A nurse is caring for a client who has active tuberculosis. Which of the following actions should the nurse take?

Remain 1 m (3 feet) away from the client when providing care.

Apply a surgical mask before entering the client’s room.

Ensure the door to the client’s room is closed at all times.

Place a “no visitors” sign on the client’s door.

Answer and Explanation

The Correct Answer is C

Choice A Reason:

Remaining 1 meter (3 feet) away from the client when providing care is not sufficient to prevent the spread of tuberculosis (TB). TB is an airborne disease, and the bacteria can remain suspended in the air for several hours. Therefore, maintaining a distance alone does not provide adequate protection against inhaling the bacteria.

Choice B Reason:

Applying a surgical mask before entering the client’s room is not the most effective measure. Surgical masks are designed to protect against large droplets and splashes, but they do not provide adequate protection against airborne particles like TB bacteria. Instead, healthcare workers should use N95 respirators, which are specifically designed to filter out airborne particles.

Choice C Reason:

Ensuring the door to the client’s room is closed at all times is a critical measure in preventing the spread of TB. This action helps to contain the airborne bacteria within the room, reducing the risk of transmission to others in the healthcare facility. This is part of airborne precautions, which are essential for managing patients with active TB.

Choice D Reason:

Placing a “no visitors” sign on the client’s door can help limit the number of people exposed to the TB bacteria, but it is not the most critical action. While it is important to restrict visitors, ensuring the door is closed and using appropriate personal protective equipment (PPE) are more effective measures in controlling the spread of TB.

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Correct Answer is ["A","B","E"]

Explanation

Choice A Reason:

Using an electric shaver is recommended for clients who have received chemotherapy because it reduces the risk of cuts and bleeding. Chemotherapy can lower platelet counts, leading to an increased risk of bleeding. Traditional razors can cause nicks and cuts, which can be problematic for clients with low platelet counts.

Choice B Reason:

Avoiding crowds is crucial for clients who have received chemotherapy because their immune systems are often weakened, making them more susceptible to infections. Crowded places increase the risk of exposure to pathogens, which can lead to serious infections in immunocompromised individuals.

Choice C Reason:

Taking temperature weekly is not sufficient for clients who have received chemotherapy. These clients are at a higher risk of infections, and any sign of fever should be monitored closely. It is generally recommended to take the temperature daily or more frequently if the client feels unwell.

Choice D Reason:

Consuming a low-residue diet is not typically necessary for clients who have received chemotherapy unless they are experiencing specific gastrointestinal issues. A balanced diet with adequate nutrients is usually recommended to support overall health and recovery.

Choice E Reason:

Monitoring for bruising is important for clients who have received chemotherapy because it can indicate low platelet counts or other bleeding disorders. Early detection of bruising can help in managing and preventing more serious bleeding complications.

A. Lemonade B. Tomato soup C. Gelatin D. Black coffee

Correct Answer is C

Explanation

Choice A Reason

Lemonade is not suitable for a client with acute gastritis. Lemonade is acidic and can irritate the stomach lining, potentially worsening the symptoms of gastritis. It is important to avoid acidic foods and beverages to prevent further irritation.

Choice B Reason

Tomato soup is also not recommended for a client with acute gastritis. Tomatoes are acidic and can exacerbate gastritis symptoms. Foods that are low in acidity are better choices for individuals with this condition.

Choice C Reason

Gelatin is the correct choice. It is bland, non-acidic, and easy to digest, making it suitable for someone recovering from acute gastritis. Gelatin can help soothe the stomach lining without causing irritation.

Choice D Reason

Black coffee should be avoided by clients with acute gastritis. Coffee is acidic and can irritate the stomach lining, leading to increased discomfort and symptoms. Caffeine can also stimulate acid production, which is not ideal for someone with gastritis.

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A nurse is caring for a client who has active tuberculosis. Which of the following actions should the nurse take?

Nursing Test Bank

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