Question 1

The nurse is teaching the patient about flossing and oral hygiene.The nurse teaches the patient that

Accepted Answer

Dental flossing removes plaque and tartar between teeth.To prevent bleeding,the patient should use unwaxed floss.Flossing once a day is sufficient.If toothpaste is applied to the teeth before flossing,fluoride will come in direct contact with tooth surfaces,aiding in cavity prevention.

Question 2

The nurse is preparing to provide a complete bed bath to an unconscious patient.The nurse decides to use a bag bath.She does this for which of the following reasons?

Accepted Answer

When washbasins are not cleaned and dried completely after use,the risk of contamination by gram-negative organisms is introduced.Successive uses of the washbasin cause the patient's skin to harbor more gram-negative organisms.Bag baths do not contain soap.Instead,they contain a no-rinse surfactant,a humectant to trap moisture,and an emollient that significantly reduces overall skin dryness,especially skin flaking and scaling.

Question 3

The nurse is caring for an elderly patient with Alzheimer's disease who is ambulatory but requires total assistance with his activities of daily living (ADLs).The nurse notices that his skin is dry and wrinkled.The nurse should

Accepted Answer

Decreasing the number of baths per week may help prevent further drying of the skin.As people age,the skin loses its resiliency and moisture,and sebaceous and sweat glands become less active.Daily bathing as well as bathing with water that is too hot or soap that is harsh causes the skin to become excessively dry.

Question 4

The nurse is caring for a patient who has multiple ticks on her legs and body.To rid the patient of ticks,the nurse should

Accepted Answer

Using blunt tweezers,grasp the tick as close to the head as possible and pull upward with even,steady pressure.Hold until the tick pulls out,usually for about 3 to 4 minutes.Save the tick in a plastic bag,and put it in the freezer if necessary to identify the type of tick.Because ticks transmit several diseases to people,they must be removed.Allowing them to drop off by themselves is not an option.Lindane is an ingredient that was used in treatment for pediculosis capitis (head lice); it should no longer be used because the ingredient is toxic and is known to cause adverse reactions.

Question 5

A self-sufficient bedridden patient unable to reach all body parts needs which type of bath?

Accepted Answer

A partial bath consists of washing body parts that the patient cannot reach,including the back,and providing a back rub.Dependent patients in need of partial hygiene or self-sufficient bedridden patients who are unable to reach all body parts receive a partial bed bath.Complete bed baths are administered to totally dependent patients in bed.The bag bath contains several soft,nonwoven cotton cloths that are pre-moistened in a solution of no-rinse surfactant cleanser and emollient.It can be used for any patient.The sponge bath involves bathing from a bath basin or a sink with the patient sitting in a chair.

Question 6

After the patient's bath,the nurse should

Accepted Answer

Consult the medical record for any contraindications to a massage (e.g.,fractured ribs,burns,heart surgery).A backrub of 3 minutes' duration actually enhances patient comfort and relaxation and thus is very therapeutic.It is important to ask whether a patient would like a backrub because some individuals dislike physical contact.

Question 7

In providing oral care to an unconscious patient,it is important for the nurse to

Accepted Answer

When providing oral hygiene to an unconscious patient,the nurse needs to protect him or her from choking and aspiration.Have two nurses provide care.One nurse does the actual cleaning,and the other caregiver removes secretions with suction equipment.The nurse can delegate nursing assistive personnel to participate.Some agencies use equipment that combines a mouth swab with the suction device.This device can be used safely by one nurse to provide oral care.Commercially made foam swabs are ineffective in removing plaque.Do not use lemon-glycerin sponges because they dry mucous membranes and erode tooth enamel.While cleansing the oral cavity,use a small oral airway or a padded tongue blade to hold the mouth open.Never use your fingers to hold the patient's mouth open.A human bite contains multiple pathogenic microorganisms.

Question 8

The nurse is providing perineal care to an uncircumcised male patient.When providing such care,the nurse should

Accepted Answer

Return the foreskin to its natural position.Keeping the foreskin retracted leads to tightening of the foreskin around the shaft of the penis,causing local edema and discomfort.The foreskin may not return to its natural position on its own.Patients at greatest risk for infection are uncircumcised males.

Question 9

The unconscious patient is resisting attempts by the nurse to provide oral hygiene.To provide the needed care,the nurse may

Accepted Answer

If the patient is unconscious or uncooperative,or is having difficulty keeping the mouth open,insert an oral airway.Insert it upside down,then turn the airway sideways and over the tongue to keep the teeth apart.Insert when the patient is relaxed.Do not use force.Never place fingers into the mouth of an unconscious or debilitated patient.The normal response of the patient is to bite down.Position the patient on his side or turn his head to allow for drainage.Placing the patient on his back could lead to aspiration.Hydrogen peroxide and sodium bicarbonate effectively remove debris but,if not diluted carefully,may cause superficial burns.

