A student nurse is performing a urinary catheterization for the first time and inadvertently contaminates the catheter by touching the bed linens. What should the nurse do to maintain surgical asepsis for this procedure?

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Gather new sterile supplies and start over. Maintaining surgical asepsis is crucial to prevent infection during procedures like urinary catheterization. By touching the contaminated bed linens, the catheter is no longer sterile, increasing the risk of introducing harmful microorganisms into the patient's urinary tract. Choosing option A) Nothing, because the patient is on antibiotics, is incorrect as antibiotics do not negate the importance of maintaining asepsis during invasive procedures. Option B) Complete the procedure and then report what happened is also incorrect as it compromises patient safety by proceeding with a contaminated catheter. Option C) Apologize to the patient and complete the procedure is inappropriate as it overlooks the potential harm caused by using a contaminated catheter. Educationally, this question emphasizes the fundamental principle of asepsis in nursing practice. It highlights the importance of adhering to strict infection control measures to ensure patient safety and prevent healthcare-associated infections. Nurses must understand the significance of maintaining a sterile field during invasive procedures to provide high-quality and safe patient care.

Correct Answer: A

Rationale: In this scenario, advising the previously well 25-week pregnant woman to check her serology (Option A) is the most appropriate course of action. Checking her serology will help determine if she is immune to chickenpox. If she is immune, she is not at risk. Option B, which suggests administering zoster immunoglobulin if serology is negative, is incorrect because zoster immunoglobulin is not indicated for routine exposure to chickenpox. Option C, prophylactic aciclovir if serology is negative, is also incorrect as aciclovir is not routinely recommended for exposure to chickenpox in pregnant women. From an educational standpoint, it is crucial for healthcare professionals to understand the implications of infectious diseases, especially during pregnancy. By advising the pregnant woman to check her serology, healthcare providers can make informed decisions regarding the management of potential exposures to infectious diseases, ensuring the safety of both the mother and the unborn child.

Correct Answer: C

Rationale: In this scenario, the most appropriate anti-tetanus regimen for the 56-year-old man with a penetrating wound contaminated with debris and a history of tetanus vaccination is option C) ADT only. This is because he has a reliable record of having received 3 doses of tetanus vaccine in the past, which indicates he has developed immunity to tetanus. ADT (Adult Diphtheria Tetanus) provides adequate coverage for tetanus in individuals who have previously received the primary series of tetanus vaccinations. Option A) ADT plus tetanus Ig is not necessary in this case because the patient's history of tetanus vaccination suggests that he does not need additional passive immunization with tetanus Ig. Option B) Tetanus Ig only is not needed as the patient has a documented history of adequate tetanus vaccination. Option D) Child diphtheria tetanus is incorrect as it is not appropriate for an adult patient, especially one with a history of tetanus vaccination. Educationally, this question highlights the importance of understanding individual patient histories, especially regarding tetanus vaccination status, in determining the appropriate anti-tetanus regimen. It reinforces the principles of evidence-based practice and tailored patient care based on immunization records and guidelines.

Correct Answer: C

Rationale: In this question about erysipelas, a skin infection caused by Group A Streptococcus bacteria, option C is the correct answer. Bacteremia (presence of bacteria in the bloodstream) is not common in lower extremity manifestations of erysipelas. Option A is true because erysipelas can indeed affect the face and scalp in infants and the elderly due to their relatively weaker immune systems in these areas. Option B is also correct as erysipelas can progress to skin desquamation, which is the shedding of the outer layers of the skin. Option D is true as fever is a common symptom of erysipelas due to the body's immune response to the bacterial infection. Educationally, understanding the key clinical manifestations and complications of erysipelas is crucial for healthcare professionals, especially nurses preparing for the NCLEX exam. Knowing the typical presentation of erysipelas helps in early recognition and appropriate management of the infection. Remembering that bacteremia is less common in lower extremity manifestations than in other forms of erysipelas is essential for accurate clinical decision-making.

Correct Answer: C

Rationale: The correct answer is C) A medium flow and warm water when washing hands. This option is correct because using a medium flow of water helps to effectively rinse off the soap and dirt from your hands without splashing water everywhere. Warm water is recommended because it helps to effectively remove oils and soil from the hands, making it easier to lather the soap and cleanse thoroughly. Option A) A medium flow and hot water is incorrect because hot water can be harsh on the skin and may lead to dryness and irritation over time. Option B) A slow flow and warm water is not ideal as a slow flow may not effectively rinse off all the soap and dirt from the hands. Option D) A fast flow and cool water is also incorrect as cool water is less effective at removing oils and soil from the hands compared to warm water. In an educational context, it is important for healthcare professionals to understand the proper technique for handwashing to prevent the spread of infections. Teaching students the correct flow of water and temperature to use during handwashing reinforces good hygiene practices and helps maintain a safe healthcare environment.