Which of the following actions can the nurse take to help prevent a health care-associated infection in an incontinent patient?
Avoiding use of a urinary catheter
Applying absorbent briefs
Restricting Fluids
Toileting patient every 4 hours
The Correct Answer is B
A. Avoiding use of a urinary catheter: While avoiding unnecessary urinary catheterization is important to prevent healthcare-associated urinary tract infections, this action may not be directly applicable to an incontinent patient who requires interventions to manage incontinence.
B. Applying absorbent briefs: Using absorbent briefs helps contain urine and feces, reducing the risk of skin breakdown and contamination of the environment.
C. Restricting Fluids: Restricting fluids may lead to dehydration and is not a recommended approach for preventing healthcare-associated infections in incontinent patients.
D. Toileting patient every 4 hours: Toileting frequency should be individualized based on the patient's needs and not restricted to a specific time interval. Additionally, simply toileting the patient may not be sufficient to prevent healthcare-associated infections if proper hygiene practices are not followed.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","D","E"]
Explanation
A. Hypoglycemic: Hypoglycemia is not typically considered a sign or symptom of sepsis. In sepsis, blood glucose levels may fluctuate, but hypoglycemia is less common.
B. Elevated White Blood Count: An elevated white blood count (leukocytosis) is a common sign of sepsis, indicating the body's immune response to infection.
C. Pruritus: Pruritus, or itching, is not typically associated with sepsis. Itching may occur in certain skin conditions or allergic reactions but is not a hallmark sign of sepsis.
D. Hypotension: Hypotension, or low blood pressure, is a serious sign of sepsis and can indicate septic shock, a life-threatening complication.
E. Altered Mental Status: Altered mental status, such as confusion, disorientation, or decreased level of consciousness, can occur in sepsis due to systemic inflammation and impaired perfusion to the brain.
Correct Answer is B
Explanation
A. Implement neutropenia isolation: Neutropenia isolation is not applicable for a client with C. diff infection. Neutropenia isolation is used for clients with low neutrophil counts to protect them from exposure to pathogens due to their compromised immune system.
B. Disinfect equipment with bleach solution: Clostridium difficile spores are resistant to many disinfectants, but they can be effectively killed by bleach solutions (sodium hypochlorite).
Disinfecting equipment with bleach solution helps prevent the spread of C. diff infection.
C. Monitor the client for manifestations of fluid overload: Manifestations of fluid overload, such as edema or shortness of breath, are not typically associated with C. diff infection. Monitoring for fluid overload is important in other clinical contexts, such as heart failure.
D. Use alcohol hand sanitizer following client care: Alcohol-based hand sanitizers are not effective against C. diff spores. Hand hygiene should be performed with soap and water, as alcohol-based sanitizers are not effective against C. diff spores.
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