hard · NCLEX-RN safety
A surveillance stool PCR for an asymptomatic 82-year-old female client in the intensive care unit is positive for carbapenem-resistant Enterobacterales (CRE) colonization. The client is alert and oriented, passing soft, formed stool once daily, with a temperature of 98.6 F (37.0 C), blood pressure 118/72 mm Hg, and heart rate 68/min. The provider orders empiric intravenous imipenem/cilastatin and blood, urine, and sputum cultures. Which actions by the nurse demonstrate safe clinical judgment and diagnostic stewardship? Select all that apply.
- Implement contact precautions immediately and post appropriate signage.
- Draw the ordered blood cultures and collect urine and sputum specimens immediately.
- Administer the imipenem/cilastatin after cultures are drawn to ensure early sepsis treatment.
- Question the order for empiric imipenem/cilastatin.
- Clarify with the provider whether the cultures are indicated given the lack of clinical infection cues.
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