A nurse is a long-term care facility is caring for a client who has methicillin-resistant Staphylococcus aureus (MRSA). Which of the following actions should the nurse take?
Ensure that the negative air pressure is active for the client’s room
Place the client in a room with a high-efficiency particulate air (HEPA) filter.
How the client wear a mask when they are out of their
Don gloves prior to assisting the client with brushing their teeth.
The Correct Answer is D
A) "Ensure that the negative air pressure is active for the client’s room.": Negative air pressure is used for airborne precautions, such as in the case of tuberculosis or other airborne infections. MRSA is primarily spread through direct contact, not airborne transmission, so negative air pressure is not necessary in this situation.
B) "Place the client in a room with a high-efficiency particulate air (HEPA) filter.": A HEPA filter is used for airborne precautions to filter out airborne particles like those found in diseases such as tuberculosis or measles. Since MRSA is transmitted through direct contact and not airborne particles, placing the client in a room with a HEPA filter is not necessary.
C) "Have the client wear a mask when they are out of their room.": MRSA is typically spread by direct contact with infected wounds, bodily fluids, or contaminated surfaces. It is not transmitted via respiratory droplets, so there is no need for the client to wear a mask when they leave their room. The focus should be on contact precautions rather than respiratory precautions.
D) "Don gloves prior to assisting the client with brushing their teeth.": MRSA is a contact-borne infection, so it is essential to use proper personal protective equipment, such as gloves, when coming into direct contact with the client or any of their bodily fluids or contaminated items (such as toothbrushes). Donning gloves prior to assisting with brushing their teeth ensures that the nurse avoids direct contact with potential sources of infection. This is an important measure in preventing the spread of MRSA.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A) Facial erythema:
Facial erythema is commonly seen in children with pertussis due to the intense coughing fits that are characteristic of the disease. The child may experience bursts of violent coughing, which can lead to a flushed appearance, especially in the face, due to increased pressure during coughing. This manifestation is a common and expected sign in children with pertussis.
B) Peeling of the hands and feet:
Peeling of the hands and feet is not a typical manifestation of pertussis. This is more commonly associated with conditions such as toxic shock syndrome or Kawasaki disease. Pertussis primarily presents with respiratory symptoms such as coughing and a characteristic "whooping" sound, not peeling skin.
C) Fever:
While a mild fever may occur in some children with pertussis, it is not the most prominent symptom. Pertussis is more often characterized by severe coughing fits, which can cause vomiting and a distinctive "whooping" sound, particularly during the paroxysmal stage. Fever is typically mild and not the hallmark of the disease.
D) Beefy, red tongue:
A beefy, red tongue is not a typical finding in pertussis. This symptom is more commonly seen in conditions such as scarlet fever or vitamin B12 deficiency. Pertussis primarily presents with respiratory symptoms like severe coughing and difficulty breathing, and does not typically affect the tongue in this manner.
Correct Answer is B
Explanation
A) I will take my inhaler treatment before each meal and at bedtime:
Budesonide is a corticosteroid inhaler used for asthma management, but it is not specifically required to be taken before meals. The timing of inhaler use should be directed by the healthcare provider based on the individual treatment plan. Taking the inhaler at meals is not typically necessary unless specifically instructed, and there is no standard requirement for it to be taken at bedtime either.
B) I will rinse my mouth and gargle with water after each inhaler treatment:
Rinsing the mouth and gargling with water after using an inhaled corticosteroid, like budesonide, is an essential step to reduce the risk of developing oral thrush, a fungal infection. Corticosteroids can promote fungal growth in the mouth, so rinsing helps to clear any residual medication from the mouth and prevent this complication. This statement demonstrates an accurate understanding of the proper use of the inhaler.
C) I should use my inhaler when I have an asthma attack:
Budesonide is a maintenance medication used to control asthma symptoms over the long term, not for immediate relief during an asthma attack. For acute asthma attacks, a fast-acting bronchodilator like albuterol is used, not a corticosteroid like budesonide. The adolescent’s statement reflects a misunderstanding of the purpose of budesonide, which is for prevention and long-term control.
D) I should use my inhaler before exercising:
Using an inhaler before exercise may be appropriate for clients who have exercise-induced bronchoconstriction or asthma, but budesonide is not typically used as a pre-exercise medication. Instead, a short-acting bronchodilator is used before exercise to prevent asthma symptoms during activity. Budesonide is generally used for long-term asthma management rather than for acute symptom relief.
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