A nurse is observing a new nurse irrigate a client's wound. Which of the following actions should the nurse identify as an indication that the new nurse understands wound irrigation?
Cleanses the wound with povidone-iodine on cotton balls
Administers analgesia PO 20 min prior to irrigation
Warms the irrigation solution in the microwave prior to application
Irrigates the wound from the cleanest to the most contaminated area
The Correct Answer is D
Choice A reason: Cleansing wounds with povidone-iodine on cotton balls is not recommended because it can damage granulation tissue and delay healing. Cotton fibers may also remain in the wound, increasing infection risk.
Choice B reason: Administering analgesia prior to irrigation is appropriate for pain management but does not directly demonstrate correct irrigation technique. While important, it is not the best indicator of proper wound irrigation practice.
Choice C reason: Warming irrigation solution in the microwave is unsafe because it can cause uneven heating and burns. Solutions should be warmed to room temperature using safe methods, not microwaves.
Choice D reason: Irrigating from the cleanest to the most contaminated area is the correct technique. This prevents the spread of microorganisms from contaminated areas into clean tissue, promoting healing and reducing infection risk.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Clients do not need provider approval to sign advance directives. Advance directives are legal documents that reflect the client’s autonomy and do not require medical authorization.
Choice B reason: Clients do not need to contact the court to change a living will. They can revise or revoke their advance directives at any time as long as they are competent to make decisions.
Choice C reason: Appointing a health care surrogate is correct. This allows clients to designate someone to make medical decisions on their behalf if they become unable to do so, ensuring their wishes are respected even during periods of impaired judgment.
Choice D reason: Clients are not required to designate a guardian to initiate advance directives. Guardianship is a legal process separate from advance directives and is not necessary unless the client has been deemed legally incompetent.
Correct Answer is A
Explanation
Choice A reason: Art therapy is particularly effective for clients with schizophrenia who struggle to verbalize emotions. Creative expression through art provides a nonverbal outlet for feelings and can enhance communication, self-awareness, and emotional regulation. This makes option A the correct answer.
Choice B reason: A speech-language pathologist focuses on communication disorders related to speech, language, and swallowing. While helpful for clients with speech impairments, this referral does not address emotional expression difficulties in schizophrenia. This option is incorrect.
Choice C reason: A social worker assists with social services, housing, and community resources. While valuable for overall support, this referral does not directly address the client’s difficulty expressing feelings. This option is incorrect.
Choice D reason: A recreational therapist focuses on leisure activities to improve socialization and quality of life. While beneficial, recreational therapy does not specifically target emotional expression. This option is incorrect.
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