A nurse is caring for a client who is restrained to each extremity. Which of the following assessments should the nurse perform first?

Elimination needs

Comfort level

Skin integrity

Peripheral pulses.

Answer and Explanation

The Correct Answer is D

When a client is restrained to each extremity, it is important for the nurse to assess the client’s peripheral pulses first to ensure that circulation is not compromised.

Choice A, Elimination needs, is important but not the first priority in this situation.

Choice B, Comfort level, is also important but not the first priority in this situation.

Choice C, Skin integrity, is important but not the first priority in this situation.

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Correct Answer is B

Explanation

Prepare the client for a central venous line.
Parenteral nutrition (PN) with 20% dextrose and fat emulsions is a hypertonic solution that requires infusion through a central venous line to prevent damage to peripheral veins.

Choice A is wrong because the PN infusion bag should be changed every 24 hours, not every 48 hours.

Choice Cis wrong because blood glucose should be monitored more frequently than once daily when initiating PN therapy.

Choice Dis wrong because PN and fat emulsions can be administered together in a total nutrient admixture (TNA)1.

A. Remove the needle from the syringe. B. Recap the needle before disposal. C. Discard the needle in a puncture-proof container. D. Place the needle on the bedside table.

Correct Answer is C

Explanation

After administering an injection, a nurse should discard the needle in a puncture-proof container.
This is a recommended practice to ensure the safety of injections and related practices.
Choice A is wrong because removing the needle from the syringe is not necessary.
Choice B is wrong because recapping the needle before disposal is not recommended as it increases the risk of needlestick injuries.
Choice D is wrong because placing the needle on the bedside table poses a risk of injury and infection.

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A nurse is caring for a client who is restrained to each extremity. Which of the following assessments should the nurse perform first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is planning care for a client who has a new prescription for parenteral nutrition (PN) in 20% dextrose and fat emulsions. Which of the following is an appropriate action to include in the plan of care?

Correct Answer is B

Explanation

A nurse is preparing to administer an injection to a client. Which of the following actions should the nurse plan to take after administering the injection?

Correct Answer is C

Explanation

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