a client has been placed in isolation because he is diagnosed with a contagious illness the nurse should be aware that
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Nursing Elites

NCLEX-PN

Nclex Questions Management of Care

1. A client has been placed in isolation because he is diagnosed with a contagious illness. The nurse should be aware that:

Correct answer: A

Rationale: Isolation techniques are used to prevent or limit the spread of infection. Special handling of articles and linens soiled by any body fluid is essential. Linens should be placed in impervious bags before being removed from the client's bedside to prevent exposure of personnel and contamination of the environment. Double-bagging is required if the outside of the bag becomes contaminated. This practice ensures that potentially infectious materials are properly contained and disposed of. Choices B, C, and D are incorrect because the focus in this scenario is on proper handling and disposal of soiled linens to prevent the spread of infection, not on serving meals, psychological effects of isolation, or the use of paper trays and plastic utensils.

2. When observing a dressing change by a graduate nurse on a Stage III pressure ulcer to the greater trochanter by the staff nurse, a need for further teaching is indicated after the following observation by the nurse:

Correct answer: B

Rationale: The correct answer is that the new graduate irrigates the pressure ulcer with half-strength hydrogen peroxide. Pressure ulcers should not be cleaned with substances that are cytotoxic, such as hydrogen peroxide or betadine. This can cause further damage to the wound and delay the healing process. Choice A is incorrect because irrigating the pressure ulcer with normal saline is an appropriate practice. Choice C is incorrect because packing the wound with sterile kerlix soaked in normal saline is also an appropriate step. Choice D is incorrect because applying a Duoderm dressing after cleansing is a standard procedure in wound care.

3. The nurse should teach parents of small children that the most common type of first-degree burn is:

Correct answer: D

Rationale: The most common type of first-degree burn in small children is sunburn, often due to lack of protection and overexposure to the sun. This type of burn highlights the importance of educating parents about using sunscreens and ensuring children are adequately protected from the sun's harmful rays. Choices A, B, and C describe scenarios that can lead to burns but are not the most common type of first-degree burn in small children, making them incorrect.

4. The healthcare professional seeks to assess the renal function of an elderly client who is about to receive a nephrotoxic medication. Which of the following labs provides the best indicator for renal function?

Correct answer: D

Rationale: In the context of an elderly client, assessing renal function before administering a nephrotoxic medication is crucial. While urinalysis and blood urea nitrogen provide valuable information on hydration status and overall health clues, they are not specific indicators of renal function. The chemistry of electrolytes may show abnormalities in renal failure, but it does not directly measure the kidneys' ability to eliminate waste. Creatinine clearance, on the other hand, is considered the best indicator for renal function in the elderly. This test accounts for decreases in lean body mass that can affect blood creatinine levels and is widely used to estimate the glomerular filtration rate, reflecting the kidneys' filtration capability. Therefore, creatinine clearance is the most appropriate lab test to assess renal function in this scenario.

5. A case management clinical pathway for congestive heart failure might include all of the following except:

Correct answer: D

Rationale: In a case management clinical pathway for congestive heart failure, the focus is on providing medical care and support to the patient. Choices A, B, and C are integral parts of managing congestive heart failure. Physician follow-up appointments with transportation ensure continuity of care, client education about medication use is crucial for adherence, and a nutritional consult helps in managing the patient's diet. However, insurance review for reimbursement is not typically part of the clinical pathway as it pertains to financial aspects and is usually handled by billing departments or external agencies. Therefore, the correct answer is 'insurance review for reimbursement.'

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