A nurse is providing teaching to a client about healthy lifestyle changes. The client states. "I work long hours at work. I never have time for exercise or anything but fast food." Which goal should the nurse include in the client's nursing plan of care?

The client will reduce weight by 4.5 kg (10 lb) within 2 weeks.

The client will reduce daily stress and increase activity by exercising.

The client will improve overall health by the next visit.

The client will introduce two green vegetables into their diet by the end of the month.

Answer and Explanation

The Correct Answer is D

Effective nursing care plans utilize SMART criteria to ensure that health objectives are specific, measurable, achievable, relevant, and time-bound. Behavior modification in the context of occupational stress requires incremental changes to avoid patient burnout and non-compliance with the therapeutic regimen. Establishing realistic goals fosters a sense of self-efficacy, which is essential for long-term adherence to nutritional and physical activity interventions.

Rationale:

A. Setting a goal to lose 4.5 kg in 14 days is clinically unrealistic and potentially dangerous for most patients. Rapid weight loss can lead to electrolyte imbalances or gallstone formation rather than sustainable fat reduction. Healthy weight management typically targets a loss of 0.5 to 1 kg per week to ensure metabolic stability.

B. This statement serves as a general nursing objective rather than a measurable goal for the patient's plan of care. It lacks specific parameters, such as the duration, frequency, or type of exercise the client will perform. Without clear metrics, the nurse cannot objectively evaluate whether the client has successfully met the requirement.

C. Improving overall health is an overly vague outcome that cannot be accurately quantified or assessed during follow-up. A nursing goal must define exactly what "improvement" looks like through objective data or specific behavioral changes. Broad statements fail to provide the client with a clear roadmap for lifestyle modification.

D. This goal is highly attainable because it introduces a specific, minor change that fits into a busy schedule. By including a clear deadline of one month, the nurse can objectively measure success during the next clinical encounter. Small dietary adjustments are more likely to result in permanent, healthy habit formation.

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Correct Answer is D

Explanation

A random stool specimen is a non-invasive diagnostic procedure used to detect pathogens, occult blood, or fecal fat content. Proper collection technique prevents contamination from urine or external chemicals, ensuring the diagnostic validity of the laboratory analysis. The nurse must provide clear instructions on the use of personal protective equipment and the safe disposal of biohazardous materials to prevent nosocomial transmission.

Rationale:

A. The introduction of chemical agents like chlorhexidine into the collection container is contraindicated because it alters the specimen’s composition. Disinfectants can kill the very microorganisms the laboratory is attempting to culture, leading to false-negative results. The commode should be clean and dry, free from all detergents or antiseptic solutions.

B. Specimens should never be stored in a refrigerator that contains medication or food due to the risk of cross-contamination. Facility protocols require a dedicated, labeled biohazard refrigerator for the temporary storage of laboratory samples. Proper placement ensures that pharmaceutical integrity is maintained while following strict infection control guidelines.

C. Collecting specific components like pus with a sterile swab is an advanced technique typically reserved for culture and sensitivity testing. For a random stool specimen, the UAP should collect a representative sample of the stool itself rather than focusing on exudates. Advanced specimen retrieval often requires licensed nursing judgment to ensure proper sampling.

D. Used tongue blades are considered contaminated waste and must be handled to prevent the spread of enteric pathogens. Wrapping them in a paper towel before placing them in the biohazard receptacle reduces the risk of accidental contact for environmental services staff. This practice maintains a clean environment and adheres to standard precautions for fecal matter.

A. No respiratory protection needed B. N95 particulate respirator C. Surgical mask with eye shield D. Double-layered surgical mask

Correct Answer is B

Explanation

A generalized vesiculopustular rash with lesions in the same stage of development is highly suggestive of a viral orthopox infection, consistent with monkeypox, which is transmitted via respiratory droplets, direct contact with lesions, and contaminated fomites. Infection control requires airborne-level precautions due to potential aerosolization during close patient contact and procedures.

Rationale:

A. No respiratory protection is inappropriate because suspected orthopox viral infections require transmission-based precautions. Close-contact spread and droplet dissemination can occur, placing staff at risk without respiratory protection.

B. An N95 particulate respirator provides airborne and droplet protection, filtering infectious particles during close patient care. This is required when managing suspected orthopox infections with rash and systemic viral presentation to prevent inhalation exposure.

C. A surgical mask with eye shield offers droplet protection only, which is insufficient for suspected orthopoxvirus cases. It does not provide adequate filtration of airborne particles during prolonged or close exposure to infected lesions.

D. A double-layered surgical mask does not meet respiratory protection standards for high-risk viral infections. It lacks certified filtration efficiency and does not protect against aerosolized particles or close-contact viral transmission risks.

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A nurse is providing teaching to a client about healthy lifestyle changes. The client states. "I work long hours at work. I never have time for exercise or anything but fast food." Which goal should the nurse include in the client's nursing plan of care?

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A nurse is delegating collection of a random stool specimen to an unlicensed assistive personnel (UAP). Which information should the nurse provide?

Correct Answer is D

Explanation

The nurse is assessing the client who has recently returned from a 2-month mission in Africa. The nurse notes that the client has a rash consisting of firm, round pustules, all at the same stage of development. What type of respiratory protection is appropriate for the staff?

Correct Answer is B

Explanation

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A nurse is providing teaching to a client about healthy lifestyle changes. The client states. "I work long hours at work. I never have time for exercise or anything but fast food." Which goal should the nurse include in the client's nursing plan of care?