A nurse assesses a client with psychotic symptoms and determines ...

[c0205847]

A nurse assesses a client with psychotic symptoms and determines that the client likely poses a safety threat and needs vest restraints. The client is adamantly opposed to this. What would be the best nursing action?
 
  A) Contact the physician and obtain necessary orders
  B) Restrain the client with vest restraints
  C) Ask a family member to come in to supervise the client
  D) Apply wrist restraints instead of vest restraints

Question 2

A nurse is caring for a client who is admitted to the infection control room of a health care facility with acute diarrhea that is caused by an antibiotic-resistant microorganism.
 
  Which of the following isolation measures is taken in the infection control room? A) Door to the room is kept open for cross-ventilation.
  B) Sink is located outside the room for handwashing.
  C) Private bathroom is provided for flushing contaminated liquids.
  D) Housekeeping personnel clean the infection control room first.

[Viet Thy]

Answer to Question 1

A
Feedback:
If a nurse feels that a client needs to be restrained, the nurse should inform the physician and obtain necessary orders. The nurse should also discuss this with the client's family members and ask their opinion. Applying a wrist restraint instead of a vest restraint is inappropriate if a vest restraint is genuinely necessary. It would be inappropriate to delegate this aspect of care to a family member.

Answer to Question 2

C
Feedback:
The infection control room has a private bathroom so that personnel can flush contaminated liquids and biodegradable solids. Infection control personnel keep the door to the room closed to control air currents and the circulation of dust particles. A sink is also located in the room for handwashing. The housekeeping personnel should clean the infection control room last to avoid transferring organisms on the wet mop to other client areas.

[c0205847]

Excellent

[bdobbins]

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