillary refill time is the time it takes for blood to return to the capillaries after pressure has been applied to the skin.
A normal capillary refill time is less than 2 seconds.
A capillary refill time of 6 seconds indicates poor blood flow to the left toe and requires immediate intervention by the nurse.
Choice B is not the correct answer because while a pain level of 7 on a scale from 0 to 10 at the operative site is concerning, it does not require immediate intervention by the nurse.
Choice C is not the correct answer because an oral temperature of 38.3° C (100.9° F) is only slightly elevated and does not require immediate intervention by the nurse.
Choice D is not the correct answer because while 100 mL of blood in a closed-suction drain may be concerning, it does not necessarily require immediate intervention by the nurse.
Correct Answer is D
Explanation
The nurse should plan to insert a large-bore nasogastric tube for a client who has upper gastrointestinal bleeding due to a peptic ulcer.
This allows for gastric lavage and can help diagnose the source of bleeding.
Choice A is wrong because a 22-gauge IV line may be too small for rapid fluid resuscitation.
Choice B is wrong because ketorolac is a nonsteroidal anti-inflammatory drug (NSAID) that can increase the risk of gastrointestinal bleeding.
Choice C is wrong because nitroprusside is a vasodilator used to treat hypertensive emergencies and is not typically used for upper gastrointestinal bleeding.
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