A female adult who works in the mailroom of an ammunitions plant opened an envelope that contained a white powder. Believing that she might have been exposed to anthrax, the client is immediately transported to the emergency department (ED) of a local hospital. Which intervention(s) in the emergency disaster response plan should the nurse implement? Select all that apply.

Instruct the client to shower and wash her hair thoroughly.

Clean all surfaces touched by the client with vinegar and water.

Place the client in a room with lead doors to contain airborne anthrax.

Bag the clothes the client is wearing in plastic bags.

Place the client on airborne precautions.

Answer and Explanation

Correct Answer : A,D,E

Rationale:

A. Instruct the client to shower and wash her hair thoroughly: Decontamination by showering is essential to remove any anthrax spores from the skin and hair. Thorough washing reduces the risk of further spread and protects healthcare personnel and other patients.

B. Clean all surfaces touched by the client with vinegar and water: Vinegar and water are not effective against anthrax spores. Proper decontamination requires specific agents, such as a 0.5% hypochlorite (bleach) solution, under the guidance of hazardous materials protocols.

C. Place the client in a room with lead doors to contain airborne anthrax: Lead doors are used for radiation containment, not for biological threats like anthrax. Anthrax is not typically airborne unless aerosolized, so this intervention is unnecessary and ineffective.

D. Bag the clothes the client is wearing in plastic bags: Contaminated clothing can carry anthrax spores. Placing clothes in sealed plastic bags is a critical step in preventing environmental contamination and ensuring safe disposal.

E. Place the client on airborne precautions: While anthrax is not usually spread from person to person, airborne precautions are used if aerosol exposure is suspected, as in bioterrorism events. This helps contain spores until full decontamination is completed.

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Correct Answer is B

Explanation

Rationale:

A. Self-description of pain: Pain assessment is important in general care but is not directly related to assessing for obstructive sleep apnea. OSAS is more concerned with sleep patterns, airway obstruction, and associated risk factors like weight and anatomy rather than pain.

B. Body mass index: BMI is a key factor in determining OSAS risk. Obesity, especially central adiposity, contributes to pharyngeal narrowing and increased airway resistance during sleep. A high BMI is one of the most significant predictors of obstructive sleep apnea.

C. Level of consciousness: While decreased alertness can result from sleep deprivation caused by OSAS, it is a non-specific finding. It may support further evaluation but does not directly assess the risk for OSAS or its underlying causes.

D. Breath sounds: Although breath sounds can reveal lung pathology, they typically remain normal in OSAS unless another respiratory condition is present. They are not the most important assessment for evaluating sleep-disordered breathing risk.

A. She is a gravida 6, para 5. B. She received butorphanol 2 mg IV during labor. C. She is over 35 years of age. D. The second stage of labor lasted 10 minutes.

Correct Answer is A

Explanation

Rationale:

A. She is a gravida 6, para 5: A high parity (multiple previous births) stretches the uterus significantly over time, increasing the risk of uterine atony—a leading cause of postpartum hemorrhage due to the uterus failing to contract effectively.

B. She received butorphanol 2 mg IV during labor: Butorphanol is a narcotic analgesic and does not directly contribute to excessive postpartum bleeding or uterine atony in typical doses.

C. She is over 35 years of age: Advanced maternal age can increase some obstetric risks, but it is not as directly associated with postpartum hemorrhage as high parity.

D. The second stage of labor lasted 10 minutes: A short second stage may lead to perineal trauma, but it is less likely to cause excessive vaginal bleeding compared to uterine atony from high parity.

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Naxlex Comprehensive Predictor Exams

Which information is most important for the nurse to obtain when determining a client's risk for obstructive sleep apnea syndrome (OSAS)?

Correct Answer is B

Explanation

When assessing a recently delivered, multigravida client, the nurse finds that her vaginal bleeding is more than expected. Which factor in this client's history is related to this finding?

Correct Answer is A

Explanation

While changing a client's postoperative dressing, the nurse observes purulent drainage at the site. Before reporting this finding to the healthcare provider, the nurse should note which of the client's laboratory values?

Patient Data Exhibits For each action, identify if it is indicated or not indicated when monitoring the effects of lorazepam administration. Each row must have one response action selected.

Which dietary intervention(s) should the nurse include in the plan of care for a client who had bariatric surgery? Select all that apply.

The nurse assisting the healthcare provider with a wound debridement at the bedside of a client who is mildly confused. The client is draped and a sterile field is created. Which nursing intervention should the nurse implement for client safety?

The nurse is planning an educational session for new parents on ways to prevent sudden infant death syndrome (SIDS). Which information is most important to provide parents of newborns and infants?

A child is diagnosed with acquired aplastic anemia. The nurse knows that this child has the best prognosis with which treatment regimen?

The nurse is caring for a client who has been admitted with recurring migraine headaches. To assess the quality of the client's pain experienced from the migraine headache, which approach should the nurse use?

The nurse administers ophthalmic timolol to a client with glaucoma. The client routinely takes carvedilol, spironolactone, and ibuprofen daily. Which medication(s) should the nurse withhold? Select all that apply.