Isolation Precautions for Pneumonia

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I completed the KAPLAN NCLEX course a couple of months ago and will soon take the NCLEX. I would really appreciate it if someone could give me some insight into the KAPLAN question that follows.

An older client diagnosed with pneumonia is admitted to the medical/surgical unit. The nurse should place the patient in a room with which of the following patients?

1. A 20-year-old in traction for multiple fractures of the left lower leg.

2. A 35-year-old with recurrent fever of unknown origin.

3. A 50-year-old recovering alcoholic with cellulitis of the right foot.

4. An 89-year-old with Alzheimer's disease awaiting nursing home placement.

Explanation

Strategy: Determine the transmission of organisms.

(1) patients with fractures are considered "clean"; don't place with an infectious patient

(2) don't know the cause of the fever

(3) CORRECT - generalized nonfollicular infection that involves deeper connective tissue, both patients have infections

(4) elderly are high risk for developing pneumonia

A. In the KAPLAN class, we learned that pneumonia is categorized under Droplet precautions. Yet in this question it must be OK to put a pneumonia patient with another patient. Is this allowed for all the diseases listed under Droplet precautions?

B. We also learned that skin infections are categorized under Contact precautions which requires a private room. Therefore why is it OK to put the cellulitis patient with another patient?

C. Also, the explanation for answer choice 3 indicates that it is OK to partner the pneumonia and cellulitis patients because they both have infections, even though they are different infections. It is not clear to me why the fact that they both have infections makes it OK to partner them. Wouldn't they both then be at risk for catching each other's infections in addition to the one they already have? It seems the thinking is "These patients are already in bad shape so its not a big deal if we make them worse."

Thanks for your help.:)

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Specializes in Emergency, Telemetry, Transplant.
I completed the KAPLAN NCLEX course a couple of months ago and will soon take the NCLEX. I would really appreciate it if someone could give me some insight into the KAPLAN question that follows.

An older client diagnosed with pneumonia is admitted to the medical/surgical unit. The nurse should place the patient in a room with which of the following patients?

1. A 20-year-old in traction for multiple fractures of the left lower leg.

2. A 35-year-old with recurrent fever of unknown origin.

3. A 50-year-old recovering alcoholic with cellulitis of the right foot.

4. An 89-year-old with Alzheimer’s disease awaiting nursing home placement.

Explanation

Strategy: Determine the transmission of organisms.

(1) patients with fractures are considered "clean"; don’t place with an infectious patient

(2) don’t know the cause of the fever

(3) CORRECT - generalized nonfollicular infection that involves deeper connective tissue, both patients have infections

(4) elderly are high risk for developing pneumonia

A. In the KAPLAN class, we learned that pneumonia is categorized under Droplet precautions. Yet in this question it must be OK to put a pneumonia patient with another patient. Is this allowed for all the diseases listed under Droplet precautions?

B. We also learned that skin infections are categorized under Contact precautions which requires a private room. Therefore why is it OK to put the cellulitis patient with another patient?

C. Also, the explanation for answer choice 3 indicates that it is OK to partner the pneumonia and cellulitis patients because they both have infections, even though they are different infections. It is not clear to me why the fact that they both have infections makes it OK to partner them. Wouldn't they both then be at risk for catching each other's infections in addition to the one they already have? It seems the thinking is "These patients are already in bad shape so its not a big deal if we make them worse."

Thanks for your help.:)

If indeed this pt had to be placed on droplet precautions, they should not be 'rooming' with anyone, whether or not that other person has an infection. Second, generally, PNA pt's are not normally isolated anyway (yes, there are exceptions to this rule). Finally, in the real world, I would want to know what is mean by "recovering" alcoholic. Recovering, as in did not have a drink and 3 days and is in the middle of the DTs, or went through AA and has not a drink in 5 years? I know that on the NCLEX you will not have such information, but to make a decision, I think it is important (certainly more important than his cellulits). In short, I don't like the question and I like the rational even less.

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IMO? Question sucks. Rationale sucks. It's been a while, but I remember when studying, that while the Kaplan "process" for how to take the test is helpful, their questions kind of sucked. I'd advise taking the process they teach you (which I think is a helpful strategy) and practice your questions from somewhere else. And don't sweat too much over the occasional question that doesn't make much sense. If it's only occasional, you're on your way to passing. Good luck!

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Thanks for your comments and suggestions.

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