A nurse is helping to place a client into the prone position.
The nurse should use a small pillow to relieve pressure from which of the following areas of the client's body?
Heels
Coccyx
Occiput
Breasts
The Correct Answer is D
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
a. To ensure accurate identification and avoid medication errors, the nurse should use at least two patient identifiers, such as the client's full name and date of birth. This information is critical in verifying that the right patient receives the correct medication.
b.While a telephone number could potentially be used as an identifier, it is not typically used in acute care settings due to the possibility of errors or outdated information. It is also not practical as a primary means of patient identification.
c.Knowing the client's room number is important to confirm the correct location of the client in the acute care setting. This helps ensure that the nurse administers the medications to the correct client. However, the room number alone is not sufficient for accurate client identification. Room numbers may change, and multiple clients may share the same room. Relying on the room number alone can lead to errors.
d.While the client's diagnosis is important for understanding their medical condition and providing appropriate care, it is not specifically required for identifying the client when administering medications.
Correct Answer is B
Explanation
Crackles heard in the lungs.
Fluid overload occurs when there is an excessive accumulation of fluid in the body, and it can occur in clients receiving enteral tube feedings. Crackles heard in the lungs, also known as rales, are abnormal lung sounds that can indicate the presence of fluid in the lungs. These crackling sounds occur when there is an excess of fluid in the alveoli or when air passes through fluid- filled airways. Crackles can be heard during auscultation of the lungs using a stethoscope and are a significant sign of fluid overload.
decreased skin turgor in (option A) is incorrect because it, is a sign of dehydration rather than fluid overload. Decreased skin turgor occurs when the skin lacks elasticity and is often seen in clients who are dehydrated.
weight loss in (option C) is incorrect because it, is not typically associated with fluid overload. Fluid overload usually results in weight gain or fluid retention rather than weight loss.
decreased blood pressure in (option D) is incorrect because it, is more commonly associated with hypovolemia or fluid deficit rather than fluid overload. In fluid overload, blood pressure may be elevated due to increased fluid volume.
In summary, crackles heard in the lungs are a manifestation of fluid overload and can be a significant sign for the nurse to assess and address in a client receiving enteral tube feedings.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.