A nurse caring for a patient who suffered a severe sprain and has an order for a cold pack application to the injured area would prevent patient injury by:.
using heavy pressure on the cold pack for greater effectiveness.
leaving the pack in place for over 30 minutes at a time.
preparing to apply heat instead if cold is not effective.
placing a towel between the pack and the skin.
The Correct Answer is D
Choice A rationale:
Using heavy pressure on the cold pack for greater effectiveness is not the correct approach when applying a cold pack to an injured area. Applying excessive pressure can lead to tissue damage, frostbite, and can be uncomfortable for the patient. Cold packs should be applied with gentle, even pressure to avoid complications.
Choice B rationale:
Leaving the cold pack in place for over 30 minutes at a time is not recommended. Prolonged exposure to cold can also cause tissue damage, including frostbite. It is generally advised to limit cold pack applications to 20-30 minutes at a time to prevent complications.
Choice C rationale:
Preparing to apply heat instead if cold is not effective is not the appropriate action in this scenario. When a healthcare provider orders a cold pack application, it is essential to follow the prescribed treatment plan. Heat should only be considered if it is specifically ordered as an alternative treatment.
Choice D rationale:
Placing a towel between the pack and the skin is the correct approach to prevent patient injury when applying a cold pack. This helps to protect the skin from direct contact with the cold pack, reducing the risk of frostbite or cold-related injuries. It ensures a barrier between the cold pack and the patient's skin, providing a safe and comfortable application.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale:
False. Pain should not be assessed only for patients who complain of pain. Pain assessment should be a routine part of patient care, as not all patients may be able to verbalize their pain or may underreport it. Identifying and addressing pain is crucial for patient well-being.
Choice B rationale:
False. Pain treatment does not necessarily end at discharge. The management of pain may continue beyond the hospital setting, and a plan for pain management post-discharge may be needed. This ensures that patients receive appropriate pain relief and support during their recovery.
Choice C rationale:
True. According to the Joint Commission's standards, all patients have the right to appropriate assessment of pain. This means that every patient, regardless of their condition or the presence of pain complaints, should have their pain assessed and managed as necessary.
Choice D rationale:
False. Pain treatment is not solely based on objective data collected by the nurse. Pain is a subjective experience, and it is essential to consider the patient's self-report of pain, in addition to any objective data, when determining the appropriate treatment. Objective data can help, but it should not be the sole basis for pain management.
Correct Answer is D
Explanation
Choice A rationale:
Sleeping with the window open for fresh air may not be the best solution in this scenario. While fresh air can be beneficial for sleep, it might not effectively block out the noise from the freeway and the nearby apartment complex. Furthermore, depending on the climate and location, having the window open might lead to discomfort or temperature-related issues.
Choice B rationale:
Performing exercise at bedtime is not a recommended solution for someone experiencing difficulty sleeping due to external noise. Exercise before bedtime can increase alertness and make it even more challenging to fall asleep, especially if it's vigorous exercise. It may exacerbate the problem rather than alleviate it.
Choice C rationale:
Having a couple of drinks at bedtime is not a suitable solution for sleep problems. Alcohol can disrupt sleep patterns and lead to poor-quality sleep. It may help the patient fall asleep initially but can lead to frequent awakenings and a less restful night's sleep.
Choice D rationale:
The correct choice is to wear soft earplugs for sleep. Soft earplugs can effectively reduce or block out external noise, providing a quieter sleep environment. This is a practical and safe solution to address the noise issue in the patient's apartment complex. It promotes better sleep quality without any negative side effects.
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