The nurse is assigned to work with a new nursing assistant. Which action by the nursing assistant requires intervention by the registered nurse?
a. Using an alcohol-based hand rub after caring for a client with diarrhea
b. Washing hands for 20 seconds using warm water and friction
c. Cleaning especially carefully under fin-gernails and around a wedding band
d. Using chlorhexidine for handwashing when caring for clients on neutropenic precautions
A
Alcohol-based hand rubs are not effective against spore-forming organisms such as Clostridium difficile, which is a common cause of diarrhea among hospitalized clients. The nursing assistant should wash hands with soap after caring for such clients in case they have an undiagnosed in-fection with this bacterium. The other actions are appropriate.
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Patients with severe left ventricular dysfunction are at risk for sudden cardiac death. What medical intervention can be done that may extend the survival of the patient?
A) Insertion of an implantable cardioverter defibrillator B) Insertion of an implantable pacemaker C) Begin a calcium channel blocker D) Begin a beta-blocker
State legislatures are gradually changing the care that patients potentially receive from health maintenance organizations (HMOs). What is one means by which this improvement has occurred?
1. States have set the premiums that enrollees pay for HMO coverage. 2. States have mandated how many HMOs will operate within the state. 3. States have mandated that all citizens be covered by HMOs if that is the desire of the citizen. 4. States have allowed patients who receive substandard care to successfully bring suit against HMOs.
An example of a successful campaign against which of the following communicable diseases was carried out during the 1960s and 1970s?
a. Tetanus b. Measles c. Pertussis d. Smallpox
An older adult is transferred to the hospital with anorexia, nausea, vomiting and confusion. The client was s... (Lanoxin) 0.25 mg, furosemide (Lasix) 40 mg, and potassium chloride (Micro-K) 10 mEq 3 months ago. Which .. take first?
A. Administer a prescribed dose of digoxin immune fab (Digibind) B. Administer the doses of any home medications yet yet taken that day C. Apply a cardiac telemetry monitor D. Complete a neurological assessment