A nurse is teaching a newly licensed nurse about advance directives for clients who have schizophrenia. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching?

Choice A reason: Discarding disposable razors after one week of use is not sufficient for infection control in MRSA folliculitis. MRSA is highly contagious and can spread through contaminated personal items. The recommendation is to discard razors after each use to prevent re-inoculation of bacteria and transmission to others. Keeping a razor for a week allows bacterial colonization and increases the risk of spreading infection to new areas of the skin or to other individuals. Therefore, this statement is incorrect because it does not meet the strict hygiene requirements necessary for MRSA management.

Choice B reason: Continuing to participate in contact sports is unsafe for an adolescent with MRSA folliculitis. MRSA spreads easily through skin-to-skin contact and shared equipment, both of which are common in contact sports. Allowing participation increases the risk of transmitting MRSA to teammates and others. Public health guidelines emphasize restricting participation until the infection is fully treated and lesions are healed. Thus, this statement is inappropriate and incorrect because it disregards infection control measures.

Choice C reason: Applying over-the-counter hydrocortisone cream daily is not recommended for MRSA folliculitis. Corticosteroids suppress local immune responses and can worsen bacterial infections by reducing inflammation without addressing the underlying pathogen. MRSA requires targeted antimicrobial therapy, not corticosteroid treatment. Using hydrocortisone could delay healing, increase bacterial proliferation, and potentially worsen the infection. Therefore, this statement is incorrect because it promotes an unsafe and ineffective treatment approach.

Choice D reason: Changing clothing daily and washing it in hot water is the correct teaching for an adolescent with MRSA folliculitis. MRSA can survive on fabrics and surfaces, making clothing a potential reservoir for reinfection or transmission. Hot water laundering helps kill bacteria and reduces contamination risk. Daily clothing changes prevent prolonged bacterial contact with the skin and minimize spread to household members. This recommendation aligns with infection control practices and is the most appropriate teaching statement for preventing recurrence and transmission.

Choice A reason: Preventing injury to the sciatic nerve is achieved by proper site selection for intramuscular injections, such as using the ventrogluteal site. The Z-track method does not specifically prevent nerve injury.

Choice B reason: The Z-track technique involves pulling the skin laterally before inserting the needle, then releasing it after injection. This creates a zigzag path that seals the medication in the muscle tissue, preventing leakage into subcutaneous tissue. This decreases the risk of subcutaneous infiltration and irritation, which is the primary purpose of the technique.

Choice C reason: The Z-track method does not increase the volume of medication that can be injected. The maximum volume depends on the muscle site chosen, not the injection technique.

Choice D reason: The Z-track technique does not increase absorption rate. Absorption depends on the medication’s properties and the vascularity of the muscle site. The technique is used to prevent leakage and irritation, not to alter absorption.