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Difficulty: HardStandard and Transmission-Based Precautions

A practical nurse (PN) is reviewing the daily tasks for a group of clients on a medical-surgical unit. Which planned action demonstrates correct adherence to transmission-based precautions and falls safely within the PN's scope of practice?

  1. A
    Securing an N95 particulate respirator onto a patient actively coughing with pulmonary tuberculosis prior to transport through the hospital corridors.
  2. B
    Doffing a contaminated isolation gown and gloves in the hallway immediately after exiting the private room of a client with an actively draining methicillin-resistant Staphylococcus aureus (MRSA) wound.
  3. Dedicating a reusable electronic thermometer and blood pressure cuff to stay inside the room of a client who has a positive culture for vancomycin-resistant enterococcus (VRE).Answer
  4. D
    Completing the comprehensive admission assessment to establish the required isolation protocols for a newly admitted individual presenting with an unknown vesicular rash.

Answer

The correct action is dedicating a reusable electronic thermometer and blood pressure cuff to stay inside the room of a client who has a positive culture for vancomycin-resistant enterococcus (VRE).
For clients on contact precautions, such as those infected with vancomycin-resistant enterococcus (VRE), infection control standards require the use of dedicated client care equipment. Leaving items like a blood pressure cuff and thermometer inside the room prevents the transmission of the pathogen to other areas. Executing this standard protocol is a safe, appropriate action that falls comfortably within the practical nurse's scope of practice.

Step-by-Step Solution

1
Analyze each option to determine if the infection control procedure described follows current CDC guidelines for transmission-based precautions.
Transporting a TB client requires a surgical mask (not N95) on the client. Removing PPE for MRSA must occur inside the room (not the hallway). VRE requires dedicated equipment inside the room.
Identifying precise infection control rules eliminates incorrect procedural choices.
2
Evaluate the remaining actions against the standardized scope of practice for a practical nurse (PN).
Performing an initial, comprehensive admission assessment to determine isolation needs for an undiagnosed condition requires RN-level clinical judgment.
The PN must recognize which tasks can be safely and legally performed or delegated.
3
Synthesize the findings to select the single action that satisfies both safe infection control and legal scope of practice.
Dedicating equipment for a VRE client is the only action that is both clinically correct and within the PN's professional boundaries.
Only one option completely adheres to both safety standards and nursing regulations.

Key Concept

Integration of Transmission-Based Precautions and PN Scope of Practice
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Topics

Standard and Transmission-Based Precautions

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