A nurse is mentoring a new nurse who is learning to start IVs. The nurse tells the new nurse that in case the patient needs subsequent venipuncture sites, the best place to initially start an IV is the:

most appropriate distal vein on the nondominant arm.

most appropriate proximal vein available on either arm.

antecubital vein of the patient's nondominant arm.

antecubital vein of the patient's dominant arm.

Answer and Explanation

The Correct Answer is A

A. Distal veins, such as those in the hand or forearm of the nondominant arm, are often preferred for initial IV placement. These veins are typically smaller but can be easier to access and cause less discomfort for the patient compared to more proximal veins.

B. Proximal veins, such as those in the upper arm (brachial or basilic veins), may be considered if distal veins are not accessible or suitable. However, proximal veins are larger and can be more difficult to cannulate, potentially causing more discomfort and increasing the risk of complications.

C. The antecubital veins, located in the bend of the elbow, are commonly used for venipuncture due to their accessibility and size. The antecubital vein of the nondominant arm is often preferred to minimize interference with the patient's daily activities and reduce the risk of complications associated with frequent use of the dominant arm.

D. While the antecubital vein of the dominant arm may also be accessible, it is generally recommended to preserve this area for procedures that require a higher level of dexterity and strength. Frequent venipuncture in the dominant arm can lead to discomfort and potential complications, such as phlebitis or thrombosis.

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Correct Answer is C

Explanation

C. This method is recommended because it is less painful, as the sides of the fingertips have fewer nerve endings compared to the pads or 'balls' of the fingers.

A. Avoiding the use of the thumbs is not necessary unless they are calloused or used frequently for other tasks that could affect sensitivity.

B. Avoiding the use of the dominant hand's fingers are not necessary unless they are calloused or used frequently for other tasks that could affect sensitivity.

D. Using the ball of the finger is not recommended for blood glucose monitoring because it can be more painful and may lead to less blood flow, resulting in difficulty obtaining an adequate blood sample.

A. Ask the provider to prescribe diphenhydramine as a precaution. B. Confirm with the client that the reaction he had was truly anaphylaxis. C. Administer the medication. D. Notify the provider to request a different antibiotic.

Correct Answer is D

Explanation

D. The nurse should promptly notify the healthcare provider to discuss the allergy history and request an alternative antibiotic that is not structurally related to penicillin or cephalosporins. Examples of alternative antibiotics may include antibiotics from different classes such as macrolides or fluoroquinolones, depending on the indication and sensitivity profile.

A. Diphenhydramine (Benadryl) is an antihistamine that can help manage allergic reactions. However, it should not be used as a standalone precautionary measure for a client with a history of anaphylaxis to penicillin. Anaphylaxis is a severe allergic reaction that can lead to life-threatening symptoms such as difficulty breathing, swelling, and low blood pressure.

B. Before taking any further steps, the nurse should clarify and confirm the nature and severity of the client's allergic reaction to penicillin. Anaphylaxis is a serious allergic reaction characterized by rapid onset and potentially life-threatening symptoms. Clarifying the history ensures accurate decision- making regarding the administration of cephalexin.

C. This is not recommended without further clarification and assessment. Given the history of anaphylaxis to penicillin, there is a significant risk of cross-reactivity with cephalosporins like cephalexin. Cephalosporins have a structural similarity to penicillin and can provoke allergic reactions in individuals with penicillin allergy, including anaphylaxis.

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A nurse is mentoring a new nurse who is learning to start IVs. The nurse tells the new nurse that in case the patient needs subsequent venipuncture sites, the best place to initially start an IV is the:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reinforcing teaching with a client who has diabetes mellitus about using a glucometer to monitor her blood glucose. Which of the following actions should the nurse identify as an indication that the client understands the instructions?

Correct Answer is C

Explanation

Correct Answer is D

Explanation

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