A nurse is serving on a committee whose task is to plan cost-effective care at the facility. Which of the following client care tasks should the nurse recommend?

Replace total parenteral nutrition solution bags every 48 hr.

Replace peripheral IV solution bags every 96 hr.

Change peripheral IV primary tubing every 96 hr.

Change total parenteral nutrition IV tubing every 48 hr.

Answer and Explanation

The Correct Answer is C

Choice A Reason:
Replacing total parenteral nutrition solution bags every 48 hr is incorrect. Total parenteral nutrition (TPN) solution bags typically need to be replaced more frequently than every 48 hours to prevent bacterial contamination and ensure the integrity of the solution. However, the frequency of bag changes may vary depending on institutional protocols and specific patient needs.
Choice B Reason:
Replacing peripheral IV solution bags every 96 hr is incorrect. Peripheral IV solution bags may be changed less frequently than every 96 hours, as long as the solution remains sterile and the integrity of the infusion system is maintained. However, the frequency of bag changes may vary based on institutional policies and patient-specific factors.
Choice C Reason:
Changing peripheral IV primary tubing every 96 hr is correct. Changing peripheral IV primary tubing every 96 hours is a recommendation consistent with infection control guidelines and helps prevent contamination and bloodstream infections. This practice is cost-effective while ensuring patient safety.
Choice D Reason:
Changing total parenteral nutrition IV tubing every 48 hr is incorrect. Total parenteral nutrition (TPN) IV tubing typically needs to be changed more frequently than every 48 hours to prevent bacterial contamination and ensure the integrity of the TPN solution. However, the frequency of tubing changes may vary depending on institutional protocols and patient-specific factors.

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Correct Answer is B

Explanation

Choice A Reason:
Restraints should never be prescribed on an "as needed" basis (PRN). Each application of restraints requires a specific and current provider order.
Choice B Reason:
Apply the appropriate restraint, using a clove hitch or a square knot.When applying restraints, using a square knot isessential to ensure that the restraints remain secure but can be easily removed in case of an emergency. A square knot provides a balance between security and quick release when needed.
Choice C Reason:
Restraints should be tied to a non-movable part of the bed frame, not to a part that moves, to prevent injury to the client.
Choice D Reason:
Restraints should be checked and removed more frequently, typically every 2 hours, to assess the client’s skin integrity and circulation, and to provide range-of-motion exercises.

A. "I will wear a cover gown when caring for a client who has herpes simplex." B. "I will place a client who requires protective isolation in a negative airflow room." C. "I will wear an N95 respirator mask when caring for a client who is on contact precautions." D. "I will use an alcohol-based hand cleanser when caring for a client who has Clostridium difficile."

Correct Answer is A

Explanation

Choice A Reason:
Herpes simplex virus (HSV) requires contact precautions when there are active lesions. Wearing a cover gown helps prevent the transmission of the virus through direct contact with the client or contaminated surfaces, indicating proper understanding of isolation guidelines.

Choice B Reason:
Protective isolation (also known as reverse isolation) is used for clients who are immunocompromised, and they require a positive airflow room, not a negative airflow room. Positive airflow rooms help keep contaminants out, while negative airflow rooms are used for clients with airborne infectious diseases to prevent the spread of pathogens to other areas.

Choice C Reason:
An N95 respirator mask is required for airborne precautions (e.g., for tuberculosis, measles, or varicella) rather than contact precautions. Contact precautions generally involve wearing gloves and a gown, but an N95 mask is not necessary.

Choice D Reason:
For clients with Clostridium difficile (C. difficile) infection, soap and water must be used for hand hygiene, not alcohol-based hand cleansers. Alcohol-based hand sanitizers are not effective against C. difficile spores, so proper handwashing with soap and water is essential to prevent the spread of this infection.

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A nurse is serving on a committee whose task is to plan cost-effective care at the facility. Which of the following client care tasks should the nurse recommend?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is orienting a newly licensed nurse about the use of restraints. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching?

Correct Answer is B

Explanation

A nurse manager is reviewing isolation guidelines with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching?

Correct Answer is A

Explanation

While auditing the medical records of clients currently on an oncology unit, the nurse manager finds that six of the 15 records lack documentation regarding advance directives. Which of the following is the priority action for the nurse to take?

A charge nurse is evaluating a newly licensed nurse and presents a performance improvement plan to the nurse for remediation. Which of the following outcomes should indicate to the charge nurse that the plan has been effective?

A nurse working in an emergency department is caring for a group of clients. Which of the following clients should the nurse report for suspected maltreatment?

A nurse is providing discharge teaching to the parent of a toddler who has a new diagnosis of asthma. The parent states she is unable to afford the nebulizer prescribed for the child. Which of the following referrals should the nurse recommend?

A nurse on a medical surgical unit is caring for a group of clients with the assistance of a licensed practical nurse (LPN) and an assistive personnel. Which of the following tasks should the nurse assign to the LPN?

A nurse in the emergency department is preparing to care for a client who arrived via ambulance. The client is disoriented and has a cardiac arrhythmia. Which of the following actions should the nurse take?

A nurse is preparing to fax information to a rehabilitative facility prior to transferring a client. Which of the following actions should the nurse plan to take?

A nurse is caring for a client who requests a copy of their medical records immediately. Which of the following responses should the nurse make?