A nurse is caring for a client who has diarrhea due to shigella. Which of the following precautions should the nurse implement for this client?

Have the client wear a mask when receiving visitors.

Wear a gown when caring for the client.

Assign the client to a room with negative-pressure airflow exchange.

Limit the client's time with visitors to no more than 30 min per day.

Answer and Explanation

The Correct Answer is B

A. Have the client wear a mask when receiving visitors: Mask use is primarily indicated for airborne or droplet precautions to prevent respiratory transmission of pathogens. Shigella is transmitted via the fecal-oral route, not through respiratory droplets, so a mask is not required for visitors or staff in this case.

B. Wear a gown when caring for the client: Contact precautions are appropriate for clients with diarrhea caused by Shigella because the bacteria can be transmitted through direct or indirect contact with fecal matter. Wearing a gown protects the nurse’s clothing from contamination and helps prevent the spread of infection to other clients or surfaces.

C. Assign the client to a room with negative-pressure airflow exchange: Negative-pressure rooms are used for airborne pathogens such as tuberculosis, not for enteric infections like Shigella. Shigella does not remain suspended in the air and therefore does not require special airflow control.

D. Limit the client's time with visitors to no more than 30 min per day: Restricting visitation time is not a standard precaution for fecal-oral infections. Infection control relies on proper hand hygiene, use of personal protective equipment, and environmental cleaning rather than strictly limiting visitor duration.

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Correct Answer is D

Explanation

A. "Most people are happy when their children grow up and leave home.": This response minimizes the client’s feelings and may make them feel dismissed. It does not explore or validate the client’s sense of loss or lack of purpose, which is important for emotional support during the transition of children leaving home.

B. "You should be proud that your children are becoming independent.": While acknowledging accomplishments can be positive, this statement shifts focus away from the client’s current feelings of uselessness. It does not address the underlying emotional experience or provide guidance on finding new sources of meaning in middle adulthood.

C. "Maybe you should consider why you are feeling useless.": This statement can come across as judgmental or directive and may make the client feel blamed for their emotions. Open, empathetic exploration of feelings is more effective than prompting the client to analyze themselves prematurely.

D. "People in middle adulthood often find satisfaction in nurturing and guiding young people.": This response normalizes the client’s feelings while offering a constructive perspective. It validates the sense of loss and provides an avenue for reframing purpose by suggesting alternative meaningful roles, such as mentoring, volunteering, or community involvement.

A. Wrap blankets around all four sides of the bed. B. Apply restraints during seizure activity. C. Place the client in a supine position during seizure activity. D. Have a tongue depressor at the client's bedside.

Correct Answer is A

Explanation

A. Wrap blankets around all four sides of the bed: Protecting the client from injury is the primary goal during seizure precautions. Padding the bed rails with blankets or seizure pads helps prevent trauma to the head and extremities during tonic-clonic movements. This reduces the risk of injury without restricting the client’s movement and is a standard safety measure.

B. Apply restraints during seizure activity: Restraining a client during a seizure can cause significant injury, including musculoskeletal damage or impaired breathing. During tonic-clonic seizures, the client’s movements are involuntary, and applying restraints may increase the risk of fractures or soft tissue injury.

C. Place the client in a supine position during seizure activity: Placing a client flat on their back increases the risk of airway obstruction and aspiration of saliva or vomitus during a seizure. The recommended position is side-lying (lateral) if possible, which promotes drainage of secretions and helps maintain a clear airway. Maintaining airway safety is a key priority during seizures.

D. Have a tongue depressor at the client's bedside: Inserting objects such as a tongue depressor or any device into the client’s mouth during a seizure is contraindicated. This practice can lead to broken teeth, airway obstruction, or injury to the oral cavity. Modern seizure management emphasizes protecting the client from injury and maintaining airway safety.

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A nurse is caring for a client who has diarrhea due to shigella. Which of the following precautions should the nurse implement for this client?

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