A nurse is giving a presentation to a group of colleagues about the prevention of hepatitis transmission. Which of the following recommendations would the nurse suggest a healthcare worker use when working in the hospital?

Correct Answer: A

Rationale: The correct answer is A) Perform handwashing even after removing gloves. This recommendation is crucial in preventing hepatitis transmission because thorough hand hygiene, including washing hands after glove removal, is essential in reducing the spread of infections in healthcare settings. Option B) Wear a gown only if body fluids may be splashed is incorrect as proper personal protective equipment, including gowns, should be worn whenever there is a risk of exposure to body fluids, not just when splashing is anticipated. Option C) Receive hepatitis A vaccine regardless of risk is incorrect as hepatitis A vaccine is not specifically related to preventing transmission in healthcare settings. Healthcare workers should follow standard precautions and receive the appropriate vaccines based on their job duties and exposure risks. Option D) Perform CPR without a pocket mask is incorrect as using a pocket mask during CPR is essential to prevent direct contact between the healthcare worker and the patient's respiratory secretions, reducing the risk of infection transmission. In an educational context, emphasizing the importance of hand hygiene, appropriate personal protective equipment use, vaccination based on exposure risks, and following proper infection control protocols are critical components of preventing healthcare-associated infections like hepatitis in hospital settings. Healthcare workers must be vigilant in following these recommendations to ensure patient and staff safety.

Correct Answer: D

Rationale: In the context of selecting a weight reduction plan with an obese patient, the correct answer is D) Whether financial considerations will affect the patient's choices. This is the priority decision because the patient's financial situation can significantly impact their ability to access and sustain a weight reduction plan. Considering financial constraints allows healthcare providers to tailor recommendations that are feasible and sustainable for the patient. Option A) What is most important for the nurse to first assess is not the most critical in this scenario because financial considerations can have a more immediate impact on the patient's ability to engage in a weight reduction plan. Option B) The patient's motivation to lose weight is important but assessing financial considerations should come first as it can influence the patient's motivation and ability to follow through with a plan. Option C) The length of time that the patient has been obese is relevant for understanding their health history but does not take precedence over addressing financial factors that may affect their current and future weight reduction efforts. In an educational context, understanding the influence of social determinants of health, such as financial constraints, is crucial for providing patient-centered care. By prioritizing the assessment of financial considerations, healthcare providers can work collaboratively with patients to develop realistic and sustainable weight reduction plans that align with their individual needs and circumstances.

Correct Answer: C

Rationale: The correct answer to the question is C) Recurrent herpes simplex infections. This is the right choice because oral herpes infections have been associated with an increased risk of oral cancer, particularly in individuals with weakened immune systems. Recurrent herpes infections can lead to chronic inflammation and tissue damage in the oral cavity, which can contribute to the development of oral cancer. Option A) what should the nurse specifically ask the patient about during a history, while important in gathering information, is too broad and does not directly address the risk factor for oral cancer as requested in the question. Option B) Excessive exposure to sunlight is a risk factor for skin cancer, particularly melanoma, and is not directly related to the development of oral cancer. Option D) Use of any type of tobacco products is a well-known risk factor for oral cancer. However, in this case, the question is specifically asking about risk factors related to oral herpes infections and oral cancer. In an educational context, it is important for healthcare providers to be aware of the various risk factors associated with oral cancer to provide comprehensive care to their patients. Understanding how certain conditions or behaviors can increase the likelihood of developing oral cancer allows for early detection, prevention, and appropriate management strategies to be implemented. By knowing the specific risk factors, healthcare professionals can tailor their assessments and interventions to address individual patient needs effectively.

Correct Answer: B

Rationale: In teaching patients at risk for upper GI bleeding to prevent bleeding episodes, it is crucial for the nurse to emphasize that the use of over-the-counter (OTC) medications of any kind should be avoided (Option B). This is the correct answer because many OTC medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), aspirin, and certain supplements, can increase the risk of GI bleeding by irritating the stomach lining or interfering with blood clotting. Option A, testing all stools and vomitus for blood, although important for monitoring, does not address prevention strategies. Option C, taking antacids with prescribed medications, is not a universal preventive measure for upper GI bleeding. Option D, using misoprostol (Cytotec), is a treatment option for protecting the gastric mucosa in certain cases but is not a primary prevention strategy. Educationally, it is essential to teach patients about the potential risks associated with OTC medications and the importance of consulting healthcare providers before taking any new medication, especially if they are at risk for upper GI bleeding. Emphasizing lifestyle modifications, medication management, and regular monitoring can empower patients to take an active role in their health and prevent complications like GI bleeding.

Correct Answer: B

Rationale: In the postoperative assessment of a patient who has undergone the first phase of a total proctocolectomy with ileal pouch and anal anastomosis for ulcerative colitis, the nurse should expect to find a loop ileostomy with a plastic rod to hold it in place. This is because after this surgical procedure, a loop ileostomy is often created temporarily to divert fecal flow while the newly created ileal pouch heals. The plastic rod is used to prevent the stoma from retracting into the abdomen. Option A (rectal tube set to low continuous suction) is incorrect because in this surgical procedure, the colon and rectum are usually removed, so there is no need for a rectal tube. Option C (a colostomy stoma with an NG tube in place to provide pouch irrigations) is incorrect because in this procedure, an ileal pouch is created, not a colostomy stoma. Additionally, irrigations are not typically done in the immediate postoperative period. Option D (a permanent ileostomy stoma in the right lower quadrant of the abdomen) is incorrect because the first phase of a total proctocolectomy with ileal pouch and anal anastomosis does not involve the creation of a permanent ileostomy. Educationally, understanding the postoperative care and expected findings following specific surgical procedures is crucial for nurses caring for patients with gastrointestinal conditions. This knowledge ensures appropriate assessment, intervention, and patient education to promote optimal recovery and outcomes.