A nurse is collecting data on a client who has impaired mobility.
The nurse should monitor the client for a pressure injury due to which of the following factors?
Decreased serum calcium.
Decreased circulation.
Increased collagen.
Increased muscle mass.
The Correct Answer is B
Choice A rationale:
Decreased serum calcium does not directly contribute to pressure injury development.
Choice B rationale:
Decreased circulation can lead to tissue ischemia and necrosis, increasing the risk of pressure injury.
Choice C rationale:
Increased collagen is beneficial for wound healing and does not increase the risk of pressure injury.
Choice D rationale:
Increased muscle mass can actually provide more padding over bony prominences, reducing the risk of pressure injury.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","D","E"]
Explanation
E. Using a thermometer to check the temperature of the pad, Securing the pad to the patient, Instructing the patient not to sleep on the pad, Inspecting the plug and cord for cracks or fraying.
Choice A rationale:
It’s important to check the temperature of the pad to prevent burns.
Choice B rationale:
Securing the pad ensures it stays in place and provides consistent heat.
Choice C rationale:
Patients should not lie on top of the pad as it can lead to burns.
Choice D rationale:
Patients should not sleep on the pad to prevent prolonged exposure which can lead to burns.
Choice E rationale:
Inspecting the plug and cord prevents electrical hazards.
Correct Answer is A
Explanation
Choice A rationale:
The side-lying position allows gravity to assist in wound irrigation and prevent pooling of the solution.
Choice B rationale:
High-Fowler’s position is not ideal for abdominal wound irrigation as it can lead to pooling of the solution.
Choice C rationale:
In the supine position, the solution can pool around the wound and not effectively irrigate it.
Choice D rationale:
The dorsal recumbent position is not ideal as it can also lead to pooling of the solution.
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