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 A

Explanation

A. Respect the daughter's decision to refuse the transfusion.Since the daughter has been designated as the durable power of attorney for health care, she has the legal authority to make medical decisions on behalf of her mother. The nurse should respect her decision, even if it involves refusing treatment.

B. Encourage the daughter to let her mother have the transfusion.While the nurse can provide information and support, they should not pressure or coerce the daughter into making a different decision.

C. Discuss taking guardianship of the client with the facility administration.This is unnecessary as the daughter already has the legal authority to make decisions through the durable power of attorney.

D. Ask the provider to give consent for the transfusion.The provider cannot override the decision made by the designated durable power of attorney unless there is evidence that the daughter is not acting in the client's best interest.

A. The client requires additional help to stand. B. The client has increased difficulty dressing C. The client reports insomnia. D. The client has difficulty swallowing

Correct Answer is D

Explanation

A. The client requires additional help to stand:

While needing additional help to stand is relevant information, it may be expected in Parkinson's disease due to issues with mobility and balance. It is not an immediate priority unless it signals a significant change or poses an immediate risk.

B. The client has increased difficulty dressing:

Increased difficulty dressing is a common manifestation of Parkinson's disease and is important to address but may not be as urgent as issues related to swallowing.

C. The client reports insomnia:

Insomnia is a common issue in Parkinson's disease but may not be an immediate priority unless it significantly impacts the client's overall well-being or contributes to other health concerns.

D. The client has difficulty swallowing:

This is the correct answer. Difficulty swallowing (dysphagia) in Parkinson's disease is a serious concern as it can lead to complications such as aspiration pneumonia and malnutrition. It requires prompt attention and intervention to ensure the client's safety and prevent potential complications.

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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

A murse is caring for an older adult client who has advanced dementia and needs a blood transfusion. The client previously designated her ad daughter on a durable power of attorney for health care form, and the daughter refuses the treatment. Which of the following actions should the nurse take?

Correct Answer is A

Explanation

A nurse in a long-term care facility is collecting data for an interdisciplinary care conference for a client who has Parkinson's disease. Which of the following findings is the priority for the nurse to report at the conference?

Correct Answer is D

Explanation

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