Safety and Infection Control Mastery Exam

Drill 11 #1:

An outpatient client is scheduled to receive an oral solution of radioactive iodine. In order to reduce radiation exposure to others, which information should the nurse reinforce?

• No solid food may be eaten for six hours after ingestion.

• Urine and saliva will be radioactive for 24 hours after ingestion.

• Wash laundry separately and rinse twice in hot water.

• Wait for 48 hours to have grandchildren visit at home.

Answer explanation

Rationale: The client's urine and saliva will be radioactive for 24 hours after ingestion. The nurse should teach or reinforce teaching to double flush the commode after use, use disposable utensils and avoid close contact with children and pregnant women for seven days after therapy. Because the treatment may cause nausea, it is best that the client does not eat two hours before or after iodine administration. It is not necessary to wash laundry separately or in hot water.

Drill 11 #2:

The 4-year-old child is newly diagnosed with hepatitis A. Which instructions should the nurse reinforce with the child's parents?

• Use gentle cleansers to protect jaundiced child’s skin from breakdown.

• Child can return to daycare two days after starting antibiotic treatment.

• Keep child on bedrest for several weeks before gradually resuming activity.

• Wash hands thoroughly with soap and warm water after contact with the child

Drill 11#2:

What is the primary way hepatitis A virus spreads?

• Through airborne particles

• Through contaminated food or water

• Through blood transfusions

• Through insect bites

Answer explanation

Rationale: The hepatitis A virus spreads through contaminated food or water, as well as unsanitary conditions in childcare facilities or schools. The infection resolves spontaneously and symptom relief is usually the only treatment. The child does not have to be confined to bed and they can safely return to daycare or school one week after symptoms begin. In children under 6-years-old, who represent approximately 1/3 of all cases of hepatitis A, the disease may be asymptomatic, and jaundice is rarely evident.

Drill 11 #3:

What should be done first if a child is suspected of swallowing a poisonous substance?

• Empty the child's mouth of any poisonous substance still present

• Give the child a glass of milk to drink to neutralize the poisonous substance

• Induce vomiting if the child is suspected of swallowing something poisonous

• Start treatment before calling the Poison Control Center

Answer explanation

Rationale: Emptying the mouth of the poison prevents any further ingestion. It should be done first to minimize further contact with and absorption of the substance. The parent should call the Poison Control Center before giving any treatment. Never induce vomiting unless instructed to do so by the Poison Control Center or a health care provider. The same applies to giving the child milk to drink because not all poisons are neutralized that way.

Drill 11 #4:

The parent of a toddler who is being treated for suspected poisoning asks, “Why is activated charcoal used?” What is the best response by the nurse?

• Activated charcoal binds with the poison to limit absorption in the digestive tract.

• Activated charcoal causes vomiting, which will eliminate the poison from the body.

• When the poison is absorbed into the blood stream, the activated charcoal will neutralize it.

• The activated charcoal will protect the kidneys from any long-lasting damage.

Drill 11 #4:

What is the primary function of activated charcoal in treating poisoning?

• To cause vomiting and eliminate the poison from the body.

• To bind with the poison and limit its absorption in the digestive tract.

• To neutralize the poison once it is absorbed into the bloodstream.

• To protect the kidneys from long-lasting damage.

Answer explanation

Rationale: Treatment with activated charcoal is a method for removing ingested poisons from the gastrointestinal (GI) tract. Activated charcoal is an inert substance that adsorbs drugs and other chemicals. Because charcoal particles cannot be absorbed into the blood, the adsorption of poisons into the charcoal prevents toxicity. The charcoal-poison complex is eliminated in the stool. Clients should be advised that charcoal will turn the feces black. Activated charcoal has the consistency of a fine powder and is mixed with water (or juice) for oral administration. The adult dose is 25 to 100 gm. Pediatric doses range from 25 to 50 gm. When administered within 30 minutes after poison ingestion, charcoal can adsorb about 90% of the dose. However, if given 60 minutes after poison ingestion, the amount adsorbed decreases to only 37%. Therefore, charcoal should be given as soon as possible after poison exposure.

What should clients be advised about the effect of activated charcoal on their stool?

• It will turn the stool white.

• It will turn the stool black.

• It will have no effect on the stool color.

• It will cause diarrhea.

What is the consistency of activated charcoal before it is mixed with water or juice for oral administration?

• A thick paste

• A fine powder

• A gel-like substance

• A solid tablet

What is the recommended pediatric dose range for activated charcoal in cases of poisoning?

• 10 to 20 gm

• 25 to 50 gm

• 50 to 75 gm

• 75 to 100 gm

What percentage of the poison dose can activated charcoal adsorb if administered within 30 minutes after ingestion?

• 50%

• 70%

• 90%

• 100%