A nurse is assisting in the admission of a client who has measles. Which of the following isolation precautions should the nurse initiate?
Contact.
Airborne.
Protective environment.
Droplet.
The Correct Answer is B
Choice A rationale:
Contact precautions are indicated when the client has a condition that can be easily transmitted through direct contact with the client or their environment. Measles, which is an airborne disease, requires more stringent precautions due to its mode of transmission.
Choice B rationale:
The correct choice. Measles is spread through airborne particles, making airborne precautions necessary. These precautions include placing the client in a negative pressure room, wearing appropriate respiratory protection (e.g., N95 mask), and ensuring that healthcare providers are properly protected from inhaling infectious particles.
Choice C rationale:
A protective environment is a specialized form of isolation used for clients with compromised immune systems, such as those undergoing stem cell transplants. It involves maintaining a sterile environment to prevent the introduction of pathogens. This level of precautions is not applicable to clients with measles.
Choice D rationale:
Droplet precautions are appropriate for diseases that are transmitted through respiratory droplets generated by coughing, sneezing, or talking. Measles, however, is transmitted through smaller airborne particles that can remain suspended in the air for longer periods, making airborne precautions the most suitable choice.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale:
This response indicates an understanding of the teaching about celiac disease. Rice is a gluten-free grain, which makes rice pudding a suitable dessert option for a child with celiac disease. Gluten is a protein found in wheat, barley, and rye, and individuals with celiac disease need to avoid gluten-containing foods.
Choice B rationale:
Barley is a gluten-containing grain, and feeding a child a barley-based breakfast cereal is not appropriate for someone with celiac disease. Gluten-containing grains can trigger adverse reactions in individuals with celiac disease due to their inability to properly digest gluten.
Choice C rationale:
Rye bread contains gluten, and making sandwiches using rye bread is not a suitable choice for a child with celiac disease. Gluten-free bread options, typically made from rice, corn, or other gluten-free flour, should be chosen instead.
Choice D rationale:
Chocolate malt may contain ingredients that could potentially contain gluten, and it's not a safe snack option for a child with celiac disease. Individuals with celiac disease need to be cautious about hidden sources of gluten in processed foods.
Correct Answer is B
Explanation
Choice A rationale:
Avoiding discussions about the child's diagnosis with the sibling might create confusion and anxiety for the sibling. Open communication is essential for helping siblings understand their brother or sister's condition and cope with the changes in the family dynamic.
Choice B rationale:
Encouraging phone calls between the siblings is a positive step in promoting sibling adaptation when one of them has a chronic illness like cystic fibrosis. Maintaining connections through communication helps siblings feel involved, valued, and informed about each other's lives and challenges.
Choice C rationale:
Designating one parent to stay at home with the sibling might lead to feelings of isolation and neglect for the child with cystic fibrosis. Siblings also need support and attention during this time, and isolating one parent could hinder healthy sibling relationships.
Choice D rationale:
Avoiding having the sibling visit the child in the facility may prevent the sibling from understanding the condition and create a sense of fear or confusion. Controlled, supervised visits can actually be beneficial, as they allow the siblings to interact and support each other in a safe environment.
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