A nurse is obtaining a capillary blood specimen to measure a client's blood glucose. Which of the following actions should the nurse take?

Allow the antiseptic to dry before puncturing.

Apply sterile gloves.

Hold the lancet at a 45° angle.

Massage the client's finger away from the puncture site.

Answer and Explanation

The Correct Answer is A

A. Allow the antiseptic to dry before puncturing.: This is correct. It is important to allow the antiseptic (such as alcohol) to dry before puncturing the skin. If the antiseptic is not allowed to dry, it can cause hemolysis of the blood sample and lead to inaccurate glucose readings.

B. Apply sterile gloves.: This is incorrect. While gloves should be worn to maintain hygiene and safety, non-sterile gloves are sufficient for a capillary blood glucose test. Sterile gloves are not necessary unless the procedure requires aseptic technique.

C. Hold the lancet at a 45° angle.: This is incorrect. The lancet should be held at a 90° angle to the skin to ensure a proper and clean puncture.

D. Massage the client's finger away from the puncture site.: This is incorrect. The finger should not be massaged before or after the puncture site because it can cause tissue damage and lead to inaccurate blood samples due to the mixing of interstitial fluid with the blood sample.

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Correct Answer is A

Explanation

A. Write the information at an 8th-grade reading level.: Health literacy is a key consideration when developing educational materials for the general public. Writing at an 8th-grade reading level ensures the content is accessible and understandable to a wide audience. This increases the likelihood that the target population will comprehend and retain the information.

B. Explain medical terminology using basic, one-syllable words.: While medical terms should be simplified, using only one-syllable words may result in oversimplification and miscommunication. Clear explanations should be provided in layman's terms, but not necessarily using only one-syllable words.

C. Use a 12-point font size.: A 12-point font size is a reasonable choice for readability, but 14-point or larger is often recommended for easier reading, especially for older adults or those with vision impairments.

D. Present information from complex to simple.: It is generally more effective to start with simple, basic concepts and build up to more complex information. Presenting information in a logical, structured manner—starting from the basics—will help the reader better understand the material.

A. Assist the client into a supine position. B. Explain that nonreactivity might require immediate medication administration. C. Remind the client to press the button when she feels fetal movement. D. Tell the client the test should take about 10 min.

Correct Answer is C

Explanation

A. Assist the client into a supine position is incorrect. A supine position can reduce uterine blood flow and may lead to hypotension. The nurse should assist the client into a left-lateral position for optimal results during a nonstress test.

B. Explain that nonreactivity might require immediate medication administration is incorrect. Nonreactivity can indicate fetal distress, but it does not necessarily require medication immediately. Further testing or evaluation would be needed first.

C. Remind the client to press the button when she feels fetal movement is correct. The purpose of the nonstress test is to monitor fetal heart rate acceleration in response to movement. The client is typically instructed to press a button when she feels fetal movement so the nurse can correlate it with fetal heart rate patterns.

D. Tell the client the test should take about 10 min is incorrect. The nonstress test typically takes 20–40 minutes, depending on fetal activity and the need for monitoring.

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A nurse is obtaining a capillary blood specimen to measure a client's blood glucose. Which of the following actions should the nurse take?

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