a nurse is assessing a client who has a stool culture that is positive for clostridium difficile which of the following infection control precautions
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Nursing Elites

ATI RN

ATI RN Exit Exam

1. A client who has a positive stool culture for Clostridium difficile should be placed in which type of room for infection control purposes?

Correct answer: B

Rationale: Placing the client in a private room is the appropriate infection control measure for C. difficile to prevent the spread of infection. While wearing a face shield may be necessary for procedures that generate splashes or sprays, it is not the primary precaution for C. difficile. Negative pressure rooms are typically used for airborne infections, not for C. difficile. Using an alcohol-based hand rub is important for hand hygiene but is not specific to managing C. difficile infection.

2. A nurse is caring for a client who is receiving TPN. Which of the following actions should the nurse take to prevent infection?

Correct answer: D

Rationale: The correct answer is D: 'Use sterile technique when changing the central line dressing.' When caring for a client receiving TPN, it is crucial to maintain aseptic technique to prevent infections. Changing the central line dressing with sterile technique helps reduce the risk of introducing pathogens into the client's system. Choices A, B, and C are incorrect because changing the TPN tubing every 72 hours, monitoring blood glucose, and monitoring urine output are important aspects of care but are not directly related to preventing infection in clients receiving TPN.

3. A nurse in an emergency department is assessing a client who reports ingesting thirty diazepam tablets. After securing the client's airway and initiating an IV, which of the following actions should the nurse do next?

Correct answer: B

Rationale: Administering flumazenil is the priority to reverse the effects of diazepam overdose. Flumazenil is a specific benzodiazepine receptor antagonist that can rapidly reverse the sedative effects of diazepam. Monitoring the IV site for thrombophlebitis is important but not the immediate priority in this situation. Evaluating the client for further suicidal behavior is important for comprehensive care but is not the most urgent action at this moment. Initiating seizure precautions may be necessary, but the priority is to counteract the sedative effects of diazepam with flumazenil.

4. A nurse is caring for a client who has a new prescription for warfarin. Which of the following laboratory tests should the nurse use to monitor the client's therapeutic response to the medication?

Correct answer: A

Rationale: The correct answer is A: INR. The INR (International Normalized Ratio) is the laboratory test used to monitor the therapeutic response of warfarin. It helps ensure that the client's clotting time is within the desired range to prevent complications such as excessive bleeding or clotting. Choice B, aPTT (Activated Partial Thromboplastin Time), is not typically used to monitor warfarin therapy but rather for assessing heparin therapy. Choice C, Platelet count, assesses the number of platelets in the blood and is not specifically used to monitor warfarin therapy. Choice D, Hemoglobin A1C, is a test used to monitor long-term blood sugar control in diabetic patients and is not relevant to monitoring warfarin therapy.

5. When collecting a sputum specimen from a client with tuberculosis, what action should the nurse take?

Correct answer: A

Rationale: The correct answer is to obtain the specimen immediately upon the client waking up. Collecting sputum early in the morning provides the best sample for tuberculosis testing. Option B is incorrect because waiting a day can decrease the accuracy of the specimen. Option C is incorrect as it does not specify the optimal timing for specimen collection. Option D is incorrect as sterile gloves should be worn for infection control but do not specifically relate to the timing of specimen collection.

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