Question 10

The nurse is providing a complete bed bath to a patient using a commercial bath cleansing pack (bag bath).In doing so,the nurse should

Accepted Answer

The nurse should allow the skin to air dry for 30 seconds.Drying the skin with a towel removes the emollient that is left behind after the water/cleanser solution evaporates.It is permissible to lightly cover the patient with a bath blanket or towel to prevent chilling.The cleansing pack contains eight to ten pre-moistened towels for cleansing.Use a single towel for each general body part cleansed.

Question 11

The patient is diagnosed with pediculosis capitis (head lice)and was treated upon admission and was re-treated 24 hours later,yet the patient is still infested.The nurse should next

Accepted Answer

Manual removal is the best option when treatment has failed.Re-treating with a medicated shampoo may lead to adverse reactions and should not be done without consulting the care provider.Products containing lindane should not be used because the ingredient is toxic and is known to cause adverse reactions.Although bathing or showering is a good idea,this is usually considered a treatment for pediculosis corporis (body lice),not pediculosis capitis (head lice).

Question 12

The nurse is caring for a patient who has head lice (pediculosis capitis).The nurse knows that in treating this condition,one must understand that

Accepted Answer

Head lice are difficult to remove and spread to furniture and other people if not treated.Caution against use of products containing lindane because the ingredient is toxic and is known to cause adverse reactions.Treatments need to be repeated 12 to 24 hours after the initial treatment.Manual removal is the best option when treatment has failed.

Question 13

When providing the patient with a complete bed bath using soap and water (not a bag bath),it is important to

Accepted Answer

Moisture and sediment that collect in skinfolds predispose skin to maceration.Towel dry to prevent maceration.Soap irritates the eyes.Use of separate sections of the mitt reduces infection transmission.Bathing the eye from inner to outer canthus prevents secretions from entering the nasolacrimal duct.Alkaline soap residue is irritating to skin and can decrease the normal protectiveness of acid pH.

Question 14

In examining a patient for pediculosis capitis (head lice),the nurse would expect to find

Accepted Answer

With head lice,the parasite is on the scalp attached to hair stands.Bites or pustules may be observed behind the ears and at the hairline.Grayish-white parasites with red legs are pediculosis pubis (crab lice),not head lice,and are found in pubic hair.Alopecia (hair loss)is found in all races,with brittle and broken hair and balding patchiness in the periphery of the hairline.

Question 15

Scaling of the scalp accompanied by itching is known as

Accepted Answer

Dandruff is scaling of the scalp that is accompanied by itching.Pediculosis (lice)consists of tiny,grayish-white parasite insects that infest mammals.Alopecia is hair loss or balding.Ticks are small,gray-brown parasites that burrow into the skin and suck blood.

Question 16

When providing basic eye care,the nurse

Accepted Answer

When cleansing the patient's eyes,obtain a clean washcloth and cleanse from inner canthus to outer canthus.Use a different section of the washcloth for each eye.Cleansing simply involves washing with a clean washcloth moistened in water.Soap causes burning and irritation.Never apply direct pressure over the eyeball because this causes serious injury.Unconscious patients often require more frequent eye care.

Question 17

The female nurse is caring for a male patient who is uncircumcised but not ambulatory,although he has full function of arms and hands.The nurse is providing the patient with a partial bed bath.Perineal care for this patient

Accepted Answer

Patients most in need of perineal care are those at greatest risk for acquiring an infection such as uncircumcised males.If a patient is able to perform perineal self-care,encourage this independence.Embarrassment should not cause the nurse to overlook the patient's hygiene needs.The nurse should provide this care only if the patient is unable to do so.

Question 18

Patients with diabetes mellitus need special foot care to prevent the development of ulcers.Knowing this,the nurse

Accepted Answer

Patients with peripheral vascular disease or diabetes mellitus often require nail care from a specialist to reduce the risk of infection.Some agencies allow cutting of nails with a provider's order; however,most do not.Patients with diabetes do not soak hands and feet.Soaking increases the risk of infection because of maceration of the skin.When assessing the patient's feet,the nurse palpates the dorsalis pedis of the foot,not the brachial artery.

Question 19

In providing perineal care to a female patient,the nurse should wash

Accepted Answer

Cleansing from pubic area to rectum (front to back)reduces the transfer of microorganisms to the urinary meatus and decreases the risk of urinary tract infection.Cleansing from rectum to pubic area or back to front increases the risk of urinary tract infection.Circular motions are used in male perineal care.

Question 20

The patient is being treated for cancer with weekly radiation and chemotherapy treatments.The nurse is aware that the patient's oral mucosa needs to be assessed because chemotherapy and radiation can

Accepted Answer

Patients frequently develop common oral problems as a result of inadequate oral care or as a consequence of disease (e.g.,oral malignancy)or as a side effect of treatments such
as radiation and chemotherapy.

Quiz 87: Hygiene