Nursing Prioritization, Delegation and Assignment NCLEX Practice Quiz #4

There are four clients with infections in the ED and only one private room is available. Which among the clients is the most appropriate to occupy the private room? • A. A client with a cough who may have tuberculosis • B. A client with toxic shock syndrome and a temperature of 102.4°F (39.1°C) • C. A client with diarrhea caused by C. difficile • D. A client with a wound infected with Vancomycin-resistant enterococci (VRE) Correct Answer: A. A client with a cough who may have tuberculosis Private rooms should be occupied mainly for clients with infections that require airborne precautions such as TB. Despite the gains in tuberculosis control and the decline in both new cases and mortality, it still accounts for a huge burden of morbidity and mortality worldwide. • Option B: Standard precautions are required for the client with toxic shock syndrome. Any source of bacteria such as tampons or nasal packing should immediately be removed. Emergent surgical consultation should be obtained for any wound debridement or surgical cause. This is critical in the early management of toxic shock syndrome. • Option C: The primary mode of the disease transmission is the fecal-oral route. Effective prevention of C. difficile infection includes several generalized strategies and certain targeted strategies. General strategies such as early detection of the disease, placing the patient under isolation with a dedicated toilet and contact precautions, promoting hygiene measures such as improved hand hygiene, and environmental cleaning are effective measures in preventing infections from C. difficile infections. • Option D: Clients with VRE infections that require contact precautions should ideally be placed in private rooms; however, they can be placed in rooms with other clients with the same diagnosis. The primary transmission of vancomycin-resistant Enterococcus in the hospital setting is through the hands of healthcare providers. Basic infection control prevention practices such as hand hygiene can help. Contact precautions such as wearing gowns and gloves also decrease transmission