The nurse is caring for a client who tests positive for gonorrhea. The client reports having had prior sexually transmitted infections (STIs). Which response should the nurse provide?

Urge the client to have regular STI screening every two years.

Answer questions directly and correct any misinformation.

Clarify that all STIs are transmitted through sexual intercourse.

Provide counseling that most contraceptives protect against infection.

Answer and Explanation

The Correct Answer is B

A. Urge the client to have regular STI screening every two years: Screening every two years is insufficient for individuals with recurrent STIs. More frequent testing is recommended to prevent reinfection and detect new infections early.

B. Answer questions directly and correct any misinformation: Providing accurate, evidence-based information helps the client understand STI transmission, prevention, and treatment. Direct responses foster trust, support informed decision-making, and address misconceptions effectively.

C. Clarify that all STIs are transmitted through sexual intercourse: Not all STIs are transmitted solely through intercourse; some, like herpes or HPV, can be transmitted via skin-to-skin contact. This statement could be misleading and does not fully educate the client.

D. Provide counseling that most contraceptives protect against infection: Most contraceptives, such as oral contraceptives or IUDs, do not protect against STIs. Only barrier methods, like condoms, reduce the risk of STI transmission.

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Correct Answer is C

Explanation

A. Ensure that the restraints are snug against the client's wrists: Restraints should be snug enough to prevent injury but not so tight as to impair circulation. However, this does not address the safety concern related to the type of knot used.

B. Move the ties so the restraints are secured to the side rails: Restraints should never be tied to the side rails because this can cause injury if the rail moves or the client attempts to climb over it.

C. Ensure that the knot can be quickly released: Using a quick-release knot, such as a half bow or slip knot, is essential to ensure the nurse can rapidly remove the restraints in an emergency, such as sudden respiratory distress or circulatory compromise.

D. Tie the knot with a double turn or square knot: Square knots are secure but not quick to release. In contrast, safety guidelines recommend quick-release knots for client restraints to allow for prompt intervention.

A. Maintain the client on bedrest. B. Administer the client's routine daily aspirin. C. Encourage a diet high in iron and ascorbic acid. D. Encourage the client to dangle the legs frequently.

Correct Answer is A

Explanation

A. Maintain the client on bedrest: The client’s symptoms are consistent with deep vein thrombosis (DVT). Bedrest with limited movement prevents dislodgment of the clot, which could otherwise travel to the lungs and cause a pulmonary embolism. This is the safest initial intervention while anticoagulation is being started.

B. Administer the client's routine daily aspirin: Aspirin has antiplatelet effects but is not the treatment of choice for acute DVT. Starting aspirin with heparin therapy is not recommended, as it increases the risk of bleeding without additional therapeutic benefit.

C. Encourage a diet high in iron and ascorbic acid: While iron and vitamin C support red blood cell production, this dietary intervention does not address the acute management of a thrombus. It may be useful in anemia prevention but is not a priority here.

D. Encourage the client to dangle the legs frequently: Dangling the legs promotes venous stasis and may worsen the clot or increase the risk of embolization. Clients with DVT should avoid activities that increase venous pooling until cleared by the healthcare provider.

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The nurse is caring for a client who tests positive for gonorrhea. The client reports having had prior sexually transmitted infections (STIs). Which response should the nurse provide?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Before leaving the room of a client who is confused, the nurse observes that a half bow knot was used to attach the client's wrist restraints to the movable portion of the client's bed frame. Which action should the nurse take before leaving the room?

Correct Answer is C

Explanation

Correct Answer is A

Explanation

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