When caring for a patient on Droplet Precautions, it is most important for the nurse to:

Cover the patient with a clean sheet when transporting the patient to x-ray.

Wear a gown and gloves for any contact with the patient.

Wear the appropriate respiratory device for any entry into the room.

Wear a mask if working within 3 feet of the patient.

Answer and Explanation

The Correct Answer is D

Choice A rationale

Covering the patient with a clean sheet helps in preventing contamination during transport, but it is not the most critical action to prevent droplet transmission.

Choice B rationale

Wearing a gown and gloves is important for contact precautions, but droplet precautions specifically require protection from respiratory droplets.

Choice C rationale

Wearing the appropriate respiratory device is important in airborne precautions, but droplet precautions primarily require mask use.

Choice D rationale

Wearing a mask within 3 feet of the patient is crucial for droplet precautions to prevent the spread of respiratory droplets from the infected patient.

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Correct Answer is ["A","B"]

Explanation

Choice A rationale

Withholding food and fluids is essential to prevent complications should surgery be needed.

Choice B rationale

Administering prophylactic IV antibiotics helps prevent infection, which is critical in cases of appendicitis.

Choice C rationale

Applying heat to the abdomen can increase circulation and the risk of rupture in appendicitis.

Choice D rationale

Administering an enema can increase the risk of perforation in appendicitis.

Choice E rationale

Ambulation can exacerbate pain and the risk of rupture in a client with suspected appendicitis.

A. Fecal-smelling breath. B. Severe abdominal distention. C. Weakness, weight loss, and anorexia. D. High-pitched tinkling bowel sounds. E. Intense thirst.

Correct Answer is ["A","B","D"]

Explanation

Choice A rationale

Fecal-smelling breath is a symptom of small intestine obstruction due to bacterial fermentation of trapped food, which produces a foul odor that can be detected on the breath.

Choice B rationale

Severe abdominal distention occurs in small intestine obstructions because of the accumulation of gas and fluids proximal to the obstruction site, leading to a noticeable increase in abdominal girth.

Choice C rationale

Weakness, weight loss, and anorexia are more characteristic of chronic gastrointestinal conditions rather than acute small intestine obstruction. These symptoms develop over a longer period and are not acute manifestations.

Choice D rationale

High-pitched tinkling bowel sounds are a typical finding in small intestine obstruction. They occur due to increased peristaltic activity proximal to the obstruction site as the intestines attempt to move the obstructed contents.

Choice E rationale

Intense thirst is not a primary manifestation of small intestine obstruction. While dehydration can occur, it is not specific to small intestine obstruction and can be a result of many other conditions.

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When caring for a patient on Droplet Precautions, it is most important for the nurse to:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a client with suspected appendicitis. Nursing interventions for this client would include: (SELECT ALL THAT APPLY)

Correct Answer is ["A","B"]

Explanation

A nurse is assessing a client who has an obstruction in the small intestine. Clinical manifestations that the nurse would expect include: (SELECT ALL THAT APPLY)

Correct Answer is ["A","B","D"]

Explanation

A nurse is instructing a nursing student about principles of aseptic technique. The nurse would recognize the need for further instruction if the nursing student states, "I must:

An organism that is included in the extended-spectrum beta-lactamase-producing pneumonia (ESBL) group is:

When removing a used facemask, the nurse correctly:

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The nurse clarifies that the difference between the use of earlier types of isolation procedures and the use of current Standard Procedures plus Transmission-Based Precautions as outlined by the CDC:

When caring for a patient on Droplet Precautions, it is most important for the nurse to:

A nurse is reinforcing teaching with 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?

The patient inquires about how his body will kill pathogens unassisted by antibiotics. The nurse responds that a process called phagocytosis will: