Question

Difficulty: MediumStandard and Transmission-Based Precautions

A practical nurse is providing care for several clients who require specific infection control measures on a medical-surgical unit. Which action demonstrates the correct application of transmission-based precautions?

  1. Removing the isolation gown and gloves inside the room prior to exiting the room of a client diagnosed with scabies.Answer
  2. B
    Wearing a fit-tested N95 respirator mask while obtaining vital signs for a client diagnosed with seasonal influenza.
  3. C
    Placing a client with an intact, localized herpes zoster rash in an airborne infection isolation room with negative air pressure.
  4. D
    Transporting a client with active pulmonary tuberculosis through the hallway while the nurse wears an N95 respirator and the client remains unmasked.

Answer

Removing the isolation gown and gloves inside the room prior to exiting the room of a client diagnosed with scabies.
Scabies requires Contact Precautions. To prevent the spread of the infestation to other areas of the healthcare facility, the nurse must remove the contaminated gown and gloves inside the client's room and perform hand hygiene immediately before crossing the threshold into the hallway.

Step-by-Step Solution

1
Determine the correct transmission-based precaution for scabies.
Scabies is transmitted via direct skin-to-skin contact, requiring Contact Precautions.
Identifying the transmission route is necessary to apply the correct protective measures.
2
Evaluate the procedural standards for Contact Precautions.
Standards dictate that the gown and gloves must be removed inside the client's room before leaving.
Removing contaminated PPE inside the room prevents the spread of pathogens to the hallway and other hospital areas.
3
Evaluate the remaining options for adherence to infection control protocols.
The other actions apply inappropriately escalated precautions (N95 for influenza, airborne room for localized shingles) or omit critical source control (unmasked TB client during transport).
Verifying why the distractors are incorrect confirms that the scabies PPE doffing procedure is the only appropriate action.

Key Concept

Transmission-Based Precautions Implementation
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