A nurse is providing teaching about cough etiquette to a client who has influenza. Which of the following instructions should the nurse include in the teaching?
"Cover your nose and mouth with a tissue when coughing."
"If you are coughing frequently, you should wear gloves when preparing meals."
"Stay 2 feet away from others when coughing."
"Turn your head away when coughing."
The Correct Answer is A
A. "Cover your nose and mouth with a tissue when coughing.": Covering both the nose and mouth with a tissue prevents respiratory droplets from spreading into the environment, reducing transmission of influenza to others. Proper disposal of the tissue and hand hygiene should follow.
B. "If you are coughing frequently, you should wear gloves when preparing meals.": Gloves are not a primary measure for cough etiquette. Hand hygiene and avoiding food preparation while symptomatic are more effective in preventing the spread of influenza.
C. "Stay 2 feet away from others when coughing.": Droplet precautions for influenza recommend maintaining at least 3 feet of distance, and ideally up to 6 feet, to prevent exposure. Two feet is inadequate to protect others from respiratory droplets.
D. "Turn your head away when coughing.": Turning the head alone does not sufficiently contain respiratory secretions. Droplets can still disperse into the air, so using a tissue or the elbow crease is more effective.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. "VRE is transmitted through the air by coughing and sneezing.": VRE is not airborne; it spreads primarily through direct contact with contaminated surfaces or hands of healthcare workers. Airborne precautions are not required for this organism.
B. "VRE infection requires health care workers to wear an N95 respirator.": N95 respirators are required for airborne pathogens such as tuberculosis, not for VRE. Contact precautions, including gloves and gowns, are used for preventing transmission of VRE.
C. "VRE infection is treated with vancomycin antibiotics.": Vancomycin-resistant enterococci are resistant to vancomycin by definition, so other antibiotics such as linezolid or daptomycin are used instead. Treating with vancomycin would be ineffective.
D. "VRE is a common cause of health care-associated infections.": VRE is a significant pathogen in healthcare settings, often causing bloodstream, urinary tract, and wound infections. It is considered a common cause of health care–associated infections due to its resistance and ease of spread.
Correct Answer is B
Explanation
A. Insert an indwelling urinary catheter: Indwelling catheters increase the risk of urinary tract infections and are not recommended solely for immobility. Managing incontinence with skin care and barrier products is safer for preserving skin integrity.
B. Use an alcohol-free barrier product: Alcohol-free barrier products protect the skin from moisture, friction, and irritation without causing dryness. This helps maintain skin integrity, especially in clients who are immobile and at high risk for breakdown.
C. Reposition the client every 4 hr: Immobile clients should be repositioned at least every 2 hours, not every 4. Prolonged pressure over bony areas can rapidly lead to pressure injuries if turning is delayed.
D. Massage the skin over bony prominences: Massaging over bony prominences can damage fragile tissue and worsen the risk of pressure injury. Instead, gentle repositioning and cushioning should be used to protect the skin.
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