A nurse is preparing for the admission of client who has suspected active tuberculosis. Which of the following precautions should the nurse plan to implement to safely care for this client?
Assign the client to a room with other clients who require droplet precautions.
Modify the protocol for donning and removing personal protective equipment before entering or leaving the client's room.
Have staff and visitors wear gowns, masks, and gloves while in the client's room.
Place the client in a private room with a special ventilation system.
The Correct Answer is D
Rationale:
A. Clients with active tuberculosis should not be placed in a room with other clients, even if they require droplet precautions, as TB requires airborne precautions.
B. While PPE protocols are important, the most critical precaution for TB is ensuring the client is in the correct environment to prevent airborne transmission.
C. Wearing gowns, masks, and gloves is important, but the most essential measure is the room's ventilation system.
D. Active tuberculosis is an airborne infectious disease, so the client should be placed in a private room with a negative pressure ventilation system to prevent the spread of the bacteria through the air.
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Correct Answer is D
Explanation
Rationale:
A. Platelets at 150,000/mm3 are within the lower range of normal but not immediately concerning.
B. A positive Western blot test is confirmatory for HIV but is not an immediate concern compared to other lab values.
C. A WBC count of 5,000/mm3 is within normal limits and not a primary concern for an HIV-positive client.
D. A CD4-T-cell count of 180 cells/mm3 indicates advanced immunosuppression, which is critical to monitor in HIV-positive clients to assess the progression of the disease and the risk for opportunistic infections.
Correct Answer is B
Explanation
Rationale:
A. Pill rolling movements and drooling are more characteristic of Parkinson’s disease rather than serotonin syndrome.
B. Serotonin syndrome can present with autonomic instability such as dilated pupils, hyperthermia, and loss of muscle coordination due to increased serotonin levels.
C. Tinnitus is not a common symptom of serotonin syndrome; jerking movements may occur but are not specific to this condition.
D. Suicidal ideations are not typical of serotonin syndrome; they may be more related to underlying mood disorders or medication effects.