and Verified Detailed Answer
Clients in healthcare settings are at increased risks for infections due to: (mark
ALL that apply)
A. More disease causing microorganisms
B. Invasive procedures
C. Lower resistance to microorganisms
D. Longer hospital stays
E. Open visiting hours
F. Nurses' increased resistance - ✔✔A. More disease causing microorganisms
B. Invasive procedures
C. Lower resistance to microorganisms
D. Longer hospital stays
The nurse can best minimize the risk for infection when initiating an intravenous
site by:
A. Proper vein selection
B. Hand hygiene prior to procedure
C. Appropriate site dressing
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,D. Gloving for procedure - ✔✔B. Hand hygiene prior to procedure
A nurse must display understanding of the mental implications of a client on
isolation precautions when planning to control the risk of:
A. Denial
B. Aggression
C. Regression
D. Isolation - ✔✔D. Isolation
You are caring for a patient who underwent surgery 48 hours ago. The patient's
WBC are elevated. You should:
A. Start antibiotics
B. Assess wound
C. Document the findings and reassess in 2 hours
D. Place the patient on isolation precautions - ✔✔B. Assess wound
Which of the following clients who is experiencing the heat of mid-August is at
greatest risk for heatstroke heat exhaustion?
A. 65 year old diagnosed with COPD
B. 34 year old novice marathon runner
C. 15 year old playing in an outdoor tennis tournament
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,D. 9 month old whose bedroom is cooled with a mechanical fan - ✔✔A. 65 year
old diagnosed with COPD
While caring for a child, you identify that additional safety teaching is needed
when a young and inexperienced mother states that:
A. Teenagers need to practice safe sex
B. A 3 year old can safely sit in the front seat of the car
C. Children need to wear safety equipment when bike riding
D. Children need to learn to swim even if they do not have a pool - ✔✔B. A 3
year old can safely sit in the front seat of the car
The nurse is conducting an admission interview and assessment on a cognitively
impaired, uncooperative client for the risk of injury. Which of the following
options will most likely provide the information to confirm the diagnosis?
A. Base degree of risk on observable data at the time of the client's current
hospital admission
B. Closely monitor the client's behavior and habits until risk for injury can be
reasonable determined
C. Make certain critically sound assumptions are based on the client's
developmental stage and current cognitive status
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, D. Interview the client's family, friends and/or caregivers regarding
prehospitalization risk factors - ✔✔D. Interview the client's family, friends
and/or caregivers regarding prehospitalization risk factors
A nurse floats to a busy surgical unit and administers a wrong medication to a
patient. This error can be classified as:
A. A poisoning accident
B. An equipment-related accident
C. A procedure-related accident
D. An accident relates to time management - ✔✔C. A procedure-related
accident
A newly admitted client was found wandering the hallways for the past two
nights. The most appropriate nursing interventions to prevent a fall for this
client would include:
A. Raise all four side rails when darkness falls
B. Use an electronic bed-monitoring device
C. Place the client in a room close to the nursing station
D. Use a loose-fitting vest-type jacket restraint - ✔✔B. Use an electronic bed-
monitoring device
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