ATI Fundamentals II Practice Exam

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Which precaution should a nurse take to initiate a protective environment for a client who has had an allogeneic stem cell transplant?

Instruct the patient to remain in bed at all times

Make sure the patient wears a mask when outside the room if there is construction in the area

A protective environment for a client who has undergone an allogeneic stem cell transplant is crucial due to their heightened risk for infections and complications as a result of immunosuppressive therapy. This environment aims to minimize exposure to potential pathogens, especially during the early phase of recovery when the immune system is particularly vulnerable.

Wearing a mask when outside of the room, particularly in environments where there could be exposure to dust, debris, or other irritants (such as during construction), supports infection prevention. The mask provides a barrier against respiratory droplets and airborne particles, significantly reducing the risk of acquiring infections from the environment.

In contrast, remaining in bed at all times is not practical or necessary for creating a protective environment. Limiting visitors altogether may not be feasible or beneficial; rather, specific precautions can be taken to minimize risk while still allowing for essential support. Finally, although ensuring the patient does not leave the hospital can be part of their care plan during acute treatment phases, it does not address the specific need for infection control in potentially hazardous environments. Therefore, the recommendation to wear a mask when exiting the room during construction is the most appropriate and effective way to establish a protective environment.

Have the patient avoid all visitors until discharge

Ensure the patient does not leave the hospital

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