A nurse is caring for a client who requires a sterile dressing change. The nurse should recognize that the surgical field has been contaminated if which of the following actions occur?
A pair of sterile forceps is allowed to rest in a container of sterile water on the field.
The sterile solution is poured with the bottle held over the field.
Unnecessary sterile items are placed on the field.
The handle of a pair of sterile scissors is resting 5 cm (2 in) from the field's edge.
The Correct Answer is B
Rationale:
A. Allowing sterile forceps to rest in a container of sterile does not affect the sterility of the field.
B. Pouring sterile solution with the bottle held over the field is an inappropriate technique since it breaches the sterility of the field.
C. Placing unnecessary sterile items on the field is not ideal, but it does not indicate contamination of the surgical field.
D. The handle of a pair of sterile scissors resting 5 cm (2 in) from the field's edge does not indicate contamination of the surgical field. The scissors should be placed within easy reach of the nurse but should not touch non-sterile items.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Rationale:
A. Bowling is a low-impact activity that may not provide the weight-bearing exercise needed to help prevent osteoporosis.
B. Jogging is a high-impact activity that may not be appropriate for an older adult at risk for osteoporosis due to the potential for joint and bone stress.
C. Passive range-of-motion exercises are not weight-bearing and may not provide the same benefits as weight-bearing exercise.
D. Walking is a weight-bearing exercise that can help to increase bone density and reduce the risk of osteoporosis.
Correct Answer is B
Explanation
Rationale:
A. This response addresses the client's desire to have family visits but does not directly address the client's concerns about end-of-life care.
B. Asking the client to express their expectations about activities related to the end-of-life allows the nurse to understand the client's wishes and concerns and to provide appropriate support.
C. This response addresses the client's need for pain management but does not directly address the client's concerns about end-of-life care.
D. This response addresses the client's need for spiritual support but does not directly address the client's concerns about end-of-life care.
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