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Difficulty: Very hardStandard and Transmission-Based Precautions

A practical nurse (PN) prepares to enter a client's room and correctly follows the sequence of applying an isolation gown, followed by an N95 respirator, and finally clean gloves. For which of the following assigned clients is this specific combination of personal protective equipment (PPE) strictly required by transmission-based precautions prior to room entry?

  1. A client with disseminated varicella-zoster virus who requires assistance with daily hygieneAnswer
  2. B
    A client with bacterial meningitis caused by Neisseria meningitidis who requires a routine vital signs assessment
  3. C
    A client with active pulmonary tuberculosis (TB) who is resting quietly in bed and receiving continuous intravenous fluids
  4. D
    A client with Clostridioides difficile (C. diff) and a concurrent respiratory syncytial virus (RSV) infection requiring linen changes

Answer

The client with disseminated varicella-zoster virus is the correct answer because this condition uniquely requires the combination of Airborne (N95 respirator) and Contact (gown and gloves) precautions prior to room entry.
Disseminated varicella-zoster virus requires both Airborne and Contact precautions. Airborne precautions require the nurse to don an N95 respirator before entry, and Contact precautions mandate an isolation gown and clean gloves prior to entering the room. The stem correctly describes the donning sequence for this specific combination of required PPE.

Step-by-Step Solution

1
Analyze the PPE combination listed in the stem.
The nurse is donning an isolation gown, an N95 respirator, and clean gloves prior to room entry.
Identifying the specific PPE helps determine which isolation precaution categories are being implemented.
2
Map the PPE to specific transmission-based precaution categories.
An N95 respirator indicates Airborne precautions. A gown and gloves required prior to entry indicates Contact precautions.
Understanding what each PPE item is used for allows you to filter the client diagnoses based on their required precautions.
3
Evaluate the transmission-based precaution requirements for each client option.
Bacterial meningitis requires Droplet; TB requires Airborne; C. diff and RSV require Contact and Droplet; Disseminated varicella-zoster requires Airborne and Contact.
This systematic evaluation ensures the correct pathogen is matched to the PPE.
4
Select the client that requires both Airborne and Contact precautions.
The client with disseminated varicella-zoster virus is the only match.
Disseminated shingles can be transmitted through both airborne aerosols and direct contact with blister fluid, necessitating the full PPE combination described.

Key Concept

Standard and Transmission-Based Precautions
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Topics

Standard and Transmission-Based Precautions

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