A nurse is providing discharge teaching to a client who has an impaired immune system due to chemotherapy. Which of the following information should the nurse include in the teaching?

"Wash your toothbrush in the dishwasher once each month."

"Change your pet's litter box daily."

"Change the water in your drinking glass every 4 hours."

"Wash your perineal area two times each day with antimicrobial soap."

Answer and Explanation

The Correct Answer is C

A. The nurse should recommend that the client avoid using a toothbrush that is not regularly disinfected. However, washing the toothbrush in the dishwasher may not be sufficient. The client should replace the toothbrush regularly and disinfect it appropriately.

B. Changing the pet's litter box daily is not safe for clients with an impaired immune system. The nurse should advise the client to avoid cleaning the litter box or, if necessary, to wear gloves and a mask while performing the task, and ask someone else to do it if possible.

C. Changing the water in the drinking glass every 4 hours is an important infection control measure for clients with compromised immune systems. Stagnant water can promote bacterial growth, which poses an increased risk for infection in immunocompromised clients.

D. Washing the perineal area two times each day with antimicrobial soap is unnecessary and may cause irritation or disrupt the natural flora of the skin. The nurse should recommend gentle cleansing with mild soap and water instead. Overuse of antimicrobial products can lead to skin damage or resistance.

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Correct Answer is A

Explanation

A. Humidified oxygen is an essential intervention for a client with flail chest. Flail chest occurs when multiple rib fractures result in a segment of the chest wall that moves independently during breathing. This leads to respiratory distress, and providing humidified oxygen helps improve oxygenation and reduce airway irritation.

B. Fluid restriction is not indicated for flail chest unless there is another specific condition (e.g., heart failure) that requires it. The primary concern in flail chest is respiratory support, not fluid management.

C. While acetaminophen may be used for pain management, it is not the priority in managing flail chest. Pain control is important, but the focus should be on ensuring adequate ventilation and oxygenation.

D. Antibiotic medication is not indicated unless there is evidence of infection, such as pneumonia. Flail chest itself does not require antibiotics unless there are associated complications like a chest infection.

A. Ask a family member to be present during the admission. B. Obtain a board that uses colored pictures as communication. C. Familiarize themselves with commonly used signed language. D. Request an interpreter during the initial assessment.

Correct Answer is D

Explanation

A. While a family member may assist in communication, it is not the most appropriate or professional option, especially if the family member may not be trained to provide accurate information or may not be fluent in sign language.

B. A board with colored pictures could be useful in some situations, but it is not the most effective or respectful way to communicate with a client who uses sign language.

C. Familiarizing oneself with commonly used sign language is helpful for general communication, but it is not sufficient for ensuring effective and accurate communication in a healthcare setting.

D. Requesting a trained interpreter is the best approach to ensure clear, accurate communication with the client. A professional interpreter can facilitate the conversation and provide the necessary support for the client’s understanding and expression of their healthcare needs.

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A nurse is providing discharge teaching to a client who has an impaired immune system due to chemotherapy. Which of the following information should the nurse include in the teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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

Correct Answer is A

Explanation

A client who is deaf and communicates using sign language is being admitted by a nurse who does not know sign language. Which of the following actions should the nurse take?

Correct Answer is D

Explanation

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