A nurse is caring for a client on a psychiatric unit.
For each potential action, click to specify if the action is indicated or. contraindicated for the client.
Ask the client about the content of their hallucinations.
Instruct the client on expected hygiene practices.
Assess the client for suicidal ideation.
Allow the client to watch TV at a high volume.
Place the client in a room near the activity room.
The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"B"},"E":{"answers":"B"}}
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Explanation: Evisceration is a surgical emergency that occurs when the abdominal contents protrude through the incision site. The nurse should instruct the client to lie supine with his knees flexed to reduce tension on the wound and prevent further damage.
The nurse should also cover the wound with a moist sterile dressing and notify the surgeon immediately. Positioning the client in semi-Fowler's position, covering the wound with a dry sterile dressing, or covering the wound with a transparent dressing are not appropriate actions for evisceration.
Correct Answer is C
Explanation
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