Answer to Question 1
C
For diseases transmitted by large droplets (larger than 5 m), such as streptococcal pharyngitis, pneumonia, scarlet fever in infants or small children, pertussis, mumps, meningococcal pneumonia or sepsis, or pneumonic plague, place the patient in a private room, or cohort the patient and wear a mask when closer than 3 feet from the patient. For diseases transmitted by small droplet nuclei (smaller than 5 m), such as measles, chickenpox, disseminated varicella zoster, and pulmonary or laryngeal TB, place the patient on airborne precautions in a private room with negative airflow of at least six air exchanges per hour, and wear a respirator or mask. Standard precautions apply to blood, all body fluids, secretions, excretions, nonintact skin, and mucous membranes. For diseases transmitted by direct patient or environmental contact, such as colonization or infection with multidrug-resistant organisms, respiratory syncytial virus, major wound infection, herpes simplex, and scabies, place the patient on contact precautions in a private room, or cohort the patient. Wear gloves and gowns.
Answer to Question 2
C
Unless the patient has diabetes, allow the patient's feet and fingernails to soak no longer than 10 minutes. The goal is to soften the skin and debris beneath the nails, without causing excessive dryness. Obtain a physician's order for cutting the nails (required by most agencies). The patient's skin may be cut accidentally. Certain patients are more at risk for infection, depending on their medical condition. Check agency policy for appropriate process for cleaning beneath the nails. Do not use an orange stick or the end of a cotton swab; both of these splinter and can cause injury.