A charge nurse is making a room assignment for a client who has scabies. In which of the following rooms should the nurse place the client?
A negative-pressure isolation room.
A private room.
A semi-private room with a client who has pediculosis capitis.
A positive-pressure isolation room.
The Correct Answer is B
Choice A: A Negative-Pressure Isolation Room
A negative-pressure isolation room is typically used for patients with airborne infections, such as tuberculosis, to prevent the spread of infectious particles through the air. Scabies, however, is spread through direct skin-to-skin contact or contact with contaminated items, not through the air. Therefore, a negative-pressure room is not necessary for a client with scabies.
Choice B: A Private Room
Placing the client in a private room is the appropriate action. This helps to prevent the spread of scabies to other patients and staff. Scabies is highly contagious, and isolating the affected individual minimizes the risk of transmission. The client should remain in the private room until the treatment regimen is complete and they are no longer contagious.
Choice C: A Semi-Private Room with a Client Who Has Pediculosis Capitis
A semi-private room with a client who has pediculosis capitis (head lice) is not appropriate. While both conditions involve parasites, they are different and require separate management and treatment protocols. Placing two clients with different contagious conditions in the same room increases the risk of cross-contamination and complicates infection control measures.
Choice D: A Positive-Pressure Isolation Room
A positive-pressure isolation room is used to protect immunocompromised patients from external contaminants by ensuring that air flows out of the room rather than in. This type of room is not suitable for a client with scabies, as it does not address the mode of transmission for this condition.
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Correct Answer is B
Explanation
Choice A reason: Turn the client every 4 hours:
Regularly turning the client can help prevent pressure ulcers and improve overall circulation, but it is not the most effective measure specifically for preventing ventilator-associated pneumonia (VAP). While repositioning can help with lung expansion and secretion clearance, oral care is more directly related to reducing VAP risk.
Choice B reason: Brush the client’s teeth with a suction toothbrush every 12 hours:
Oral care is crucial in preventing VAP. Bacteria from the mouth can easily travel to the lungs, especially in intubated patients. Using a suction toothbrush helps remove dental plaque and secretions, reducing the bacterial load and the risk of infection. This practice is a key component of VAP prevention bundles.
Choice C reason: Provide humidity by maintaining moisture within the ventilator tubing:
While maintaining humidity is important to prevent drying of the respiratory mucosa and to help with secretion clearance, it does not directly reduce the risk of VAP. Proper humidification is necessary for patient comfort and respiratory function but is not a primary VAP prevention strategy.
Choice D reason: Position the head of the client’s bed in the flat position:
Positioning the head of the bed flat can increase the risk of aspiration, which is a significant risk factor for VAP. The head of the bed should be elevated to 30-45 degrees to reduce the risk of aspiration and promote better lung expansion.
Correct Answer is A
Explanation
Choice A: Hemorrhage
Hemorrhage is a significant and immediate postoperative complication following a transurethral resection of the prostate (TURP). This procedure involves removing part of the prostate gland, which can lead to bleeding. Monitoring for signs of hemorrhage, such as a significant drop in blood pressure, increased heart rate, and visible blood in the urine, is crucial. Early detection and intervention are essential to manage bleeding and prevent severe complications. Hemorrhage can lead to hypovolemic shock if not addressed promptly, making it the priority complication to monitor for.
Choice B: Infection
Infection is a common postoperative complication, but it typically develops a few days after surgery rather than immediately. Signs of infection include fever, chills, and increased white blood cell count. While it is important to monitor for infection, it is not the immediate priority compared to hemorrhage. Preventive measures, such as maintaining sterile techniques and administering prophylactic antibiotics, can help reduce the risk of infection.
Choice C: Urinary retention
Urinary retention can occur after TURP due to swelling or blood clots obstructing the urethra. This condition can cause discomfort and increase the risk of bladder damage. Monitoring for urinary retention involves assessing the client’s ability to void and checking for bladder distention. While it is an important complication to monitor, it is not as immediately life-threatening as hemorrhage.
Choice D: Pain
Pain is a common postoperative symptom and should be managed effectively to ensure the client’s comfort and recovery. However, pain management is typically addressed through prescribed analgesics and is not considered a life-threatening complication. Monitoring for pain and providing appropriate pain relief are essential aspects of postoperative care, but they do not take precedence over monitoring for hemorrhage.