A nurse is caring for a client who requires protective isolation following a hematopoietic stem cell transplant. Which of the following interventions should the nurse implement to protect the client from infection?

Wear an N95 respirator when providing direct client care.

Make sure the client's room has positive-pressure airflow.

Make sure dietary plates and utensils are disposable.

Monitor the client's temperature once every 6 hr.

Answer and Explanation

The Correct Answer is B

A. While wearing an N95 respirator may be necessary for certain infections, it is not a routine precaution for clients in protective isolation.

B. Ensuring the client's room has positive-pressure airflow helps prevent the entry of airborne pathogens into the room, reducing the risk of infection for the immunocompromised client.

C. Using disposable plates and utensils helps reduce the risk of cross-contamination and infection transmission but is not directly related to airborne infection control.

D. Monitoring the client's temperature is important for assessing for signs of infection, but it does not directly prevent infection transmission in the same way as positive-pressure airflow.

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Correct Answer is A

Explanation

A. Protamine sulfate is the antidote for heparin and is necessary in case of heparin-induced bleeding or overdose.

B. Vitamin K is the antidote for warfarin, not heparin.

C. Flumazenil is the antidote for benzodiazepines, not heparin.

D. Acetylcysteine is used for acetaminophen overdose, not heparin.

A. Bilateral pedal pulses 2+. Blood glucose 310 mg/dL B. Pulse rate 84/min C. Blood pressure 106/76 mm Hg D. Temperature 36.8° C (98.2° F) E. Respiratory rate 16/min F. Oxygen saturation 96% on room air

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

Explanation

The client's condition shows signs of improvement as indicated by several findings. The blood glucose level has decreased from 468 mg/dL to 310 mg/dL, which, although still above the normal range, is a significant improvement. The pulse rate has normalized from 110/min to 84/min, and the blood pressure has improved from 96/65 mm Hg to 106/76 mm Hg, indicating better cardiovascular stability. The increase in bilateral pedal pulses from 1+ to 2+ suggests improved circulation.

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A nurse is caring for a client who requires protective isolation following a hematopoietic stem cell transplant. Which of the following interventions should the nurse implement to protect the client from infection?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Explanation

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