A nurse is teaching an assistive personnel (AP) about using personal protective equipment while caring for clients. Which of the following statements should the nurse identify as an indication that the AP understands the instructions?

"I will wear gloves and a gown when bathing a client who has open skin lesions."

"I will wear gloves when measuring a client's blood pressure."

"I will wear gloves whenever I am in contact with clients."

1 will wear gloves to minimize the number of times I have to wash my hands."

Answer and Explanation

The Correct Answer is A

A. "I will wear gloves and a gown when bathing a client who has open skin lesions.": This statement indicates an understanding of the appropriate use of personal protective equipment (PPE) in a situation where there is a risk of exposure to blood or bodily fluids. Wearing gloves and a gown helps protect the AP from potential pathogens present in the client's open skin lesions.

B. "I will wear gloves when measuring a client's blood pressure.": While it may be appropriate to wear gloves for certain procedures, it is not universally required to wear gloves when measuring blood pressure unless there are specific concerns about contamination or exposure to body fluids. This statement does not demonstrate a clear understanding of when gloves are necessary.

C. "I will wear gloves whenever I am in contact with clients.": This statement suggests a lack of understanding of the appropriate use of gloves. Gloves should be used when there is a risk of contact with blood, body fluids, or open wounds, but they are not necessary for all interactions with clients, especially if there is no risk of contamination.

D. "I will wear gloves to minimize the number of times I have to wash my hands.": This statement indicates a misunderstanding of the primary purpose of gloves. Gloves are used to protect both the caregiver and the client from infection, and hand hygiene should still be performed before and after glove use. The focus should be on infection control rather than convenience.

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Correct Answer is A

Explanation

A. Partial thromboplastin time (PTT) 65 seconds: The normal PTT range is typically between 25 to 35 seconds for patients not on anticoagulants. For a patient receiving heparin therapy, the therapeutic PTT range is usually 1.5 to 2.5 times the normal value, which translates to approximately 60 to 100 seconds. A PTT of 65 seconds is at the lower end of the therapeutic range and may require adjustment in dosage or closer monitoring, especially if there are concerns about achieving adequate anticoagulation for the treatment of a pulmonary embolism. It is important to report this value to the provider.

B. Hematocrit 45%: A hematocrit of 45% is within the normal range for adult females (38% to 47%) and males (40% to 54%). This value does not indicate any immediate concern related to heparin therapy or the treatment of a pulmonary embolism.

C. White blood cell count 8.000/mm³: A white blood cell count of 8,000/mm³ is within the normal range (4,500 to 11,000/mm³) and does not indicate any infection or inflammatory process that requires immediate reporting.

D. Platelets: The specific platelet count value is not provided. However, heparin therapy can lead to thrombocytopenia (low platelet count), so if the platelet count is below 150,000/mm³, it should be reported to the provider. Without the specific value, it is not possible to determine if this requires reporting.

A. A 60 year old patient who is on a mechanical ventilator B. A 65 year old patient who is vegetarian and obese C. A 45 year old patient who smokes a pack of cigarettes a day D. A 70 year old patient who has a normal WBC count

Correct Answer is A

Explanation

A. A 60 year old patient who is on a mechanical ventilator: This patient is at the highest risk for healthcare-acquired infections (HAIs) due to the use of mechanical ventilation. Ventilated patients are susceptible to ventilator-associated pneumonia and other respiratory infections, making them more vulnerable to HAIs.

B. A 65 year old patient who is vegetarian and obese: While obesity can increase the risk for certain complications, being vegetarian does not inherently increase the risk for HAIs. This patient may have some risk factors, but they are not as significant as those associated with mechanical ventilation.

C. A 45 year old patient who smokes a pack of cigarettes a day: Smoking is a risk factor for various health issues, including respiratory infections, but it does not specifically correlate with a higher risk of HAIs in a hospitalized setting compared to a patient on a mechanical ventilator.

D. A 70 year old patient who has a normal WBC count: Although older age can increase the risk for infections, a normal white blood cell count indicates a functioning immune response. Without additional risk factors, this patient would not be considered the most at risk for developing HAIs compared to a ventilated patient.

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