A nurse is serving on a committee that is developing infectious disease protocols. Which of the following instructions should the nurse include in the protocol for clients who have Clostridium difficile?

Disinfect hands using an alcohol-based waterless antiseptic.

Wear an N95 respirator when caring for the client.

Use diluted bleach to clean solled equipment.

Provide a room with negative-pressure airflow.

Answer and Explanation

The Correct Answer is C

A. Disinfecting hands using an alcohol-based waterless antiseptic is not effective against Clostridium difficile spores. C. difficile is a bacterium that forms spores, which are resistant to alcohol-based hand sanitizers. Handwashing with soap and water is recommended for effective removal of the spores.

B. Wearing an N95 respirator is not specifically indicated for caring for clients with Clostridium difficile. The primary mode of transmission for C. difficile is fecal-oral, and standard precautions, including gloves and gowns, are usually sufficient. N95 respirators are more commonly used for airborne precautions.

C. Using diluted bleach to clean soiled equipment is the correct instruction. Clostridium difficile spores are resistant to many disinfectants, but bleach (sodium hypochlorite) is effective in killing C. difficile spores. Diluted bleach solutions are recommended for cleaning surfaces and equipment that may be contaminated with C. difficile.

D. Providing a room with negative-pressure airflow is not typically necessary for clients with Clostridium difficile. Standard precautions, including appropriate cleaning and disinfection, are generally sufficient to prevent the spread of C. difficile in healthcare settings.

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Correct Answer is ["2.1"]

Explanation

To calculate the total daily dose of tobramycin, we use the formula:

Total Daily Dose (mg) = Dose (mg/kg/day) × Weight (kg)
Total Daily Dose (mg)=Dose (mg/kg/day)×Weight (kg)

In this case:

Total Daily Dose=3 mg/kg/day × 85 kg
Total Daily Dose=255mg/day

Since the total daily dose is divided into three doses, the nurse should administer:

Dose per Administration =Total Daily Dose/Number of Doses per Day
Dose per Administration = 255 mg/3
Dose per Administration≈85mg

Now, to calculate the volume (mL) to administer, we use the concentration of the available tobramycin solution:

Volume (mL)=Dose per Administration (mg)/Concentration (mg/mL)

In this case:

Volume=85mg/40mg/mL
Volume≈2.1mL

Therefore, the nurse should administer approximately 2.1 mL of tobramycin per dose, rounded to the nearest tenth.

A. Engage the client in a repetitive activity as a distraction. B. Place the client in a seclusion room. C. Apply wrist restraints to the client. D. Administer PRN haloperidol IM to the client

Correct Answer is A

Explanation

A. Engage the client in a repetitive activity as a distraction:

This is the correct answer. Redirecting the client's focus to a repetitive and calming activity can help distract them from the source of agitation and potentially de-escalate the situation.

B. Place the client in a seclusion room:

Seclusion should only be used in situations where it is absolutely necessary for the safety of the client or others. Placing a client with dementia in seclusion is not the first choice and should be avoided if possible.

C. Apply wrist restraints to the client:

Restraints should be a last resort and used only when there is an imminent risk of harm to the client or others. Restraints can escalate agitation and should not be the initial response.

D. Administer PRN haloperidol IM to the client:

The use of medication should be considered later in the escalation process and after other non-pharmacological interventions have been attempted. It is not the first intervention, especially when there are non-pharmacological options available.

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A nurse is serving on a committee that is developing infectious disease protocols. Which of the following instructions should the nurse include in the protocol for clients who have Clostridium difficile?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is ["2.1"]

Explanation

A nurse in a long-term care facility is monitoring clients in the day room. A client who has dementia becomes angry and starts screaming at the nurse. Which of the following interventions should the nurse take first?

Correct Answer is A

Explanation

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