A nurse is planning care for a client who has manifestations of a Clostridium difficile (C. difficile) infection. Which action should the nurse plan to take?

Place a surgical mask on the client during transport.

Use gown and gloves when entering the room.

Use an alcohol-based agent to perform hand hygiene when caring for the client.

Obtain a blood specimen to test for C. difficile.

Answer and Explanation

The Correct Answer is B

Choice A reason: Placing a surgical mask on the client during transport is not the primary precaution for C. difficile infections. C. difficile is primarily transmitted through contact with contaminated surfaces and not through respiratory droplets. Therefore, while masks may be used for other infections, they are not the main precaution for C. difficile.

Choice B reason: Using gown and gloves when entering the room is essential for preventing the spread of C. difficile. This infection is highly contagious and can be transmitted through contact with contaminated surfaces or feces. Gown and gloves provide a barrier that helps prevent the transmission of the bacteria to healthcare workers and other patients.

Choice C reason: Using an alcohol-based agent to perform hand hygiene is not effective against C. difficile spores. Hand washing with soap and water is recommended because it is more effective at removing the spores from the hands. Alcohol-based hand sanitizers do not kill C. difficile spores and should not be relied upon for hand hygiene in this context.

Choice D reason: Obtaining a blood specimen to test for C. difficile is not the standard diagnostic method. C. difficile infections are typically diagnosed through stool tests that detect the presence of the bacteria or its toxins. Blood tests are not used for diagnosing C. difficile infections.

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Correct Answer is A

Explanation

Choice A Reason:

Age dose of pain medication refers to adjusting the dosage of pain medication based on the client’s age. Elderly clients often have different pharmacokinetics and pharmacodynamics compared to younger individuals, which means they may require lower doses of medication to achieve the same effect. This adjustment helps to prevent overmedication and potential side effects, ensuring safe and effective pain management for elderly clients.

Choice B Reason:

Correct method of administering your own pain medication is important for clients who are capable of self-administering their medication. However, this choice does not directly address the issue of balance deficit and the need for an assistive device. While proper medication administration is crucial, it is not the primary concern in this scenario.

Choice C Reason:

Operator can push the PCA button for you if you are asleep is not an appropriate practice. Patient-controlled analgesia (PCA) is designed to allow clients to self-administer pain medication as needed. Allowing someone else to push the button can lead to overmedication and potential complications. This choice does not address the need for an assistive device for balance deficit.

Choice D Reason:

The pain medication is delivered at your nose is not a standard method of pain medication administration. This choice is incorrect and does not relate to the client’s need for an assistive device for balance deficit. Pain medication is typically administered orally, intravenously, or through other appropriate routes, but not through the nose.

A. Alginate dressing B. Hydrogel dressing C. Transparent dressing D. Wet-to-dry gauze dressing

Correct Answer is C

Explanation

Choice A Reason:

Alginate dressings are typically used for wounds with moderate to heavy exudate because they are highly absorbent. Stage I pressure ulcers do not usually produce exudate, making alginate dressings unnecessary and inappropriate for this type of wound.

Choice B Reason:

Hydrogel dressings are designed to provide moisture to dry wounds and are more suitable for wounds with minimal to no exudate. While they can be used for stage I pressure ulcers, they are not the most common choice as these ulcers do not typically require additional moisture.

Choice C Reason:

Transparent dressings are ideal for stage I pressure ulcers because they protect the skin from friction and shear while allowing for continuous observation of the wound. These dressings maintain a moist environment, which is beneficial for healing, and are easy to apply and remove without causing additional trauma to the skin.

Choice D Reason:

Wet-to-dry gauze dressings are generally used for debridement of necrotic tissue in more advanced wounds. They are not suitable for stage I pressure ulcers, which do not have necrotic tissue and do not require debridement.

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A nurse is planning care for a client who has manifestations of a Clostridium difficile (C. difficile) infection. Which action should the nurse plan to take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

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Correct Answer is C

Explanation

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