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Difficulty: MediumStandard and Transmission-Based Precautions

A localized outbreak of infectious diseases has led to the implementation of multiple isolation protocols on a medical-surgical unit. Which action by the practical nurse demonstrates the correct application of standard and transmission-based precautions?

  1. A
    Removing the protective surgical mask prior to doffing a contaminated isolation gown and gloves when exiting a droplet precaution room.
  2. B
    Accepting the delegation to independently formulate the initial isolation care plan and admission assessment for a client with suspected pulmonary tuberculosis.
  3. C
    Bypassing the electronic barcode scanning process when administering oral antivirals to minimize exposure time inside a contagious client's room.
  4. Leaving a dedicated disposable stethoscope and blood pressure cuff inside the room of a client receiving treatment for a Clostridioides difficile infection.Answer

Answer

Leaving a dedicated disposable stethoscope and blood pressure cuff inside the room of a client receiving treatment for a Clostridioides difficile infection.
The correct action demonstrates strict adherence to contact precautions. Clostridioides difficile (C. diff) is highly contagious, and its spores can survive on surfaces for extended periods. Providing dedicated, disposable, or room-restricted medical equipment (such as stethoscopes and blood pressure cuffs) is a mandatory intervention to prevent cross-contaminating other clients or areas of the facility.

Step-by-Step Solution

1
Identify the core requirements of contact precautions for Clostridioides difficile.
Contact precautions require a private room, gown, gloves, and dedicated client-care equipment.
C. diff spores are highly resilient and easily spread via shared equipment, making dedicated room supplies essential to stop cross-contamination.
2
Evaluate the doffing sequence for personal protective equipment (PPE) in the incorrect options.
Removing the mask before the gown and gloves is an incorrect and dangerous sequence.
Gloves are the most contaminated item and should be removed first. The mask is removed last to protect mucous membranes from accidental contamination.
3
Determine the legal scope of practice for the practical nurse regarding admissions.
Practical nurses cannot independently perform initial comprehensive assessments or formulate initial care plans.
These tasks require the advanced clinical judgment of a registered nurse, making the delegation inappropriate regardless of the client's isolation status.
4
Assess medication administration protocols within isolation environments.
Safety protocols like barcode scanning must always be strictly followed.
Infection control measures do not override fundamental medication safety rules; skipping verification risks serious patient harm.

Key Concept

Application of Infection Control Protocols and Scope of Practice
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Topics

Standard and Transmission-Based Precautions

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