An adult client is admitted with AIDS and oral candidiasis manifested by several painful mouth ulcers. The nurse delegates oral care to the unlicensed assistive personnel (UAP) and discusses how to assist the client. Which instruction should the nurse provide the UAP?
Offer the client mouthwash for thorough cleansing after brushing teeth
Provide a soft-bristled toothbrush for the client to use during oral care
Assist with personal care, but leave oral care for the nurse to complete
Wear sterile gloves when cleansing any areas of infected mucosa
The Correct Answer is B
Choice A reason: Offering mouthwash may irritate painful candidiasis ulcers in AIDS, as alcohol-based solutions exacerbate discomfort. While cleansing is important, a soft-bristled toothbrush is gentler, effectively cleaning without worsening mucosal damage, making this choice less appropriate for oral care.
Choice B reason: Providing a soft-bristled toothbrush is correct, as it gently cleans the mouth without irritating painful candidiasis ulcers in AIDS. Soft bristles minimize trauma to inflamed mucosa, promoting hygiene and comfort, making this the best instruction for safe and effective oral care by the UAP.
Choice C reason: Leaving oral care to the nurse is unnecessary, as UAPs can perform oral hygiene with proper instruction. Delegating soft-bristled toothbrush use ensures safe care for candidiasis, and reserving this task for nurses limits efficiency without clinical justification, making this choice incorrect.
Choice D reason: Wearing sterile gloves is excessive, as candidiasis is opportunistic, not requiring sterile technique. Standard precautions with clean gloves suffice for oral care in AIDS, as sterile gloves are reserved for invasive procedures, making this instruction inappropriate for routine mucosal cleansing.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Topical analgesics relieve pain but do not address psoriasis’s underlying inflammation or scaling. Psoriasis involves immune-mediated epidermal hyperproliferation, causing scaly, burning plaques. Analgesics may reduce discomfort temporarily but fail to target the inflammatory process driven by T-cell activation, making this choice ineffective for managing psoriasis symptoms.
Choice B reason: Colloidal oatmeal-based lotion soothes irritated skin but is insufficient for psoriasis, which requires anti-inflammatory treatment. Oatmeal reduces itching in conditions like eczema but does not address psoriasis’s silvery scales or immune-driven inflammation, making it an inadequate choice for controlling the client’s burning, bleeding plaques.
Choice C reason: Topical antifungals treat fungal infections, not psoriasis, which is an autoimmune condition with no fungal etiology. The silvery, scaly plaques result from rapid keratinocyte turnover, not fungal growth, so antifungals are irrelevant, failing to reduce inflammation or scaling in this chronic inflammatory dermatologic condition.
Choice D reason: Topical corticosteroids are effective for psoriasis, reducing inflammation, scaling, and burning by suppressing T-cell activity and cytokine production. They slow epidermal proliferation, alleviating silvery plaques and bleeding. Potent corticosteroids are standard for elbow and palm lesions, making this the appropriate prescription to teach the client for symptom control.
Correct Answer is C
Explanation
Choice A reason: Chronic constipation and gastrin levels are irrelevant to pancreatitis. Gastrin relates to gastric acid production, not pancreatic inflammation. Pancreatitis is confirmed by amylase/lipase elevation, and constipation does not reflect its severity, making this information less valuable for reporting.
Choice B reason: Bowel sounds and abdominal pain degree provide general data but are non-specific. Pancreatitis requires amylase/lipase levels for diagnosis, and nausea/vomiting severity better indicates clinical status, making this information secondary to laboratory confirmation and symptom severity.
Choice C reason: Severity of nausea and vomiting and serum amylase results are critical, as elevated amylase confirms pancreatitis, and nausea/vomiting severity reflects disease impact. These directly inform the provider about pancreatic inflammation and clinical status, making this the most valuable information to report.
Choice D reason: H. pylori antibodies and urine output are unrelated to pancreatitis. H. pylori causes gastritis, and urine output monitors hydration, but amylase and nausea/vomiting directly address pancreatitis’s diagnosis and severity, making this information less relevant for immediate reporting.
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