A nurse on a medical-surgical unit is evaluating an assistive personnel’s use of infection control precautions. Which of the following actions by the AP indicates correct use of the precautions?

The AP wears a surgical mask when caring for a client who has respiratory tuberculosis

The AP uses alcohol-based hand sanitizer after emptying the bed pan on a client who has Clostridum-difficle

The AP bundles the client side of linen inward when changing the sheets for a client who has an infected surgical wound

The AP removes her gloves before leaving the room of a client who has MRSA

Answer and Explanation

Correct Answer : C

a. The AP wears a surgical mask when caring for a client who has respiratory tuberculosis.

Incorrect. AP should wear an N95 Mask when caring for a client with respiratory tuberculosis helps prevent the spread of airborne pathogens, protecting both the healthcare worker and others in the environment.

b. The AP uses alcohol-based hand sanitizer after emptying the bedpan of a client who has Clostridium difficile.

This action is incorrect. Alcohol-based hand sanitizers are not effective against the spores of Clostridium difficile. Handwashing with soap and water is necessary to effectively remove the spores.

c. The AP bundles the client side of linen inward when changing the sheets for a client who has an infected surgical wound.

When handling soiled linen, it is essential to fold the client side of the linen inward to minimize the spread of contaminants. This helps to ensure that any contaminated surfaces do not come into contact with other surfaces, which is crucial for preventing the spread of infection.

d. The AP removes her gloves before leaving the room of a client who has MRSA.

For MRSA (Methicillin-resistant Staphylococcus aureus), the AP should remove gloves and perform hand hygiene before leaving the room.

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Correct Answer is A

Explanation

A. Continue the medication dosages that relieve the client’s pain:
Opioids and benzodiazepines are commonly used for pain and anxiety management in terminally ill patients. Somnolence is an expected side effect and does not necessarily warrant withholding medication unless the client shows signs of respiratory depression.

B. Contact the provider about replacing the opioid with an NSAID: NSAIDs are not sufficient for severe pain in terminal illness. Opioids are the gold standard for palliative pain management, and switching to an NSAID would likely lead to uncontrolled pain and unnecessary suffering.

C. Administer the benzodiazepine but withhold the opioid: This would leave the client in severe pain, which is unethical in hospice care. Pain relief should not be withheld solely due to sedation.

D. Withhold the benzodiazepine but continue the opioid: Benzodiazepines are often used to relieve anxiety, dyspnea, and agitation in end-of-life care. Withholding it could cause increased distress for the client. Instead of discontinuing the medication, the nurse should monitor for respiratory depression and adjust doses only if necessary.

A. “You should contact the provider about your wishes to your family member.” B. “You should speak with the facility’s ethics committee about your concerns.” C. “We’ll need to have the nursing supervisor review the client’s advance directives.” D. “As the health care surrogate, the client’s partner can make this decision.”

Correct Answer is D

Explanation

a. "You should contact the provider about your wishes for your family member."

While the provider may ultimately be involved in decision-making, it's important for the nurse to address the conflicting wishes and provide guidance on the appropriate steps to take in such situations.

b. "You should speak with the facility’s ethics committee about your concerns."

In cases of conflicting wishes or ethical dilemmas, involving the ethics committee can be beneficial. However, this response might not address the immediate need for clarification and guidance.

c. "We’ll need to have the nursing supervisor review the client’s advance directives."

Reviewing advance directives with the nursing supervisor is a reasonable step to ensure that the client's wishes are documented and followed. However, it might not directly address the conflicting wishes or provide immediate resolution.

d. "As the health care surrogate, the client’s partner can make this decision."

This is the correct response. The health care surrogate, appointed by the client or legally recognized as such, has the authority to make medical decisions on behalf of the unconscious client. It's important to follow the client's advance directives and legal designations regarding

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A nurse on a medical-surgical unit is evaluating an assistive personnel’s use of infection control precautions. Which of the following actions by the AP indicates correct use of the precautions?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A hospice nurse is caring for a client who has a terminal illness and reports severe pain. After the nurse administers the prescribed opioid and benzodiazepine, the client becomes somnolent and difficult to arouse. Which of the following actions should the nurse take?

Correct Answer is A

Explanation

Correct Answer is D

Explanation

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