A nurse is caring for a client who has a new prescription for a belt restraint. Which of the following actions should the nurse take?
Make sure four fingers fit between the restraint and the client's body.
Apply the belt restraint over the client's gown.
Check the client's skin integrity every 4 hr.
Tie the belt restraint to the side rail of the bed.
The Correct Answer is B
Rationale:
A. Ensuring that four fingers fit between the restraint and the client's body is important to prevent injury and discomfort.
B. Applying the belt restraint over the client's gown may lead to slippage and ineffective restraint.
C. Checking the client's skin integrity every 4 hours is important, but it is not specific to the use of a belt restraint.
D. Tying the belt restraint to the side rail of the bed is not appropriate because it can restrict movement and cause injury.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Rationale:
A. Ensuring that the stool specimen does not contain urine helps to prevent false-positive results, as blood from urine could interfere with the test.
B. Each fecal occult blood test should be performed using a fresh stool specimen to ensure accuracy.
C. Having the client defecate into a bedpan with water is unnecessary and may interfere with the test.
D. Standard precautions, including wearing gloves, are sufficient for handling stool specimens; sterile gloves are not required for this procedure.
Correct Answer is B
Explanation
Rationale:
A. Taking a 1-hour nap each day may disrupt the client's sleep-wake cycle and make it more difficult to sleep at night.
B. Drinking a glass of milk before bedtime can promote sleep because milk contains tryptophan, an amino acid that can help induce sleep.
C. Taking a long walk before bedtime may increase the client's energy level and make it more difficult to sleep.
D. Watching television in bed can disrupt the client's sleep-wake cycle and make it more difficult to sleep.
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