EAQ [Safety and Infection Control]
Which type of isolation precaution would the postpartum nurse plan to implement for a client who has given birth by urgent cesarean section related to active herpes simplex virus (genitalia) following onset of labor and rupture of membranes 8 hours ago?
Contact
Which information would the nurse provide to a client taking a dulaglutide?
Perform self-injection once a week
Which object would the nurse teach the client with a newly implanted pacemaker to avoid?
Strong magnets
Which age group has the highest incidence of lead poisoning?
Toddler The incidence of lead poisoning is highest in late infancy and toddlerhood. Children at this stage explore the environment and because of their increased level of oral activity, put objects into their mouths. Adults have a greater risk of cardiovascular or pulmonary disease. Drowning and motor vehicle accidents are more common among adolescents. Bicycle accidents are more common among school-aged children.
How would the nurse position a client to practice supraglottic swallowing after tracheostomy?
Upright
How would the nurse position a client with epistaxis?
Upright leaning forward
Which threats, included in the term "NBC," lead to the implementation of improved emergency medical services (EMS) and hospital safety programs? Select all that apply.
Nuclear, Biological. Chemical
Which criteria would the nurse consider when determining if an infection is a health-care associated infection?
Occurred in conjunction with treatment for an illness
Which cardiac disease has the lowest risk for maternal mortality?
Patent ductus arteriosus
Which primary objective of nursing interventions would the nurse maintain for clients with dementia, delirium, and other neurocognitive disorders?
Safety within the envirenment
Which agent of terrorism can cause death within a few minutes?
Sarin gas Sarin gas is an agent of bioterrorism that can cause death within minutes of exposure by paralyzing respiratory muscles
Which complication is prevented from occurring by performing punctal occlusion after the administration of eyedrops?
Systemic Absorption
Which finding during peritoneal dialysis would the nurse act on as a sign of infection?
The cloudy return of dialysate
Which laboratory value would the nurse assess when preparing a client for a renal biopsy?
- Hematocrit - Hemoglobin - Platelet count - Prothrombin time (PT) with international normalized ratio (INR) - Partial thromboplastin time (PTT)
Which sexually transmitted infection is caused by bacteria?
- Syphilis - Gonorrhea
Which medication is safe to take during pregnancy?
Acetaminophen
Which clinical condition is associated with lead poisoning?
Anemia
Which action would the nurse implement when caring for a client reporting a recent bee sting presenting with localized redness, swelling, intense localized pain, and itching?
Applying a cold compress to the affected area
Which product would the nurse instruct intravenous drug users (IDUs) to use for cleaning of needles and syringes between uses?
Bleach
Which characteristic aligns with prioritizing care into the triage level of "emergent"?
Immediate threat to life or limb
The nurse is educating a client about managing hypoglycemia unawareness. Which information would the nurse provide?
Refrain from alternative testing sites
Which evaluation method is the most effective way for the nurse to evaluate the teachers' knowledge of handwashing techniques after a program for teachers about infection control and hand-washing techniques?
Watch the teachers demonstrate infection control techniques
Which hospital department plays a primary role in disaster preparedness?
Emergency Department
Which action would the nurse take when caring for an older adult with a history of recent memory loss?
Employ electronic devices that provide alerts.
Which safety precaution would the nurse employ when assisting with the removal of a client's vaginal radium seeds?
Ensure that long forceps are available for removing the radium.
Which reaction is an example of a type I hypersensitivity reaction?
Anaphylaxis Serum sickness is a type III immune complex reaction. Contact dermatitis is a type IV delayed hypersensitivity reaction. A blood transfusion reaction is a type II cytotoxic reaction.
Which required noninvasive assessment and management skills certification would the nurse need to perform airway maintenance and cardiopulmonary resuscitation (CPR)?
Basic Life Support (BLS)
Which would be included in the plan of care for an obstetrical client who has been taking carbamazepine throughout the first trimester of pregnancy?
Evaluation for a neural tube defect
Which action would the nurse take when a client who had a total hip replacement states that the plan is to go swimming at the community pool the day after discharge?
Explain that the incision should not be immersed in water until it has healed. Because of the risk for infection, the client should avoid tub baths, hot tubs, pools, and immersions in other bodies of water until after the wound has healed and these activities are approved by the primary health care provider. Immersion in water for a prolonged period interferes with wound healing, because water may macerate tissue.
A child becomes cyanotic during a generalized tonic-clonic seizure. Which action would the nurse take?
The child's status and the progression of the seizure should be monitored; the child will not breathe until the seizure is over, and cyanosis should subside at that time.
Which diagnostic test result indicates if a client will develop acquired immunodeficiency syndrome (AIDS) from the human immunodeficiency virus (HIV)?
The number of CD4 + T cells available
Which activity would the nurse manager complete during an emergency event when acting as the triage officer according to the Hospital Incident Command System?
Rapidly evaluating each person who comes to the hospital
Which condition would the nurse monitor for in the client on aminoglycoside therapy and skeletal muscle relaxants?
