ATI LPN
Test Bank for Medical Surgical Nursing: Concepts for Interprofessional Collaborative Care 10th Edition
Chapter 23 Questions
Question 1 of 5
A client is admitted with possible sepsis. Which action should the nurse perform first?
Correct Answer: D
Rationale: Prior to administering antibiotics, the nurse must obtain the ordered cultures. Broad-spectrum antibiotics will be administered until the culture results are available to ensure the infection is appropriately treated.
Question 2 of 5
A nurse receives report from the laboratory on a client who was admitted for fever. The laboratory technician states that the client has a shift to the left on the white blood cell count. What action by the nurse is most important?
Correct Answer: B
Rationale: A shift to the left indicates an increase in immature neutrophils and is often seen in infections, especially those caused by bacteria. The nurse should notify the provider and request antibiotics to address the potential bacterial infection.
Question 3 of 5
A client has been admitted to the hospital for a virulent infection and is started on antibiotics. The client has laboratory work pending to determine if the diagnosis is meningitis. After starting the antibiotics, what action by the nurse is most important?
Correct Answer: C
Rationale: Since meningitis is suspected, placing the client in droplet precautions is critical to prevent the spread of infection, especially if it is caused by pathogens like Neisseria meningitidis. Monitoring for neurological deterioration and obtaining a lumbar puncture are important but secondary to initiating precautions. Administering antipyretics addresses symptoms but not the spread of infection.
Question 4 of 5
Which action by the nurse is most helpful to prevent clients from acquiring infections while hospitalized?
Correct Answer: B
Rationale: Consistent practice of proper hand hygiene is the best method to prevent infection, as most healthcare-associated infections are due to staff members' contaminated hands. Assessing the client and monitoring laboratory values will help the nurse catch signs of infection quickly, but will not prevent infection from occurring. Teaching visitors not to visit when they are ill will also help prevent infection, but not to the degree that hand hygiene will.
Question 5 of 5
The nursing instructor explaining infection tells students that which factor is the best and most important barrier to infection.
Correct Answer: D
Rationale: The skin and mucous membranes are the most important barrier against infection because they provide a physical and chemical barrier that prevents pathogens from entering the body. The other options are also barriers, but are considered secondary to skin and mucous membranes.