Level: Advanced
Difficulty: Hard
Subtopic: Pain basics
NCLEX: A 55-year-old client after abdominal surgery is being evaluated for nursing care related to pain basics. Assessme…
Nursing fundamentals Basic Care and Comfort Safety and Infection Prevention and Control
Case Study
A 55-year-old client after abdominal surgery is being evaluated for nursing care related to pain basics. Assessment data include the client tries to get out of bed unassisted and becomes unsteady. Which infection-prevention action is essential?
Question
A. Wear gloves only and skip hand hygiene when leaving the room.
B. Use sterile technique for all routine hygiene regardless of diagnosis.
C. Perform hand hygiene and apply the transmission-based precautions indicated by the client's diagnosis.
D. Skip precautions if the client has no fever.
B. Use sterile technique for all routine hygiene regardless of diagnosis.
C. Perform hand hygiene and apply the transmission-based precautions indicated by the client's diagnosis.
D. Skip precautions if the client has no fever.
Rationale
Correct answer: C. Perform hand hygiene and apply the transmission-based precautions indicated by the client's diagnosis.
Rationale: Infection control matches the pathogen route: hand hygiene plus appropriate precautions for contact, droplet, or airborne transmission.
Hint: Apply ABCs, client stability, and NCSBN clinical judgment steps before choosing an intervention.
Rationale: Infection control matches the pathogen route: hand hygiene plus appropriate precautions for contact, droplet, or airborne transmission.
Hint: Apply ABCs, client stability, and NCSBN clinical judgment steps before choosing an intervention.