A nurse is admitting a client who has neutropenia. Which of the following precautions should the nurse take?

Monitor vital signs at least every 4 hr.

Insert an indwelling urinary catheter.

Change the client's linens three times a day.

Place the client in a room with negative airflow.

Answer and Explanation

The Correct Answer is A

A.   Frequent vitals monitoring to allow for early detection of infection. Clients with neutropenia are at increased risk of infections.
B.   Indwelling catheter and other devices should be avoided in individuals with neutropenia die to risk of sepsis.
C.   Changing the client’s linen is important. However, doing it 3 times a day is not necessary.
D.   Clients should be placed in a positive airflow room to prevent contracting infections from infected persons

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Correct Answer is C

Explanation

C. When collecting a stool specimen from a client with Clostridium difficile infection, the nurse should wear gloves to prevent the spread of the bacteria to themselves and other patients. Proper hand hygiene should also be performed after glove removal.
A. While alcohol-based hand rubs are effective against many types of bacteria and viruses, they are not effective against Clostridium difficile spores. Handwashing with soap and water is recommended for hand hygiene in cases of Clostridium difficile infection, as it is more effective at removing spores from the hands.
B. Chlorhexidine is a disinfectant commonly used for skin antisepsis, but it is not effective against
D. Placing the client in a protective environment is not typically necessary for clients with Clostridium difficile gastroenteritis unless they are immunocompromised or have other conditions that require protective isolation.

A. Chloride level B. Creatinine kinase C. Uric acid D. Intrinsic factor

Correct Answer is C

Explanation

C. Uric acid is the end product of purine metabolism, and elevated levels of uric acid in the blood can predispose individuals to gout. In acute gout, there is often a marked increase in serum uric acid levels due to the release of uric acid from the breakdown of purines during the inflammatory process.
A. Chloride level is not directly associated with acute gout.
B. Creatinine kinase (CK) is an enzyme found in various tissues, including muscle tissue. Elevated CK levels are associated with muscle damage or injury, such as in cases of muscle trauma, myocardial infarction, or rhabdomyolysis.
D. Intrinsic factor is a glycoprotein produced by the parietal cells of the stomach that is necessary for the absorption of vitamin B12 in the small intestine.

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A nurse is admitting a client who has neutropenia. Which of the following precautions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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