This is the edited text:
Which of the following clients should be placed in isolation for airborne precautions?
A client with an unknown skin infection
A client that recently traveled and developed a fever with cough
A high school wrestling champion with a rash
A client with heart palpitations
The Correct Answer is B
Choice A reason: This is not the correct answer because a skin infection is not transmitted by airborne droplets. A skin infection is usually caused by bacteria, fungi, or parasites that invade the skin and cause inflammation, redness, itching, or pus. A skin infection can be contagious by direct contact with the infected area or by sharing personal items, such as towels, clothing, or razors. The client with a skin infection should be placed in isolation for contact precautions, which involve wearing gloves and gowns and using disposable equipment.
Choice B reason: This is the correct answer because a fever with cough can be a sign of a respiratory infection that is transmitted by airborne droplets. A respiratory infection is caused by viruses, bacteria, or fungi that infect the lungs, throat, or nose and cause symptoms such as fever, cough, sore throat, or difficulty breathing. A respiratory infection can be contagious by inhaling the tiny droplets that are released when the infected person coughs, sneezes, or talks. The client with a respiratory infection should be placed in isolation for airborne precautions, which involve wearing a respirator mask and placing the client in a negative pressure room.
Choice C reason: This is not the correct answer because a rash is not transmitted by airborne droplets. A rash is a change in the color, texture, or appearance of the skin that can be caused by various factors, such as allergies, infections, medications, or injuries. A rash can be contagious by direct contact with the affected skin or by sharing personal items, such as clothing, bedding, or sports equipment. The client with a rash should be placed in isolation for contact precautions, which involve wearing gloves and gowns and using disposable equipment.
Choice D reason: This is not the correct answer because heart palpitations are not transmitted by airborne droplets. Heart palpitations are the sensation of having a fast, irregular, or pounding heartbeat that can be caused by various factors, such as stress, anxiety, caffeine, nicotine, or heart conditions. Heart palpitations are not contagious and do not require isolation. The client with heart palpitations should be evaluated for the underlying cause and treated accordingly.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C","D"]
Explanation
Choice A reason: Ischemia is a cause of a pressure ulcer, because it means reduced blood flow to the tissues, which can lead to tissue hypoxia, necrosis, and ulceration. Ischemia can result from factors such as compression, friction, shear, or vascular disease.
Choice B reason: Immobility is a cause of a pressure ulcer, because it means prolonged pressure on the bony prominences, which can impair blood flow and cause ischemia, tissue damage, and ulceration. Immobility can result from factors such as paralysis, injury, illness, or sedation.
Choice C reason: Poor nutrition is a cause of a pressure ulcer, because it means inadequate intake or absorption of nutrients, such as protein, calories, vitamins, and minerals, which are essential for tissue repair and wound healing. Poor nutrition can result from factors such as anorexia, malabsorption, or poverty.
Choice D reason: Moisture is a cause of a pressure ulcer, because it means excessive wetness or dampness of the skin, which can weaken the skin barrier, increase the risk of infection, and delay wound healing. Moisture can result from factors such as incontinence, perspiration, or wound drainage.
Choice E reason: Adequate perfusion is not a cause of a pressure ulcer, but rather a protective factor. Adequate perfusion means sufficient blood flow to the tissues, which can prevent ischemia, tissue damage, and ulceration. Adequate perfusion can be promoted by factors such as regular repositioning, pressure relief, and exercise.
Correct Answer is D
Explanation
Choice A reason: This is not the priority assessment, but it is an important assessment for a client with a femur fracture. Pain is the unpleasant sensation that results from tissue damage or inflammation. Pain can affect the client's physical and psychological wellbeing and interfere with their recovery. The nurse should assess the client's pain level, location, quality, and duration using a valid and reliable pain scale. The nurse should also provide pain relief measures, such as medication, ice, elevation, or distraction, as ordered and as needed.
Choice B reason: This is not the priority assessment, but it is a relevant assessment for a client with a femur fracture. Medication history is the record of the drugs that the client is currently taking or has taken in the past, including prescription, overthecounter, herbal, or recreational drugs. Medication history can help the nurse identify any potential drug interactions, allergies, or contraindications that may affect the client's treatment and recovery. The nurse should ask the client about their medication history and document it accurately and completely.
Choice C reason: This is not the priority assessment, but it is a helpful assessment for a client with a femur fracture. Socioeconomic status is the measure of the client's income, education, occupation, and social class. Socioeconomic status can influence the client's access to health care, ability to afford treatment, compliance with therapy, and support system. The nurse should assess the client's socioeconomic status and provide appropriate referrals, resources, or assistance as needed.
Choice D reason: This is the priority assessment for a client with a femur fracture. Pedal pulses are the pulses that can be felt in the feet, such as the dorsalis pedis or the posterior tibial pulse. Pedal pulses can indicate the blood flow and perfusion to the lower extremities, which can be compromised by a femur fracture. A femur fracture can cause bleeding, swelling, or pressure that can reduce or obstruct the blood supply to the feet, leading to ischemia, necrosis, or gangrene. The nurse should assess the client's pedal pulses regularly and report any changes, such as absent, weak, or thready pulses. The nurse should also monitor the client's skin color, temperature, sensation, and movement in the feet.
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