A nurse would identify that a colleague needs additional instruction on standard precautions when the colleague exhibits which of the following behaviors?
A) The nurse wears face protection, gloves, and a gown when irrigating a wound.
B) The nurse washes the hands with a waterless antiseptic agent after removing a pair of soiled gloves.
C) The nurse puts on a second pair of gloves over soiled gloves while performing a bloody procedure.
D) The nurse places a used needle and syringe in the puncture-resistant container without capping the needle.
Ans: C
Feedback:
Gloves must be changed after contact with materials that may contain high concentration of microorganisms, even when working with the same patient. Each of the other listed actions adheres to standard precautions.
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Every time the nurse enters the room of a postpartum client who gave birth three hours ago, the client asks something else about her birth experience. The nurse would:
1. Answer questions quickly and try to divert her attention to other subjects. 2. Review documentation of the birth experience and discuss it with her. 3. Contact the physician to warn him the client might want to file a lawsuit due to her preoccupation with her birth experience. 4. Submit a referral to Social Services because you are concerned about obsessive behavior.
A female patient learns that she is the carrier of the X-linked recessive disease hemophilia A. Her spouse is free of the disease. What should the nurse teach the patient about the frequency of this disease in future children?
A) All male children will inherit it. B) All female children will be carriers like she is. C) All male children will have a 50% risk to inherit the disease. D) All female children will have a 50% risk to inherit the disease.
A client who has surgical treatment for peritonitis would be encouraged to do all of the following postoperatively. Which is the MOST important for this client?
a. active exercises of the ankles and knees b. pulmonary hygiene c. splinting the abdominal incision with a pillow d. turning every 2 hours
The nurse is caring for a client who has been prescribed an interferon. What effect does the nurse anticipate this medication will have on the client? (Select all that apply.)
Note: Credit will be given only if all correct choices and no incorrect choices are selected. 1. Anti-inflammatory action 2. Decrease the heart rate 3. Slow the spread of viral infections 4. Decrease the blood pressure 5. Increase blood glucose