A nurse is caring for a client who is sitting in a chair and asks to return to bed.
Which of the following actions is the nurse's priority?
Obtain a walker for the client to use to transfer back to bed.
Call for additional staff to assist with the transfer.
Use a transfer belt and assist the client back into bed.
Determine the client's ability to help with the transfer.
The Correct Answer is C
Choice A rationale:
Squeezing the handles together is incorrect. This action alone does not activate the fire extinguisher and will not help in extinguishing the fire. Proper operation of a fire extinguisher involves specific steps to effectively put out the fire.
Choice B rationale:
Pulling the pin found between the handles is a necessary step, but it is not the first step. Before pulling the pin, the nurse should aim the nozzle at the base of the flames to ensure effective fire suppression.
Choice C rationale:
Aiming the nozzle at the base of the flames is the first step. Directing the extinguisher nozzle at the base of the fire is crucial because it targets the source of the flames. By doing so, the nurse can smother the fire and prevent it from spreading further.
Choice D rationale:
Sweeping the nozzle back and forth at the base of the flames is the correct technique after aiming the nozzle at the base of the fire. This sweeping motion helps cover the entire area of the fire and ensures that all flames are properly extinguished.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale:
Airborne transmission typically involves smaller particles that can remain suspended in the air for longer periods. Sneezing, in this case, usually produces smaller droplets that can travel farther distances and potentially infect individuals beyond a few feet away.
Choice B rationale:
Direct contact transmission occurs when there is physical contact between an infected person and a susceptible individual. In this scenario, the infected drainage from the client's wound directly touches the nurse's cut, leading to infection. This type of transmission is characterized by the transfer of microorganisms through physical touch or contact with the skin.
Choice C rationale:
Droplet contact transmission involves larger respiratory droplets that are expelled when a person coughs, sneezes, or talks. These droplets typically do not travel far and can only infect people who are in close proximity. In this case, the scenario describes a client coughing on their hand and another person becoming infected by touching the contaminated door handle. This aligns with direct contact transmission rather than droplet contact transmission.
Choice D rationale:
Indirect contact transmission refers to the transfer of an infectious agent from a contaminated surface or object to a susceptible person. However, the scenario provided does not involve the nurse coming into contact with a contaminated surface but rather with the infected drainage directly. Therefore, this scenario is best categorized under direct contact transmission.
Correct Answer is ["A"]
Explanation
Choice A rationale:
Maintaining the patency of the client's airway is the priority action. During a seizure, the client may lose consciousness and have difficulty breathing. Ensuring a clear airway is essential to prevent hypoxia and maintain oxygenation. This can be achieved by positioning the client on her side and removing any obstructions from her mouth to allow for adequate airflow.
Choice B rationale:
Identifying the poison the client ingested is important for providing appropriate medical treatment, but it is not the priority action in this scenario. Airway management takes precedence because it addresses the immediate threat to the client's life.
Choice C rationale:
Measuring the client's blood pressure is a necessary assessment, but it is not the priority during an active seizure. Airway management and seizure control are the immediate concerns. Once the seizure is controlled and the airway is secured, other assessments, including blood pressure measurement, can be performed.
Choice D rationale:
Positioning the client on her side is a correct action, but it should be done after ensuring the patency of the airway. Placing the client on her side helps prevent aspiration in case of vomiting during or after the seizure. However, it is not the priority over ensuring the client can breathe properly.
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