A nurse is caring for a client who has a peritoneal catheter that requires a dressing change. Identify the sequence of actions the nurse should take. (Move the steps into the box on the right, placing them in the order of performance. Use all the steps.)
Remove the old dressing.
Create a sterile field.
Apply precut gauze pads to the site.
Mask self and the client.
The Correct Answer is D,A,B,C
the correct sequence is D, A, B, C. Rationale: D (Mask self and the client): First, both the nurse and the client should wear masks to reduce the risk of infection during the procedure. A (Remove the old dressing): Next, the old dressing should be removed to expose the site. B (Create a sterile field): After removing the old dressing, a sterile field is created to maintain aseptic conditions. C (Apply precut gauze pads to the site): Finally, sterile precut gauze pads are applied to the site to protect the catheter.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. "Place the patch on your upper arm": Transdermal scopolamine patches are typically applied behind the ear, not on the upper arm. Placing the patch behind the ear allows for optimal absorption of the medication through the skin.
B. "Replace a dislodged patch onto the same location": If the patch becomes dislodged, it should not be reattached. Instead, a new patch should be applied to a different area behind the ear to prevent skin irritation and ensure continuous drug delivery.
C. "Apply the patch prior to traveling": This is the correct instruction. Transdermal scopolamine patches are applied to the skin at least 4 hours before travel to prevent motion sickness during the journey. Applying the patch in advance allows time for the medication to be absorbed into the bloodstream and provide effective symptom relief.
D. "Store unused patches in the refrigerator": Transdermal scopolamine patches do not typically require refrigeration. They should be stored at room temperature in a cool, dry place. Refrigeration may alter the integrity of the patch and affect its effectiveness.
Correct Answer is D
Explanation
D. "During this test, I will push a button if my baby moves."
Rationale:
A. "This test will tell me if my baby has a genetic problem." - Nonstress testing (NST) is used to evaluate fetal well-being by assessing fetal heart rate accelerations in response to fetal movement. It does not diagnose genetic problems.
B. "I will get oxytocin during this test." - Oxytocin is not typically administered during nonstress testing. NST is a non-invasive procedure that involves placing a fetal heart rate monitor on the mother's abdomen to monitor the baby's heart rate.
C. "During this test, I must not eat or drink anything." - While it's generally recommended to have a snack or meal before the test to encourage fetal movement, fasting is not required for NST unless otherwise instructed by the healthcare provider.
D. "During this test, I will push a button if my baby moves." - This statement demonstrates an understanding of how NST works. The client is instructed to push a button whenever they feel fetal movement, allowing the healthcare provider to correlate fetal movement with changes in the fetal heart rate pattern.
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