Respiratory arrest Aminoglycosides can intensify the effect of skeletal muscle relaxants, placing the client at risk for respiratory arrest.
Which initial action would the nurse take when a toddler with autism spectrum disorder suddenly runs to the wall and starts banging his head on it?
Restrain the toddle to prevent head injury
Which information would the nurse share with an adolescent girl with a seizure disorder refusing to wear a medical alert bracelet that may help her wear the bracelet consistently?
Select a bracelet similar to bracelets worn by her peers
Which intervention is the best approach to condom use for prevention of sexually transmitted infection?
Use of a condom with oral sex
Which level of trauma center provides a full continuum of care for the trauma client?
Level I
Which initial action would the nurse take for a newly admitted client who reports memory loss, nervousness, insomnia, and fear of leaving the house?
Provide the client with a sense of security and safety
Which team member acts as a liaison between the healthcare facility and the media?
Public Information Officer
Which client condition would require the highest priority for treatment among four clients admitted at the same time under mass casualty conditions? - Massive Head Trauma - Open Fracture with a distal pulse - Shock - Strains and contusions
Shock
Which effect has resulted in the avoidance of tetracycline use in children under 8 year old?
Permanent tooth discoloration.
Which risk to the fetus is associated with a maternal diagnosis of chorioamnionitis?
- Sepsis - Bacteremia - Pneumonia - Cerebral Palsy - Respiratory Distress Syndrome (RDS)
Which action transmits the human immunodeficiency virus (HIV)?
- Sharing syringe needles - Breast-feeding a newborn - Anal intercourse Fluids such as blood and semen are highly concentrated with HIV. HIV may be transmitted parenterally by sharing needles and postnatally through breast milk. HIV may also be transmitted through anal intercourse.
Which information would the nurse include in a community education session on decreasing the risk for musculoskeletal injuries?
- Use of seatbelts - Obeying speed limits - Wearing safety equipment - Avoiding impaired vehicle use - Refraining from distracted driving
The nurse is preparing to administer methylphenidate to an older adult with apathy and depression. Which assessment would be included to monitor for complications?
- Vision - Weight - Heart rate
At which interval are humidified oxygen systems replaced to prevent infection?
1 day
Which group has the highest rate of meningococcal infection?
Young adults
Which manifestation indicates tertiary syphilis?
Gummas Gummas are chronic, destructive lesions affecting the skin, bone, live, and mucous membranes occur during tertiary syphilis. A chancre appears during primary syphilis. Alopecia and condylomata occur during secondary syphilis.
Which sexually transmitted infection causes condylomata acuminate?
HPV Condylomata acuminate are genital warts that are caused by HPV
Which assessment is necessary for the nurse to complete in a client with chronic kidney disease receiving loop diuretics?
I & Os
Which emergency medical service agency offers service such as first aid stations and special-need shelters during a disaster or pandemic disease outbreak?
Medical Reserve Corps (MRC)
Which substance will the home care nurse instruct a client to use after laryngectomy to cleanse the stoma site?
Mild soap and water
Which medication for treatment for gastroesophageal reflux disease would be contradicted in the pregnant client?
Misoprostol
Which nursing action would be included in the plan of care for a child with acute streptococcal glomerulonephritis?
Monitoring for seizures Cerebral edema from hypertension or cerebral ischemia may occur, which may result in seizures.
Which action would the nurse take to decrease the risk of transmission of vancomycin-resistant enterococci (VRE)?
Move the client to a private room
Which type of needs would the nurse identify as a high priority in the prioritization of client care?
Needs that affect safety
The nurse is caring for a child who has an external fixation device on the leg. Which is the nurse's priority goal when providing pin care?
Preventing infections Pin sites provide a direct avenue for organisms into the bone. Pin site care is priority over easing pain. Some scarring will occur at the pin insertion site regardless of pin site care. Skin has a tendency to grow around the pin, rather than break down, as long as infection is prevented
Which action would a nurse take to prevent a parallax error and to ensure accuracy when assessing a client's blood pressure?
Read the manometer at eye level
Which risk would the nurse consider when providing care for a client in the acute phase of treatment for a full-thickness burn?
The risk of septicemia and its potential complication from treatment
In which way do toddlers learn self-protection?
Through trial-and-error strategies. The toddler is developing autonomy, is curious, and learns self-protection from experience. Toddlerhood play is parallel, not interactive
Which issue related to antibiotic use is an increased risk for the older adult?
Toxicity
Which information would the nurse provide a client with diabetes mellitus (DM) regarding alcohol consumption?
With or shortly after meals
The nurse is preparing to initiate antibiotic therapy for a client who developed an incisional infection. Which task would the nurse ensure has been completed before starting the first dose of intravenous antibiotics?
Wound culture
Which statement shows that the newly diagnosed asthma patient understands how to use a peak expiratory flow meter (PEFM)?
"I have to blow out as fast and hard into the machine as I can"
At which height is it no longer safe for a toddler to sleep in a crib?
