A client is being admitted to the unit with a varicella zoster virus infection. Which room should the charge nurse assign to the client?
A private room with both contact and airborne precautions.
A semiprivate room with a roommate who has the same diagnosis and airborne precautions.
A private room with both standard and droplet precautions.
A semiprivate room with a roommate who has the same diagnosis and contact precautions.
The Correct Answer is A
A. A private room with both contact and airborne precautions is appropriate for a client with varicella zoster virus (chickenpox or shingles in an immunocompromised state). This virus can spread through direct contact with lesions and airborne transmission of respiratory droplets.
B. A semiprivate room with a roommate who has the same diagnosis and airborne precautions could be considered if the roommate also has the same strain of the virus, but a private room is generally preferred to minimize cross-contamination risks.
C. A private room with both standard and droplet precautions is insufficient. Airborne precautions are necessary because varicella zoster virus can spread via airborne routes.
D. A semiprivate room with a roommate who has the same diagnosis and contact precautions does not account for the airborne transmission risk, making this option inappropriate.
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Related Questions
Correct Answer is D
Explanation
A. Restrict oral fluid intake is not appropriate in this situation. Decreased bowel sounds and constipation may indicate a need for hydration, not restriction of fluids. Fluids are essential to help prevent and alleviate constipation.
B. Offer to warm the prune juice may be helpful in some cases to encourage the client to drink, but it does not address the underlying issue of constipation and decreased bowel sounds. A more comprehensive intervention, such as bowel training, is needed.
C. Advance to a regular diet may not be appropriate without assessing the client's tolerance for additional food types. The client is on a mechanical soft diet, which may already be sufficient. Advancing to a regular diet could potentially exacerbate the constipation.
D. Initiate bowel training protocol is the most appropriate action. Bowel training is designed to help manage constipation and promote regular bowel movements. This may include dietary adjustments, increased fluid intake, and other measures such as scheduled toileting.
Correct Answer is D
Explanation
A. Recent serum hemoglobin level of 16 g/dL (160 g/L) is within the normal range and does not indicate an increased risk for falls.
B. Expressed feelings of depression may affect motivation or activity levels but does not directly increase the risk of falls unless it leads to physical symptoms such as fatigue or unsteady gait.
C. Stooped posture with a steady gait might suggest a musculoskeletal issue, but the "steady gait" does not indicate immediate fall risk.
D. Opioid analgesic received one hour ago is the most relevant factor because opioids can cause dizziness, sedation, and impaired coordination, all of which increase the likelihood of falls. The timing of the medication further highlights the need for vigilance.
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