A nurse overhears two assistive personnel discussing a client's medical history in the hallway. Which of the following actions should the nurse take first?

Report the incident to the charge nurse.

Tell the staff members to stop their discussion.

Participate in an in-service about client confidentiality.

Speak to the staff members in private about client confidentiality.

Answer and Explanation

The Correct Answer is B

A. Reporting the incident to the charge nurse is incorrect as the first step. While this action may be necessary if the issue continues, the immediate step should be to intervene directly to stop the conversation and prevent further breach of confidentiality.

B. Telling the staff members to stop their discussion is correct. The nurse should immediately address the situation by asking the APs to stop discussing the client’s medical history in the hallway to protect client confidentiality. This is the most immediate and effective action in ensuring the client’s privacy is respected.

C. Participating in an in-service about client confidentiality is incorrect as the first step. While in-service education on client confidentiality is important, it is not an immediate action to address a current breach of confidentiality.

D. Speaking to the staff members in private about client confidentiality is incorrect. While private conversation is important to address the issue further, the first action is to stop the conversation immediately to prevent any further privacy violations.

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Correct Answer is D

Explanation

A. "My partner and I will use petroleum jelly with latex condoms.": Petroleum jelly should not be used with latex condoms as it can weaken the latex material, increasing the risk of condom breakage. Water-based lubricants are recommended with latex condoms.

B. "My partner and I will both use a condom during intercourse.": This is not necessary or recommended. Only one condom is needed, and using two (male and female condom) may cause friction and increase the likelihood of breakage.

C. "I will be able to remove my contraceptive sponge immediately after intercourse.": The sponge should be left in place for at least 6 hours after intercourse to allow its spermicide to be effective. Removing it immediately could reduce the effectiveness of the contraceptive.

D. "My partner will use condoms with spermicides, which works better.": This statement demonstrates understanding. Using condoms with spermicides can be an effective form of contraception, as the spermicide helps to kill or immobilize sperm, providing an additional layer of protection.

A. Tie the gown with the gloves on. B. Tuck the glove cuffs under the gown sleeves. C. Apply the gown before the gloves. D. Push the gown sleeves up to the elbows.

Correct Answer is C

Explanation

A. Tying the gown with the gloves on is incorrect. The correct order of donning personal protective equipment (PPE. is to apply the gown first, followed by gloves. Tying the gown after the gloves may compromise proper gown coverage.

B. Tucking the glove cuffs under the gown sleeves is incorrect. The glove cuffs should be pulled over the gown sleeves to ensure a secure, closed barrier between the gown and gloves, helping to prevent contamination.

C. Applying the gown before the gloves is correct. According to infection control guidelines, the gown should be worn first, followed by gloves. This technique ensures that the gown covers the sleeves properly and that the gloves are overlapping the gown cuffs, reducing the risk of contamination.

D. Pushing the gown sleeves up to the elbows is incorrect. Gown sleeves should remain down to cover the wrists to protect the forearms from contamination, especially when caring for a patient with Clostridium difficile, which requires contact precautions.

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A nurse overhears two assistive personnel discussing a client's medical history in the hallway. Which of the following actions should the nurse take first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reinforcing teaching with a female client about contraception. Which of the following statements by the client indicates an understanding of the teaching?

Correct Answer is D

Explanation

A nurse is caring for a client who has Clostridium difficile. When applying a cover gown, which of the following techniques should the nurse use?

Correct Answer is C

Explanation

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