A nurse is preparing a sterile field for a client who requires a dressing change. Which of the following actions should the nurse plan to take?
Drop the sterile gauze from 25.4 cm (10 in) above the sterile field.
Hold the sterile package in his dominant hand and open the top flap of the package toward his body.
Place objects 1.27 cm (0.5 in) inside the border of the sterile field.
Position the bottle outside the edge of the sterile field when pouring solution into a sterile container.
The Correct Answer is A
Rationale:
A. Drop the sterile gauze from 25.4 cm (10 in) above the sterile field: Dropping sterile items from a height of about 6 to 12 inches prevents contamination by keeping hands outside the sterile field and ensuring the item lands safely without touching nonsterile surfaces.
B. Hold the sterile package in his dominant hand and open the top flap of the package toward his body: The top flap should be opened away from the nurse’s body to maintain sterility and prevent the arm from crossing over the sterile field, which would risk contamination.
C. Place objects 1.27 cm (0.5 in) inside the border of the sterile field: The outer 2.5 cm (1 inch) of the sterile field is considered contaminated. Placing items only 0.5 inches inside this border would place them within the contaminated zone, risking sterile field compromise.
D. Position the bottle outside the edge of the sterile field when pouring solution into a sterile container: While the bottle should not touch the sterile field, it must be close enough to pour without splashing, and the sterile container must be inside the sterile field.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["8"]
Explanation
Calculation:
Desired dose = 40 mg.
Available concentration = 5 mg/mL.
- Calculate the volume to administer.
Volume (mL) = Desired dose (mg) / Available concentration (mg/mL)
= 40 mg / 5 mg/mL
= 8 mL.
Correct Answer is D
Explanation
Rationale:
A. "Every so often, I think about whether or not to have this surgery.": This statement suggests the client is still ambivalent or uncertain, which means informed consent has not yet been fully achieved. Clients must be sure and fully informed before agreeing to proceed.
B. "I will talk with the doctor about my surgery when I get into the operating room.": Informed consent must be obtained well before the procedure begins. Waiting until the operating room is inappropriate, as the client may be under stress or sedation.
C. "Can you tell me more about the surgery I am having?": This indicates the client lacks essential information about the procedure. Informed consent requires that the client already understand the nature, risks, benefits, and alternatives before signing.
D. "Signing this form indicates that I give my permission for the surgery, right?": This reflects an understanding that the consent form gives legal authorization for the procedure. It shows the client knows their signature confirms informed agreement to the surgery.
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