A nurse is assisting the provider with a lumbar puncture for a client who has manifestations of meningitis.
Into which of the following positions should the nurse assist the client?
Arms raised above her head with her legs elevated on pillows.
Trendelenburg with her body in Sims' position.
Prone with her arms at her side and her legs extended.
Head flexed to the chest and her knees pulled up to the abdomen.
The Correct Answer is D
Choice A rationale:
Placing the client's arms raised above her head with her legs elevated on pillows (choice A) is not the correct position for a lumbar puncture. This position does not facilitate proper alignment of the spine and may hinder the procedure.
Choice B rationale:
The Trendelenburg position with the body in Sims' position (choice B) is not the correct position for a lumbar puncture. This position is not commonly used for lumbar punctures and may not provide the necessary anatomical alignment for a successful procedure.
Choice C rationale:
Placing the client prone with her arms at her side and her legs extended (choice C) is not the appropriate position for a lumbar puncture. This position does not allow for proper access to the lumbar region and may impede the procedure.
Choice D rationale:
The correct position for a lumbar puncture is to have the client flex their head to the chest and pull their knees up to the abdomen (choice D) This position maximizes the space between the lumbar vertebrae, making it easier for the provider to access the subarachnoid space for cerebrospinal fluid collection.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale:
Avoiding the use of draw sheets for repositioning is not a direct intervention for managing urinary incontinence. Draw sheets are typically used for repositioning and preventing pressure injuries. Managing urinary incontinence involves strategies such as toileting schedules, absorbent products, and perineal care.
Choice B rationale:
Limiting periods of sitting in a chair to 4 hours is a general guideline for preventing pressure ulcers in individuals with limited mobility, but it is not specific to managing urinary incontinence. Clients with urinary incontinence may need to sit in chairs for extended periods, and it is essential to address incontinence management separately.
Choice C rationale:
Using a no-rinse perineal cleanser after incontinence is an appropriate intervention for maintaining skin hygiene and preventing irritation in individuals with urinary incontinence. No-rinse cleansers are designed to clean the perineal area without the need for rinsing, making them convenient for incontinence care. Choice D
Correct Answer is C
Explanation
Choice A rationale:
Rigid abdomen. A rigid abdomen is not typically associated with placenta previa. Placenta previa is a condition in which the placenta partially or completely covers the cervix, and it is more likely to present with painless vaginal bleeding rather than abdominal rigidity.
Choice B rationale:
Persistent uterine contractions. Persistent uterine contractions are not a characteristic finding in placenta previa. In fact, uterine contractions can be concerning in the presence of placenta previa as they may increase the risk of bleeding.
Choice C rationale:
Bright red vaginal bleeding. Bright red vaginal bleeding is a common and hallmark symptom of placenta previa. This bleeding typically occurs without pain and can be intermittent or continuous. It is essential to recognize this symptom promptly because it can lead to significant maternal and fetal complications.
Choice D rationale:
Increased fetal movement. Increased fetal movement is not a typical finding in placenta previa. The presence or absence of fetal movement should always be monitored during pregnancy, but it is not a specific indicator of placenta previa.
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