Which practice is recommended to prevent human immune deficiency virus (HIV) transmission?
Using standard precautions
Double gloving
Applying hand sanitizer to gloves during cares
Wearing a mask within three feet of the client
The Correct Answer is A
Choice A reason: Using standard precautions is a practice that is recommended to prevent HIV transmission, because it is a set of guidelines that apply to all clients, regardless of their infection status, and that aim to prevent the exposure to blood, body fluids, or other potentially infectious materials. Standard precautions include hand hygiene, use of personal protective equipment, safe handling and disposal of sharps, environmental cleaning, and respiratory hygiene.
Choice B reason: Double gloving is not a practice that is recommended to prevent HIV transmission, because it is not proven to be more effective or safer than single gloving. Double gloving is a technique that involves wearing two pairs of gloves, one over the other, which may provide some extra protection against needlestick injuries or glove punctures, but may also reduce the tactile sensitivity, dexterity, or comfort of the wearer. Double gloving is not a routine practice, but rather an option for certain situations, such as highrisk procedures, long surgeries, or known HIVpositive clients.
Choice C reason: Applying hand sanitizer to gloves during cares is not a practice that is recommended to prevent HIV transmission, because it is not appropriate or hygienic. Applying hand sanitizer to gloves during cares is a practice that can damage the integrity and effectiveness of the gloves, as the alcohol or other chemicals can degrade the material, cause holes, or reduce the fit of the gloves. Applying hand sanitizer to gloves during cares can also create a false sense of security, as the gloves may still be contaminated or ineffective. Hand sanitizer should be applied to the hands before and after wearing gloves, not to the gloves themselves.
Choice D reason: Wearing a mask within three feet of the client is not a practice that is recommended to prevent HIV transmission, because it is not necessary or relevant. Wearing a mask within three feet of the client is a practice that is part of the droplet precautions, which are used to prevent the transmission of infections that are spread by large respiratory droplets, such as influenza, pertussis, or meningitis. HIV is not transmitted by respiratory droplets, but rather by sexual contact, blood, or other body fluids. Wearing a mask within three feet of the client may not provide any protection against HIV, and may also cause stigma or discrimination.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Culturing the wound is not the nurse's priority assessment for this client, because it is not the most urgent and relevant action. Culturing the wound is a procedure that involves collecting a sample of the wound drainage and sending it to the laboratory for analysis, which can help identify the type and source of infection. Culturing the wound is an important intervention, but it should be done after inspecting the wound and assessing the drainage, and with a medical order and a sterile technique.
Choice B reason: Applying topical ointment to the wound is not the nurse's priority assessment for this client, because it is not the most urgent and relevant action. Applying topical ointment to the wound is a procedure that involves applying a medication or a dressing to the wound site, which can help prevent or treat infection, inflammation, or pain. Applying topical ointment to the wound is an important intervention, but it should be done after inspecting the wound and assessing the drainage, and with a medical order and a clean technique.
Choice C reason: Inspecting the wound and assessing the drainage is the nurse's priority assessment for this client, because it is the most urgent and relevant action. Inspecting the wound and assessing the drainage is a process that involves observing and measuring the wound site and the wound exudate, which can reveal the presence and severity of infection, injury, or healing. Inspecting the wound and assessing the drainage is an essential assessment, as it can guide the diagnosis, treatment, and evaluation of the client's condition.
Choice D reason: Calling the provider to initiate antibiotics is not the nurse's priority assessment for this client, because it is not the most urgent and relevant action. Calling the provider to initiate antibiotics is a communication that involves reporting the client's situation and requesting a prescription for an antimicrobial agent, which can help fight or prevent infection. Calling the provider to initiate antibiotics is an important communication, but it should be done after inspecting the wound and assessing the drainage, and with the necessary data and documentation.
Correct Answer is A
Explanation
Choice A reason: This is the priority nursing intervention because it helps to prevent infection, which is a major complication and risk factor for mortality in clients with lupus. Lupus is an autoimmune disease that causes inflammation and damage to various organs and tissues. Steroids are used to reduce inflammation and suppress the immune system, but they also increase the susceptibility to infection. The nurse should wash their hands before and after contact with the client and follow standard precautions to reduce the transmission of microorganisms.
Choice B reason: This is not the priority nursing intervention, but it is a good intervention to promote the psychosocial health of the client. Lupus can affect the client's selfesteem, mood, and social relationships, especially during a flareup, which is a period of increased symptoms and activity of the disease. The nurse should assist with the enhancement of social wellbeing by providing activities that are appropriate for the client's physical and mental condition, such as reading, listening to music, or talking with friends and family.
Choice C reason: This is not the priority nursing intervention, but it is a good intervention to evaluate the client's coping and support resources. Lupus can be a chronic and unpredictable disease that can cause stress, anxiety, and depression in the client. The nurse should assess the client's support system, such as family, friends, or community groups, that can provide emotional, practical, and financial assistance to the client. The nurse should also refer the client to counseling, support groups, or other services as needed.
Choice D reason: This is not the priority nursing intervention, but it is a good intervention to respect the client's dignity and autonomy. Lupus can affect the client's appearance, mobility, and independence, which can make them feel vulnerable and embarrassed. The nurse should ensure privacy by keeping the door always closed, unless the client requests otherwise, and by knocking and asking for permission before entering the room. The nurse should also cover the client with a blanket or gown and expose only the necessary body parts during assessment or procedures.
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