nurse is caring for a client who has Clostridium difficile (C. difficile). Which of the following actions should the nurse take?
Clean hands with soap and water after caring for the client
Place the client in a room with negative pressure airflow
Wash hands for 10 seconds after caring for the client
Apply a mask on the client when they are outside their room
The Correct Answer is A
A. Clean hands with soap and water after caring for the client: C. difficile spores are resistant to alcohol-based hand sanitizers. Therefore, it is essential to use soap and water to effectively remove the spores from hands.
B. Place the client in a room with negative pressure airflow: C. difficile is not an airborne infection, so negative pressure airflow is not required. This measure is typically used for infections such as tuberculosis.
C. Wash hands for 10 seconds after caring for the client: Handwashing with soap and water should be done for at least 20 seconds to effectively remove C. difficile spores.
D. Apply a mask on the client when they are outside their room: A mask is not necessary for clients with C. difficile, as the infection is not transmitted through respiratory droplets but rather through fecal-oral transmission.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","D"]
Explanation
A. Provide educational material written at an eighth-grade reading level: Educational material should be understandable to the client, and an eighth-grade reading level is typically accessible for most individuals.
B. Turn on the television in the client's room: Turning on the television can be distracting and is not conducive to effective preoperative teaching.
C. Use technical language in the educational session: Technical language can be confusing for clients; plain language should be used to ensure understanding.
D. Start with the most important information: Prioritizing the most critical information ensures that the client understands essential aspects of their procedure, even if they cannot retain all details.
Correct Answer is C
Explanation
A. Bronchial airway constriction: In the fight-or-flight response, bronchial airways actually dilate to increase airflow to the lungs, rather than constricting.
B. Hypoglycemia: The fight-or-flight response typically leads to increased blood glucose levels (hyperglycemia) to provide quick energy, not decreased levels.
C. Dilated pupils: During the fight-or-flight response, pupils dilate to improve vision and help the individual better detect threats. This is a classic manifestation of this stress response.
D. Decreased blood pressure: The fight-or-flight response generally increases blood pressure due to the release of adrenaline and other stress hormones that prepare the body for immediate action.
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