A nurse is caring for a client who is in contact isolation. When exiting the client's room, in what order should the nurse take the following steps when removing her personal protective equipment? (Move the nursing actions into the box on the right, placing them in the selected order of performance. All steps must be used.)
Remove gloves.
Remove protective eyewear.
Remove gown.
Remove mask
Perform hand hygiene.
The Correct Answer is A,B,C,D,E
When removing personal protective equipment (PPE) after caring for a client in contact isolation, the nurse should follow the steps in the following order:
1. Remove gloves.
2. Remove protective eyewear.
3. Remove gown.
4. Remove mask.
5. Perform hand hygiene.
By following this sequence, the nurse ensures that the removal of PPE is done in a way that minimizes the risk of contamination. Removing gloves first helps prevent the spread of potential contaminants on the hands. Removing protective eyewear next avoids any potential contact with the face or eyes during the removal process. Removing the gown comes next, followed by the mask. Lastly, performing hand hygiene after removing all PPE helps ensure the hands are thoroughly cleaned.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Elevating the head of the bed to a semi-Fowler's or high Fowler's position helps prevent aspiration during the feeding. This position facilitates proper digestion and reduces the risk of
regurgitation or reflux. It allows gravity to assist in keeping the feeding in the stomach and reduces the likelihood of complications.
The other actions mentioned are also important steps in the process but should be performed after elevating the head of the bed:
Measure stomach contents: This step is usually done before administering any enteral feeding to check for the presence of residual gastric contents. It helps determine if the client is tolerating previous feedings and guides adjustments in the feeding volume or rate if needed.
Return gastric content into the gastrostomy tube: If there is a significant amount of gastric residual, it is recommended to return the contents into the stomach before administering the feeding. This helps ensure that the client receives the full prescribed amount of the enteral feeding.
Flush the tube with water: Flushing the gastrostomy tube with water before and after the feeding helps maintain tube patency, clears any residual feeding or medication, and prevents clogging.
Correct Answer is A
Explanation
The manifestation of gastrointestinal perforation includes severe upper abdominal pain. This can be a significant symptom indicating a potential perforation in the gastrointestinal tract. It is important to note that gastrointestinal perforation is a medical emergency that requires immediate attention and intervention.
Hyperactive bowel sounds: This finding is more commonly associated with conditions like bowel obstruction or gastroenteritis rather than gastrointestinal perforation.
Bradycardia: Bradycardia (slower than normal heart rate) is not a typical manifestation of gastrointestinal perforation. It may be associated with other conditions or factors.
Report of epigastric fullness: Epigastric fullness can be a symptom of various gastrointestinal conditions, including peptic ulcer disease itself. However, it is not a specific manifestation of gastrointestinal perforation.
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