A nurse is preparing a client who has a latex allergy for surgery. Which of the following actions should the nurse plan to take?
Use IV tube ports when injecting medications.
Remove medication from multi-dose vials with the stopper in place.
Secure loose cords in stockinette with tape.
Schedule the client's surgery as the last procedure of the day.
The Correct Answer is A
A. "Use IV tube ports when injecting medications." Latex-free IV ports should be used instead of rubber stoppers found in some IV bags and vials.
B. "Remove medication from multi-dose vials with the stopper in place." Many vial stoppers contain latex, so the nurse should use single-dose vials or vials labeled as latex-free.
C. "Secure loose cords in stockinette with tape." Stockinettes are sometimes made with latex, posing a risk to the client. Non-latex materials should be used instead.
D. "Schedule the client's surgery as the last procedure of the day." Clients with latex allergies should be scheduled first to minimize exposure to airborne latex particles from gloves and equipment used earlier in the day.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. "Intensity of pain levels decrease as people age."
Pain perception does not necessarily decrease with age. Older adults experience pain similarly to younger individuals, but they may express it differently.
B. "The client is less likely to respond to analgesics." Older adults respond to analgesics, but they may be more sensitive to certain medications due to age-related physiological changes. Appropriate dosing and monitoring are essential.
C. "Pain is an expected finding for an older adult." Pain is not a normal part of aging. While some chronic conditions associated with aging can cause pain, it should always be assessed and treated appropriately.
D. "The client may under-report their pain intensity."
Older adults may under-report pain due to factors such as fear of being a burden, belief that pain is a normal part of aging, or concerns about medication side effects. Nurses should use appropriate pain assessment tools to evaluate and address their pain effectively.
Correct Answer is C
Explanation
A. Temperature of 38° C (100.4° F) A slight fever is not a primary sign of internal bleeding. It could be related to infection or another inflammatory response.
B. Respiratory rate of 10/min Internal bleeding is more likely to cause an increased respiratory rate (tachypnea) due to hypoxia rather than a decreased rate.
C. Heart rate of 112/min Tachycardia (HR >100 bpm) is an early sign of internal bleeding. The body increases the heart rate to compensate for blood loss and maintain perfusion.
D. Blood pressure of 136/88 mm Hg While low blood pressure (hypotension) can indicate severe internal bleeding, this BP is within normal range. However, a sudden drop in BP later would be a concerning sign.
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