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Question

Difficulty: MediumStandard and Transmission-Based Precautions

Charge nurses are determining shift assignments on a busy medical-surgical unit. Several clients require specific isolation protocols. Which client requiring transmission-based precautions is most appropriate to assign to the practical nurse?

  1. A stable client with a localized methicillin-resistant Staphylococcus aureus (MRSA) wound infection who requires scheduled oral antibiotics and routine dressing changesAnswer
  2. B
    A newly admitted client with suspected bacterial meningitis who requires immediate implementation of droplet precautions and a comprehensive baseline assessment
  3. C
    A client with active pulmonary tuberculosis who requires administration of a first-dose intravenous push antibiotic
  4. D
    A client on contact precautions for Clostridioides difficile who has suddenly developed severe abdominal rigidity and a rapid drop in blood pressure

Answer

The stable client with a localized methicillin-resistant Staphylococcus aureus (MRSA) wound infection who requires scheduled oral antibiotics and routine dressing changes.
The correct answer describes a client who is medically stable, has a predictable outcome, and requires interventions (oral medications and routine dressing changes) that fall securely within the practical nurse's scope of practice. The presence of MRSA contact precautions does not preclude the practical nurse from providing care, provided the client's overall condition is stable.

Step-by-Step Solution

1
Evaluate the clinical stability of each client on transmission-based precautions.
Three clients are unstable, newly admitted, or require advanced interventions; only the MRSA client is stable.
Practical nurses should be assigned to care for clients with predictable outcomes and chronic or stable conditions.
2
Analyze the specific nursing interventions required for each client.
The MRSA client requires oral medications and routine wound care, which are within the practical nurse scope.
Practical nurses cannot perform initial comprehensive assessments or administer intravenous push medications.
3
Select the client whose needs match the practical nurse scope of practice.
The stable client with the localized MRSA wound infection is selected.
This ensures safe and effective care within legal and professional boundaries while maintaining necessary infection control precautions.

Key Concept

Assigning clients on transmission-based precautions based on the practical nurse scope of practice
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Topics

Standard and Transmission-Based Precautions

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