1. Which isolation procedure will be followed for secretions and blood?
A) Respiratory B) Standard Precautions C) Contact Isolation D) Droplet
2. A 17-year-old female was raped by a young man in her neighborhood. She is in the Emergency Department for evaluation and tests. After the procedure is completed, a rape crisis counselor (nurse specialist) talks to the client in a conference room regarding the rape. Implementing counseling by the nurse specialist for the raped victim represents:
A) assessment. B) crisis intervention. C) empathetic concern. D) unwarranted intrusion.
3. The death of a beloved spouse places the surviving partner in which type of crisis?
A) maturational B) reactive C) nonreactive D) situational
4. A client with asthma develops respiratory acidosis. Based on this diagnosis, what should the nurse expect the client - s serum potassium level to be?
A) normal B) elevated C) low D) unrelated to the pH
5. A client begins a regimen of chemotherapy. Her platelet counts falls to 98,000. Which action is least likely to increase the risk of hemorrhage?
A) Test all excreta for occult blood. B) Use a soft toothbrush or foam cleaner for oral hygiene. C) Implement reverse isolation. D) Avoid IM injections.
1. Right Answer: B Explanation: Standard precautions are taken in all situations for all clients and involve all body secretions except sweat and are designed to reduce the rate of transmission of microbes from one host to another or one source (environment such as the clients bedside table) to another. Safety and Infection Control
2. Right Answer: B Explanation: Choice 2 is part of the Crisis Intervention Model. Counseling by a nurse specialist at the time of a stressful event (rape) can strengthen the clients coping. A nurse specialist in rape crisis intervention is educationally prepared in counseling and crisis intervention specific to rape victims. Coordinated Care
3. Right Answer: D Explanation: A situational crisis is an unexpected, unplanned event, such as the death of a spouse. Option 1 is a normal maturational crisis; Choices 2 and 3 are not recognized crisis states. Coordinated Care
4. Right Answer: B Explanation: Hyperkalemia occurs in a state of acidosis because potassium moves from injured cells into the bloodstream. Physiological Adaptation
5. Right Answer: C Explanation: Reverse isolation does not affect the risk of hemorrhage. Physiological Adaptation
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