1. A nurse is admitting a client who has pulmonary tuberculosis. Which of the

following transmission-based precautions should the nurse initiate?

• Airborne

• Rationale: Pulmonary tuberculosis is an infection that is transmitted by

airborne dropletssmallerthan 5 microns in diameter. Therefore, this client

requires airborne precautions to prevent communicating this infection to

others

2. A nurse in a mental health facility is preparing an educational program for a group

of staff nurses about the proper use of restraints. Which of the following

information should the nurse plan to include?

• An adult client may be in a mechanical restraint for up to 4 hours

• Rational: The nurse should specify that a client who is 18 years or older may be

in a restraint for no more than 4 hr. Children who are 9 to 17 years old are limited

to 2 hr and children who are younger than 9 years old are limited to 1 hr

3. A nurse is teaching sleep hygiene to a client who has insomnia. Which of the

following statements should the nurse make?

• Exercise in the morning after arising

• Rationale: Daily exercise has many benefits, including enhancing cardiovascular,

psychological, and musculoskeletal health. The nurse should recommend that

the client avoid exercising within 2 hr of bedtime to limit stimulation and

enhance sleep

4. A nurse is preparing to leave the room of a client who is on isolation precautions.

Which of the following actions should the nurse take when removing a tied surgical

mask?

• Remove the mask by securely holding the ties and moving it away from the face

• Rationale: The nurse should untie the bottom strings and then the top strings.

Finally, while still holding the strings, the nurse should remove the mask from

her face. This action prevents the nurse from touching the front of the mask,

which is contaminated

5. A nurse is caring for an adolescent client who is in critical condition following a motor

vehicle crash in which he was the passenger. The client's parent shouts at the nurse,

asking why her son is dying instead of the driver. Which of the following actions

should the nurse take to provide emotional support to the parent?

• Inform the parent that anger is a natural response when dealing with loss