A nursing assistant comes to work complaining of a sore throat, fever, and chills. She knows the unit is short a nursing assistant for today so she did not call in sick. Which of the following is the best action of the nurse who is in charge?
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Solution
D. The best action of the nurse is to send the ill nursing assistant home to protect the other employees and the residents from the spread of infection. Giving the nursing assistant who is ill medication (A), allowing the nursing assistant who is ill to rest after a.m. care is completed (B), and instructing all the nursing assistants on the unit to work in pairs (C) exposes others to illness and those in a weakened state of health could contact the illness.
The registered nurse calls for your help to assist with a resident who has fallen on the floor. You know this incident must be reported to the risk manager of the facility. Which of the nurse’s following actions would best relay the events that occurred?
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Solution
B. An incident report serves to accurately record what occurred, when it occurred, and all the details of the event because problems related to the incident might occur sometime later. Writing a note to the physician (A) is incorrect because the physician is called as soon as possible to update him or her on the condition of the resident. Calling the director of the facility (C) is wrong because the risk manager is responsible to investigate any accidents or incidents. Completing an adverse
drug reaction form (D) is wrong because an adverse drug reaction form is completed only when an incident occurred due to a medication.
Before serving a resident a meal, it is important for the nursing assistant to properly check that the meal belongs to the resident by which of the following activities?
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Solution
A. It is important to follow facility policy of identifying residents. The most common way is by checking the resident’s arm band; some facilities use pictures for identification. Asking the roommate to identify the resident (B), asking the resident to identify self (C), and not checking identification because you see the resident several times a week (D) are sometimes used along with choice A but not as the sole source of identification.
Which of the following actions is not a part of standard precautions?
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Solution
B. Protective equipment is chosen according to the possible substance the health-care worker might have contact with. Washing hands before and after contact with a resident (A), wearing goggles when there is possibility of splashes (C), and using gloves when there is a possibility of contact with body fluids (D) are all part of standard precautions to protect the health-care worker.
Which of following are age-related changes?
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Solution
A. Decreased hearing and vision are age-related changes. Lower intelligence level (B) is incorrect because the loss of intellectual abilities as you get older is a myth. Difficulty communicating (C) is incorrect because most elders do not have problems with communicating unless they have suffered a stroke. The ability to learn a new skill is not impaired in the elderly (D).
Which of the following is not considered appropriate handling of linen?
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Solution
C. Depositing linen on the floor causes the soiled linen to contaminate the floor and become a hazard. Changing linen promptly when soiled (A), folding the soiled portion inward (B), and carrying the linen away from your body (D) are a part of the procedure for the care of linen. When linen is soiled, it is promptly removed and then the contaminated side folded inward and carried away from your body to not contaminate the nursing assistant’s uniform.
The nursing assistant notices the smell of smoke as he passes by a resident’s room. He enters the room and sees that a pillow is on fire in the empty bed next to where a resident is sleeping. What should be the nursing assistant’s first action according to the RACE plan?
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Solution
D. With RACE, the first action is to rescue any person who might be in danger from the fire. In this case, it is the resident sitting next to the empty bed. Confine (A), alarm (B), and extinguish (C) are all incorrect because they leave the resident is harm’s way
When equipment is used by multiple residents, it is important to decrease the opportunity for contamination. One way to avoid contamination is by cleaning the equipment with the cleanser provided by the institution. When should the equipment be cleansed?
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Solution
C. Equipment used for more than one resident is cleaned immediately after each use. Before using the equipment again (A) is incorrect due to the length of time that might occur between use from one resident to another. At the end of the shift (B) is incorrect because the nursing assistant on the next shift might not realize the equipment was not been cleaned after it was used on the resident. At the time of each scheduled cleaning (D) is incorrect because scheduled cleaning is for regular deep cleaning of all equipment.
Which of the following is not an example of contamination caused by droplet transmission?
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Solution
D. Hepatitis B is transmitted through blood that is contaminated with Hepatitis B. Pneumonia (A), Influenza (B), and the common cold (C) are all transmitted via respiratory droplets.
What is the second leading cause of death in an individual 65 years of age or older?
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Solution
B. The second leading cause of death in the elderly is due to falls or complications resulting from falls. A car accident (A) is a safety issue that is sometimes overlooked in the elderly but is not a leading cause of death. Many elders have trouble swallowing due to an illness (C). Drowning (D) is not a leading cause of death in the elderly.