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.

Answer and Explanation

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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Correct Answer is B

Explanation

A. Assess the client for signs of diminished circulation in the hands is unnecessary at this stage, as the primary concern is ensuring proper crutch fit and teaching safe use.

B. Proceed with teaching the client how to walk with the crutches is correct because a space of three finger-widths between the crutch and the axilla indicates proper crutch height. This prevents nerve damage and discomfort in the axilla.

C. Ask the client to sit down while the crutch length is adjusted is not needed since the crutches are already appropriately adjusted based on the observed spacing.

D. Confer with the physical therapist for correct crutch size is unnecessary because the nurse can confirm that the crutches are properly fitted based on standard guidelines.

A. Irrigate the nasogastric tube with water. B. Elevate the head of bed 45 degrees. C. Review the advanced directive document. D. Perform oropharyngeal suctioning.

Correct Answer is D

Explanation

A. Irrigate the nasogastric tube with water may be necessary if the tube is clogged, but it does not address the immediate concern of the client choking. The priority is ensuring the client’s airway is clear.

B. Elevate the head of bed 45 degrees is a useful intervention for reducing aspiration risk, but it does not address the immediate need to clear the airway when the client is choking. Elevating the head of the bed could be helpful after the airway is cleared.

C. Review the advanced directive document is important for understanding the client’s wishes, but the immediate priority is addressing the choking. The nurse should focus on clearing the airway first, then review the advanced directive as appropriate.

D. Perform oropharyngeal suctioning is the most appropriate action. The client is vomiting and choking, which suggests a risk of airway obstruction. Oropharyngeal suctioning will help clear the airway and prevent aspiration, which is the priority in this situation.

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A client is being admitted to the unit with a varicella zoster virus infection. Which room should the charge nurse assign to the client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with a sprained ankle is seen at the clinic and is given a pair of crutches. When the client stands with the aid of the crutches, the nurse notes a space of three finger-widths between the top of the crutch and the client's axilla. Which action should the nurse take?

Correct Answer is B

Explanation

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Correct Answer is D

Explanation

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