36 inches
Which sexually transmitted infection (STI) is most commonly reported?
Chlamydia
The nurse explains to the parents of a 6-year old child with a pinworm infestation how pinworms are transmitted. Which statement indicated that the teaching has been understood?
"She needs to wash her hands before eating anything." Pinworm infestation is transferred by way of the oral-anal route, and effective hand washing is the best way to prevent transmission. Cats do not transmit pinworms. The hands should be kept away from the nose and mouth; the child should be taught to cough into a tissue or the inside elbow of the arm. Pinworms are not transmitted by coughing.
Which medication would the nurse instruct a client to avoid while talking alprazolam?
- Opioids = Alcohol - Barbiturates
Which intervention would the nurse include in the plan of care for a client admitted with herpes zoster?
- Acyclovir - Silvadene - Gabapentin - Wet compresses - Contact Isolation
Which side effect would the nurse monitor for when administering a selective serotonin reuptake inhibitor (SSRI)
- Anxiety - Nausea - Sedation - Restlessness - Suicidal Ideation - Increased energy levels
Which instruction or infection prevention would the nurse include when providing discharge education to a client who received a cadaveric renal transplant?
- Avoid eating from buffets - Obtain annual flu vaccinations - Perform regular hand hygiene - Stay away from crowded areas - Report a temperature greater than 100.5
Which information would the nurse discuss with a group of adolescents wearing orthodontic appliances to prevent infection?
- Brushing teeth twice a day - Flossing after each meal - Visiting the dentist twice a year - Drinking unsweetened drinks - Cleaning around orthodontic gear
Which information about decreasing the risk for complication would the nurse provide to a pregnant adolescent who remains sexually active with other partners?
- Calcium consumption - Exercise - Folic Acid - Condom Use - Prenatal care
Which technique would the nurse employ for an obstetrical client with a foreign body airway obstruction?
Chest Thrusts
For which client illness would airborne precautions be implemented?
Chickenpox is known or suspected to be transmitted by air. Diseases that are known or suspected to be transmitted by droplet include influenza and pneumonia. A disease that is known or suspected to be transmitted by direct contact is respiratory syncytial virus.
To which disaster triage class would the nurse infer a client with a green triage tag belongs?
Class III
Which term describes the practice of placing clients with the same infection in a semi-private room?
Cohorting
Which report by the client post transrectal prostate biopsy needs to be communicated to the health care provider as a possible sign of infection
Discharge from the penis
Which occurs immediately after birth that increases the risk for cardiac decompensation in a client with a compromised cardiac system?
Extravascular fluid is remobilized into the vascular compartment During the immediate period after birth the extravascular fluid is demobilized into the vascular compartment, increasing the client's risk for cardiac decompensation. At the moment of birth , the pressure on the veins is removed, the intra-abdominal pressure decreases dramatically, and the blood flow to the heart is significantly increased.
Which nursing intervention would the nurse take for an older adult with delirium who begins acting out while in the dayroom?
Giving the client one simple direction at a time in a firm, low-pitched voice
Which antibody forms first, after exposure to an antigen?
IgM IgM is the first antibody formed by a newly sensitized B-lymphocyte plasma cell. IgA has very low circulating levels and is responsible for preventing infection in the upper and lower respiratory tracts, and the gastrointestinal and genitourinary tracts. IgE has variable concentrations in the blood and is associated with antibody-mediated hypersensitivity reactions. IgG is heavily expressed on second and subsequent exposures to antigens to provide sustained, long term immunity against invading microorganisms.
Which condition is commonly seen following infestation with pediculosis capitis (head lice)?
Impetigo Impetigo may develop as a secondary bacterial infection because of breaks in the skin caused by scratching. Eczema is an allergic response. Cellulitis is an extended inflammation. Folliculitis is a pimple or an infection of the hair follicle.
The nurse is preparing a child who has undergone a myringotomy for discharge. Which would the parent be taught about their child's care at home?
Insert earplugs whenever a bath is given. Water in ears after myringotomy supports the growth of pathogens and should be avoided.
The nurse educator is providing information about different insulin types. Which type of insulin can be safely mixed with regular human insulin in the same syringe?
Isophane insulin neutral protamine hagedorn (NPH)
The nurse is planning to teach the four-point alternate crutch gait to a 9-year-old child with cerebral palsy. How would the nurse explain this choice to the parent?
It provides for equal but partial weight bearing on each limb.
Which nursing objective would the nurse add to the plan of care for a child with attention-deficit/hyperactivity disorder (ADHD) who engages in self-destructive behavior?
Keeping the child from inflicting any self-injury
Which position increases cardiac output in the obstetrical client with cardiac disease?
Lateral positioning
A child with meningitis suddenly assumes an opisthotonic position. In which position would the nurse position the child?
Side-lying
Which stage of human immunodeficiency virus (HIV) would a client with a CD4+ T cell count of 325 cells/mm3 be classified?
Stage 2
Which injuries would likely be given a green tag after a disaster? Select all that apply.
Strains and Abrasions