A nurse is providing discharge teaching to a client who has methicillin-resistant Staphylococcus aureus in a leg wound. Which of the following instructions should the nurse include in the teaching about this antibiotic-resistant infection?

Take a tub bath every other day using a mild soap.

Wash bathroom surfaces daily with isopropyl alcohol.

Place the soiled dressing in a sealed plastic bag before placing it in the trash can.

Was the wound area before washing the surrounding skin.

Answer and Explanation

The Correct Answer is C

A) Take a tub bath every other day using a mild soap: While maintaining hygiene is important, taking a tub bath is not the most effective way to prevent the spread of MRSA. Showering is usually recommended to help wash away bacteria without sitting in potentially contaminated water.

B) Wash bathroom surfaces daily with isopropyl alcohol: Cleaning surfaces regularly is important, but using isopropyl alcohol specifically for this purpose is not necessary. Household disinfectants that are effective against bacteria, including bleach solutions, can be used to disinfect surfaces.

C) Place the soiled dressing in a sealed plastic bag before placing it in the trash can: This instruction is crucial to prevent the spread of MRSA. Properly containing and disposing of contaminated dressings minimizes the risk of bacteria spreading to other surfaces or individuals.

D) Wash the wound area before washing the surrounding skin: When cleaning wounds, it's typically recommended to clean the surrounding skin first to avoid spreading bacteria from the wound to the clean skin. This reduces the risk of contamination and helps maintain a sterile environment around the wound.

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Correct Answer is D

Explanation

A) Diarrhea: Metabolic alkalosis is more likely to be associated with constipation rather than diarrhea. Diarrhea is typically a cause of metabolic acidosis due to the loss of bicarbonate in stool, rather than a result of metabolic alkalosis.

B) Bradycardia: Bradycardia is not a typical manifestation of metabolic alkalosis. Alkalosis can lead to arrhythmias, but it generally does not cause a slow heart rate. Instead, tachycardia might occur as the body compensates for the altered acid-base balance.

C) Tinnitus: Tinnitus is not a common symptom of metabolic alkalosis. It is more often associated with aspirin toxicity or other conditions affecting the auditory system, rather than changes in acid-base balance.

D) Tetany: Tetany is a common manifestation of metabolic alkalosis. The alkalosis causes a decrease in ionized calcium levels, which increases neuromuscular excitability and can lead to muscle cramps, spasms, and tetany. This is a key sign for nurses to monitor as it indicates significant electrolyte disturbances associated with the alkalotic state.

A. Place the client in a semi-Fowler's position, B. Infuse warm IV fluids. C. Assess the client's skin hourly when using a heating blanket. D. Rewarm the client's extremities first.

Correct Answer is B

Explanation

A) Place the client in a semi-Fowler's position:
While positioning can be beneficial for various conditions, it does not directly address the core issue of hypothermia. Rewarming the client effectively is the primary concern in hypothermia management.

B) Infuse warm IV fluids:
Administering warm IV fluids is a crucial intervention for moderate hypothermia as it helps increase the client's core body temperature more rapidly and effectively. This method ensures that the body's internal temperature is raised, which is vital for stabilizing the client.

C) Assess the client's skin hourly when using a heating blanket:
Monitoring the skin is important to prevent burns or skin damage from a heating blanket, but it is a supportive measure rather than a primary intervention. The key priority is to rewarm the client’s core.

D) Rewarm the client's extremities first:
Rewarming the extremities first can actually be harmful in hypothermia, as it can lead to a drop in core body temperature due to the return of cold blood from the periphery to the core (afterdrop). The focus should be on warming the core body first.

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A nurse is providing discharge teaching to a client who has methicillin-resistant Staphylococcus aureus in a leg wound. Which of the following instructions should the nurse include in the teaching about this antibiotic-resistant infection?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is B

Explanation

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