The nurse observes an unlicensed assistive personnel (UAP) applying an alcohol-based hand rub while leaving a client's room after taking vital signs. Which action should the nurse take?
Remind the UAP to continue rubbing the hands together until they are dry.
Instruct the UAP to return to the client's room to perform handwashing.
Supervise the UAP in the next client's room to evaluate hand hygiene.
Advise the UAP to wear gloves when obtaining vital signs for all clients.
The Correct Answer is A
A. Reminding the UAP to continue rubbing the hands together until they are dry ensures proper use of the hand rub, which is effective when fully dry.
B. Handwashing with soap and water is necessary after certain activities (e.g., after using the restroom, or when hands are visibly soiled), but using an alcohol-based hand rub is appropriate for routine hand hygiene.
C. Supervising in the next client's room is less direct and immediate than ensuring proper technique now.
D. Wearing gloves for all clients is not necessary and does not replace proper hand hygiene.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Reminding the UAP to continue rubbing the hands together until they are dry ensures proper use of the hand rub, which is effective when fully dry.
B. Handwashing with soap and water is necessary after certain activities (e.g., after using the restroom, or when hands are visibly soiled), but using an alcohol-based hand rub is appropriate for routine hand hygiene.
C. Supervising in the next client's room is less direct and immediate than ensuring proper technique now.
D. Wearing gloves for all clients is not necessary and does not replace proper hand hygiene.
Correct Answer is B
Explanation
A. A respiratory rate of 35 breaths/minute can be normal for a 2-year-old, so it is not necessarily indicative of distress by itself.
B.Flaring of the nares is a sign of increased work of breathing and is an indication of respiratory distress, as the child is using accessory muscles to breathe.
C.Diaphragmatic respirations are typical for young children and not indicative of distress unless other signs are present.
D.Bilateral bronchial breath sounds do not necessarily indicate respiratory distress and could be normal depending on the context.
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