A nurse is preparing a sterile field.
Which of the following actions should the nurse identify as contaminating the field?

Opening the sterile tray by first unfolding the flap furthest from his body.

Holding a sterile item at just above waist level.

Placing a sterile dressing 5 cm (2 in) from the border of the sterile field.

Opening a sterile package directly over the middle of the sterile field.

Answer and Explanation

The Correct Answer is D

Choice A rationale

Opening the sterile tray by first unfolding the flap furthest from the body is a correct practice to avoid reaching over the sterile field, which helps maintain the sterility of the field.

Choice B rationale

Holding a sterile item just above waist level is appropriate as long as the item remains within the sterile field's boundaries. Keeping items at this level helps prevent accidental contamination from lower surfaces.

Choice C rationale

Placing a sterile dressing 5 cm (2 in) from the border of the sterile field is acceptable, as the border is considered non-sterile, and maintaining this distance helps ensure the sterility of the item within the field.

Choice D rationale

Opening a sterile package directly over the middle of the sterile field can lead to contamination. Any particles or contaminants from the package may fall into the sterile field, compromising its sterility. .

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Correct Answer is B

Explanation

Choice A rationale

Keeping the bed flat does not necessarily aid lung expansion and can sometimes increase the risk of aspiration in patients with compromised mobility or cognition.

Choice B rationale

Encouraging the patient to cough frequently helps clear secretions from the lungs, compensating for the diminished function of cilia in elderly patients.

Choice C rationale

Encouraging bed rest can lead to complications such as muscle atrophy, decreased lung capacity, and increased risk of pressure ulcers in elderly patients.

Choice D rationale

Restricting fluid intake to prevent pulmonary congestion is not generally recommended unless there is a specific medical condition requiring fluid restriction, as adequate hydration is vital for overall health.

A. The equipment and supplies used are disposable and clean. B. The nurse will be required to don a sterile gown, mask, and eye shields. C. All organisms have been killed or removed from materials that come in contact with the patient. D. The nurse will do a 10-minute surgical scrub before beginning the procedure.

Correct Answer is C

Explanation

Choice A rationale

While disposable and clean equipment reduce the risk of infection, sterile technique requires that all organisms are killed or removed from materials to achieve an aseptic environment.

Choice B rationale

Sterile gown, mask, and eye shields are required for surgical procedures, but not necessarily for all sterile techniques, such as catheter insertions or dressing changes.

Choice C rationale

Sterile technique ensures that all organisms are killed or removed, creating an aseptic field and preventing infection.

Choice D rationale

A 10-minute surgical scrub is part of pre-surgical preparation but is not required for all sterile procedures.

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A nurse is preparing a sterile field. Which of the following actions should the nurse identify as contaminating the field?

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A nurse is preparing a sterile field.
Which of the following actions should the nurse identify as contaminating the field?