A nurse is assisting with the care of a client who is experiencing a cardiac arrest. Which of the following tasks should the nurse assign to an assistive personnel?

Perform CPR on the client.

Assist with airway intubation.

Place defibrillator pads on the client.

Maintain IV access.

Answer and Explanation

The Correct Answer is A

A) Perform CPR on the client:

Performing CPR is a critical intervention during cardiac arrest to maintain circulation and oxygenation. Assistive personnel are trained in basic CPR techniques and can effectively administer chest compressions according to established protocols. Assigning this task to assistive personnel allows the nurse to focus on other aspects of resuscitation and coordination of care.

B) Assist with airway intubation:

Airway intubation requires specialized training and skills, typically performed by licensed healthcare providers such as nurses or physicians. While assistive personnel may assist with preparing equipment or positioning the client, they are not trained to perform airway intubation procedures.

C) Place defibrillator pads on the client:

Placing defibrillator pads requires knowledge of proper positioning and electrode placement to deliver effective defibrillation shocks. This task is typically performed by healthcare providers with training in advanced cardiac life support (ACLS). Assistive personnel may assist with tasks such as preparing the client's chest and clearing the area for defibrillation, but they do not typically apply the pads themselves.

D) Maintain IV access:

Maintaining IV access involves monitoring the IV site, adjusting flow rates, and administering medications or fluids as ordered. While assistive personnel may assist with tasks related to IV access, such as holding the IV bag or adjusting tubing, they are not typically responsible for the overall management and maintenance of IV access during a cardiac arrest situation.

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Free Nursing Study Resources

Correct Answer is ["A","B","C"]

Explanation

A) Ensure the client wears nonskid slippers when walking around the house:

Wearing nonskid slippers can help improve traction and stability, reducing the risk of slips and falls, especially on smooth or slippery surfaces commonly found in homes. Ensuring the client wears nonskid slippers is a proactive measure to prevent falls.

B) Install a raised toilet seat in the client's bathroom:

A raised toilet seat can make it easier for older adults with mobility issues to sit down and stand up from the toilet safely. It reduces the distance the client needs to lower themselves, decreasing the risk of falls, especially for those with balance or strength limitations.

C) Encourage an annual review of the medications the client is taking:

Medication review is essential to identify any medications that may increase the risk of falls due to side effects such as dizziness, drowsiness, or orthostatic hypotension. An annual review ensures that any potential fall-inducing medications can be identified and addressed promptly.

D) Attach full-length side rails to the client's bed:

While side rails may prevent falls out of bed, they can also increase the risk of entrapment and injury. The use of side rails is controversial and should be based on individualized assessment and risk-benefit analysis. In many cases, alternative interventions to prevent falls should be considered before resorting to side rails.

E) Place throw rugs on uncarpeted floors in the client's home:

Throw rugs can be tripping hazards, especially for older adults with mobility issues. They can easily slip or bunch up, leading to falls. Removing throw rugs or securing them firmly to the floor is recommended to reduce the risk of falls in the home.

A. Tying the restraint to the bed frame B. Applying the restraint over the client's gown C. Placing the restraint across the client's chest D. Using a quick-release knot to secure the restraint

Correct Answer is C

Explanation

A) Tying the restraint to the bed frame: This action is appropriate and ensures that the restraint is anchored securely to the bed frame, preventing the client from removing it independently. Tying the restraint to the bed frame is a standard practice to maintain the client's safety.

B) Applying the restraint over the client's gown: While it's generally preferable to apply restraints directly to the client's skin to minimize movement and ensure effectiveness, applying the restraint over the gown is acceptable in some situations. However, it's essential to ensure that the restraint is snug and properly secured to prevent the client from slipping out of it.

C) Placing the restraint across the client's chest: Placing the restraint across the client's chest is not recommended because it can restrict chest expansion and interfere with breathing, potentially leading to respiratory compromise. Restraints should be applied to minimize movement while allowing the client to breathe comfortably.

D) Using a quick-release knot to secure the restraint: Using a quick-release knot is essential when applying restraints to ensure that they can be quickly removed in case of an emergency or if the client experiences distress. This promotes client safety and allows for rapid intervention if needed.

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