NCLEX Questions: Week 4

A 9-year-old child with leukemia is in remission and has returned to school. The school secretary calls the parent of the child and tells the parent that a classmate has just been diagnosed with varicella (chicken pox). The parent immediately calls the nurse at the physician's office because the leukemic child has never had chicken pox. The nurse would make which response to the parent?

"Bring the child to the office for an injection called immune globulin."

A pregnant client has tested positive for human immunodeficiency virus (HIV). The nurse reinforces information to the client about HIV and determines that a need for further teaching is necessary when the client makes which statement?

"I need to breast-feed my baby."

The nurse has explained to a client diagnosed with tuberculosis (TB) about how to prevent the spread of infection after discharge. The nurse determines that the client needs further teaching if the client makes which statement?

"I should use disposable plates, forks, and knives."

A child with leukemia is hospitalized and is receiving chemotherapy. Laboratory results indicate that the child is neutropenic, and protective isolation procedures are initiated. A grandparent of the child visits and brings a fresh bouquet of flowers picked from their garden and asks the nurse for a vase for the flowers. Which response by the nurse is appropriate?

"The flowers from your garden are beautiful, but they cannot be placed in the child's room at this time."

A client with tuberculosis, whose status is being monitored in an ambulatory care clinic, asks the nurse when it is permissible to return to work. What would the nurse tell the client?

"Three sputum cultures must be negative before returning to work."

The nurse reinforces instructions to a client diagnosed with impetigo. Which statements by the client indicate a need for further teaching? Select all that apply.

-"I should not wash the lesions of the infection once the skin lesions have scabbed over." -"I can wash my laundry with other household members' items."

The nurse is preparing to comb the hair of a child client who has been treated for pediculosis (lice) at a clinic. Which additional instructions would the nurse give the parents of the child? Select all that apply.

-A parent should observe all persons in the household for the presence of lice or nits. -If others in the household are found to have pediculosis, they all must be treated and have the nits removed from their hair. -All headwear and bed linens should be washed in hot water.

The nurse is preparing to set up a sterile field, using the principles of aseptic technique to perform a dressing change. Which would the nurse include in the preparations? Select all that apply.

-Avoid placing items within 1 inch of any area surrounding the outer edge of the sterile field. -Open the distal flap of a sterile package first. -Prepare the sterile field just before the planned procedure.

A client has been placed on neutropenic precautions. Which information is appropriate to provide the client when explaining what this means? Select all that apply.

-Contact the physician if even a low-grade fever develops. -Wash your hands frequently with antibacterial soap. -Get plenty of sleep and rest. -Take all medications as prescribed.

The nurse performs an audit in the hospital intensive care unit of clients who have indwelling urinary catheters. Which observations, found in the audit, pose a risk for a health care-associated infection? Select all that apply.

-Drainage bag port touching the floor -Dependent loop in the catheter tubing -Use of one measuring container between two clients with the same pathogen in the urine

A health care worker who signed a waiver and never received the hepatitis B vaccine receives a needlestick injury from a client who has hepatitis B. Which treatments are indicated for the health care worker under this situation? Select all that apply.

-Hepatitis B immune globulin -Initiate hepatitis B vaccine series -Cleanse needlestick site with soap and water

The nurse is caring for a client who has a wound infection. Contact precautions are being followed. Which are correct actions by the nurse when using personal protective equipment (PPE)? Select all that apply.

-Perform hand hygiene after removal of PPE. -Perform hand hygiene before donning any PPE. -When removing PPE, always remove gloves first. -Protective eyewear and a face shield are indicated if there is risk of splatter.

The nurse is caring for a child with human immunodeficiency virus (HIV). It is most important that the nurse plan to use which precautions to protect themself and other clients from infection with HIV? Select all that apply.

-Perform hand hygiene before and after contact with the client. -Use biohazard bags for items saturated with blood and bodily fluids. -Wear personal protective equipment (PPE) when contact with blood or other bodily fluids is anticipated.

The nurse is caring for a child with a diagnosis of roseola. The nurse provides instructions to the parent regarding preventing the transmission of the infection to other children in the family and to other household members. Which instructions would the nurse reinforce to the parent?

Avoid allowing the children to share drinking glasses or eating utensils because the disease is transmitted through the saliva.

The nurse receives a telephone call from the admissions office and is told that a child with acute bacterial meningitis will be admitted to the pediatric unit. The nurse prepares for the child's arrival and plans to implement which type of precautions?

Droplet

The nurse prepares to give a bath and change the bed linens for a client with cutaneous Kaposi's sarcoma lesions. The lesions are open and draining a scant amount of serous fluid. Based on this client scenario, which would the nurse use during the bathing of this client?

Gown and gloves

Which instructions would be included in the teaching plan for a parent whose newborn is human immunodeficiency virus (HIV) positive?

Instruct the parent and family to provide meticulous skin care to the newborn and to change the newborn's diaper after each voiding or stool.

In preparing to care for a hospitalized child with a diagnosis of measles (rubeola), which supplies would the nurse bring to the child's room to prevent the transmission of the virus?

Mask and gloves

The nurse has a prescription to obtain a sample for urinalysis from a client with an indwelling urinary catheter. To prevent contamination of the specimen, the nurse would avoid which action?

Obtaining the specimen from the urinary drainage bag

The nurse is preparing to give a bed bath to an immobilized client with tuberculosis. The nurse would wear which items when performing this care?

Particulate respirator, gown, and gloves

The nurse will perform a sterile dressing change after removing the old dressing with clean gloves. The nurse removes the gloves, uses alcohol-based hand sanitizer to perform hand hygiene, and prepares to perform open sterile gloving. The nurse removes the gloves from the outer package. The nurse is right-handed. The nurse opens the inner wrapper and flattens the wrapper to expose the gloves. Which is the next action the nurse takes when donning sterile gloves?

Pick up right glove at cuff with left thumb and forefinger.

The nurse is caring for a client with a diagnosis of leukemia who is immunosuppressed. Neutropenic precautions have been implemented. Which activity would the nurse question if observed while caring for this client?

The client orders a lunch of soup, salad with tomatoes and cucumbers, and an apple.

In assisting with developing a plan of care for a client hospitalized with tuberculosis (TB), the nurse would place emphasis on which intervention?

The strict adherence to following airborne precautions

The nurse is giving a client a bed bath and drops the towel on the floor. The nurse would take which action?

Wash the hands and go to the linen room to obtain another towel.

A client with methicillin-resistant Staphylococcus aureus (MRSA) needs to be placed on contact precautions, and the licensed practical nurse (LPN) in charge asks a newly licensed LPN to initiate contact precautions. Which action by the new LPN would indicate the need to review the procedure for contact precautions?

Wears a gown when caring for the client and removes the gown immediately after leaving the client's room