What is one of the first assessments that a nurse should include when performing an initial nutritional screening on a new patient?

Choice A reason: Gloves reduce transmission but are not sufficient alone; improper use can spread microbes. Hand washing before and after patient contact is the most effective, universal method, so this is incorrect.

Choice B reason: Hand washing before and after patient contact is the most critical step to prevent microorganism transmission, as it removes pathogens from hands, the primary vector. This is the gold standard, making it correct.

Choice C reason: Cleaning the stethoscope is important but secondary to hand washing, which addresses the most common transmission route. Hands contact patients directly, so this is incorrect as the most important step.

Choice D reason: Protective eyewear prevents specific exposures but doesn’t address general microbial spread. Hand washing is the most effective, routine prevention method, so this is incorrect for the primary step.

Choice A reason: Clubbing, characterized by bulbous nail bed enlargement, is associated with chronic hypoxemia from conditions like asthma or COPD. It results from long-term low oxygen levels, making it the expected finding in this patient with chronic respiratory issues.

Choice B reason: Onychomycosis is a fungal nail infection unrelated to hypoxemia or asthma. Clubbing is directly linked to chronic oxygen deficiency, so this is not the expected nail condition in this patient’s context.

Choice C reason: Spooning (koilonychia) is associated with iron deficiency anemia, not hypoxemia or asthma. Clubbing is the nail abnormality seen in chronic respiratory conditions, so this is incorrect for the patient’s condition.

Choice D reason: Paronychia is an infection around the nail, typically from trauma or bacteria, not hypoxemia. Clubbing is the hallmark nail change in chronic asthma with low oxygen, so this is not the expected finding.