A nurse working on a medical unit is completing the admission of a client who reports a severe allergy to penicillin. Which of the following actions should the nurse take?
Remove all objects that contain latex from the client’s room.
Verify the client’s medication prescriptions do not include cephalosporin.
Notify dietary services to adjust the client’s diet.
Have the client purchase a medication alert bracelet to wear in the hospital.
The Correct Answer is B
Choice A reason:
Removing all objects that contain latex from the client’s room is important for clients with a latex allergy, not a penicillin allergy. Latex allergies can cause severe reactions, including anaphylaxis, but this action is not relevant to a penicillin allergy.
Choice B reason:
Verifying that the client’s medication prescriptions do not include cephalosporin is crucial because cephalosporins can have cross-reactivity with penicillin. Clients with a penicillin allergy may also react to cephalosporins, so it is essential to avoid prescribing these antibiotics.
Choice C reason:
Notifying dietary services to adjust the client’s diet is not directly related to managing a penicillin allergy. Dietary adjustments are more relevant for clients with food allergies or specific dietary restrictions.
Choice D reason:
Having the client purchase a medication alert bracelet to wear in the hospital is a good practice for general safety, but it is not an immediate action the nurse should take during the admission process. The primary focus should be on ensuring that the client’s medications do not include penicillin or related antibiotics.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Airborne
Airborne precautions are used for diseases that are transmitted through tiny airborne particles that can remain suspended in the air and be inhaled by others. Examples of diseases requiring airborne precautions include tuberculosis, measles, and chickenpox. These diseases can spread over long distances and through ventilation systems. Pertussis, however, is not transmitted via airborne particles but rather through larger respiratory droplets.
Choice B reason: Contact
Contact precautions are used for infections that are spread by direct or indirect contact with the patient or the patient’s environment. This includes infections like methicillin-resistant Staphylococcus aureus (MRSA) and Clostridioides difficile (C. diff). While contact precautions are important for preventing the spread of certain infections, pertussis is primarily spread through respiratory droplets, making droplet precautions more appropriate.
Choice C reason: Protective
Protective precautions, also known as reverse isolation, are used to protect immunocompromised patients from potential infections. This type of precaution is not intended to prevent the spread of infections from the patient to others but rather to protect the patient from external sources of infection. Examples include patients undergoing chemotherapy or those with severe immunodeficiency. Pertussis does not require protective precautions as it is not about protecting the patient from others.
Choice D reason: Droplet
Droplet precautions are the appropriate transmission-based precautions for pertussis. Pertussis, also known as whooping cough, is spread through respiratory droplets that are produced when an infected person coughs, sneezes, or talks. These droplets can travel short distances and can infect others who are in close proximity. Droplet precautions include wearing a mask when within 3 feet of the patient, placing the patient in a private room if possible, and ensuring that the patient wears a mask if they need to be transported.
Correct Answer is B
Explanation
Choice A reason:
The statement “This stage is when testing occurs to identify boundaries of interpersonal behaviors” describes the storming stage of group development. During the storming stage, group members test boundaries and challenge each other, leading to conflicts and disagreements.
Choice B reason:
The norming stage is characterized by the development of group cohesion and consensus. During this stage, group members start to resolve their differences, appreciate each other’s strengths, and work together more effectively. Consensus evolves as the group establishes norms and agrees on common goals.
Choice C reason:
While constructive efforts are part of the norming stage, the statement is too vague to indicate a clear understanding of this specific stage. Constructive efforts can occur in various stages of group development, including performing.
Choice D reason:
Resistance and the formation of subgroups are typical of the storming stage, not the norming stage. In the storming stage, conflicts and power struggles are common as group members assert their opinions and roles.
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