The practical nurse (PN) is caring for a client with influenza. Which action should the PN implement to prevent the spread of influenza?

Wear a surgical mask during all client contact.

Use an isolation gown when providing client care.

Determine if the client's room has negative airflow.

Place a mask on the client if the client leaves the room.

Answer and Explanation

The Correct Answer is D

A. Wear a surgical mask during all client contact: While wearing a surgical mask protects the nurse from inhaling respiratory droplets, it is equally important to prevent the client from spreading droplets to others, especially when moving outside the room.
B. Use an isolation gown when providing client care: An isolation gown protects against contact transmission rather than droplet transmission. Influenza spreads primarily through respiratory droplets, so gowns are not the primary measure to prevent its spread.
C. Determine if the client's room has negative airflow: Negative airflow rooms are necessary for airborne infections like tuberculosis, not for droplet-spread infections such as influenza. Standard precautions for influenza focus more on masking and hygiene practices.
D. Place a mask on the client if the client leaves the room: Masking the client when outside their room helps contain respiratory droplets, minimizing the risk of infecting others. This intervention is crucial in controlling the spread of influenza within healthcare settings.

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Correct Answer is B

Explanation

A. Show the UAP how to use a transfer belt to safely move the client: A transfer belt is useful for clients who can bear some weight and follow instructions. Since the client is confused and cannot bear weight, using a transfer belt is unsafe and increases the risk of injury.
B. Work with the UAP to use a mechanical lift and sling for the transfer: A mechanical lift provides the safest method for transferring a confused, non-weight-bearing client. It minimizes the risk of injury to both the client and staff while ensuring the transfer is done safely and correctly.
C. Instruct the UAP to use a pivot technique when moving the client: Pivot techniques require the client to bear weight and follow simple directions, neither of which is appropriate given the client's confusion and inability to bear weight.
D. Notify the charge nurse that the client cannot be transferred: While updating the charge nurse may eventually be needed, the immediate action is to modify the transfer method to ensure the client's needs are safely met using appropriate equipment.

A. Limit ROM assessment to the lower extremities only. B. Defer ROM assessment because of the respiratory rate. C. Ask client to perform flexion and extension of arms 5 times. D. Observe the client performing lateral flexion of the waist.

Correct Answer is B

Explanation

A. Limit ROM assessment to the lower extremities only: Focusing only on the lower extremities does not fully address the concern. Any physical exertion could further strain the respiratory system when the client is already tachypneic and in distress.
B. Defer ROM assessment because of the respiratory rate: A respiratory rate of 30 breaths per minute indicates respiratory distress. Physical exertion, even mild, could worsen oxygenation issues. Protecting respiratory function is the priority, so the ROM assessment should be deferred until the client's condition stabilizes.
C. Ask client to perform flexion and extension of arms 5 times: Even minimal arm movements could increase oxygen demand and fatigue in a client already experiencing respiratory compromise, making this unsafe at the moment.
D. Observe the client performing lateral flexion of the waist: Lateral flexion involves significant muscular effort and could further tax respiratory function. It is not appropriate when the client is tachypneic and needs respiratory support.

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The practical nurse (PN) is caring for a client with influenza. Which action should the PN implement to prevent the spread of influenza?

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Naxlex Comprehensive Predictor Exams

The practical nurse (PN) assigns an unlicensed assistive personnel (UAP) the task of transferring an alert client from the bed to the chair. The UAP reports to-the PN that the client is confused and cannot bear weight. Which action should the PN implement?

Correct Answer is B

Explanation

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Correct Answer is B

Explanation

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