A nurse is caring for a client who has urinary incontinence. Which of the following actions should the nurse take?

Apply corn-starch to the client’s skin.

Allow the client’s skin to air-dry after cleaning.

Clean the client’s skin with a pH-balanced cleanser.

Use hot water to clean the client’s skin.

Answer and Explanation

The Correct Answer is C

Urinary incontinence can lead to skin irritation and breakdown if the skin is not properly cleaned 1. Using a pH-balanced cleanser can help maintain the skin’s natural acidity and prevent irritation.

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Correct Answer is A

Explanation

The chain of infection describes how an infection spreads based on six links of transmission: Infectious Agent, Reservoirs, Portal of Exit, Modes of Transmission, Portal of Entry, and Susceptible Host1. In this case, the client’s mouth is an example of a portal of entry, which is the route by which an infectious agent enters a new host1.

A. Localized warmth at the site of injury B. Sanguineous drainage at the site of injury. C. Palpable pedal pulses below the aﬀected injury site D. Full range of motion at the site of injury

Correct Answer is A

Explanation

Localized warmth is a classic sign of inﬂammation and can indicate the presence of an infection or injury in the aﬀected area. Sanguineous drainage is a type of wound drainage that consists of blood and is not a sign of inﬂammation. Palpable pedal pulses and full range of motion can provide information about the injury, but they are not specific to inﬂammation. Therefore, options b, c, and d are incorrect.

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A nurse is caring for a client who has urinary incontinence. Which of the following actions should the nurse take?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

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