A nurse is preparing to check the capillary blood glucose level of a school-age child. Which of the following actions should the nurse plan to take?
Allow the skin antiseptic to dry prior to puncturing the child's finger.
Place a cool washcloth on the child's finger for 5 min prior to the procedure.
Test the first drop of blood obtained after puncturing the child's finger.
Puncture the center of the pad of the child's index finger.
The Correct Answer is A
Choice A rationale:
The correct answer is choice A. This action is crucial to ensure accurate capillary blood glucose testing. Allowing the skin antiseptic to dry before puncturing the child's finger helps prevent contamination of the blood sample, which can lead to inaccurate results. Wet antiseptic can dilute the blood sample and affect the glucose reading.
Choice B rationale:
This choice is incorrect because placing a cool washcloth on the child's finger is not standard practice before capillary blood glucose testing. While warmth can help increase blood flow and make the puncture process more comfortable, using a cool washcloth is not recommended, as it may constrict blood vessels and make it harder to obtain a sufficient blood sample.
Choice C rationale:
This choice is incorrect because testing the first drop of blood obtained after puncturing the child's finger is not recommended. The first drop of blood can be diluted with interstitial fluid and may not provide an accurate glucose reading. It's important to wipe away the first drop and use the subsequent drop of blood for testing.
Choice D rationale:
This choice is incorrect because puncturing the center of the pad of the child's index finger is not the recommended site for capillary blood glucose testing. The sides of the fingertip contain an adequate blood supply and are less painful for the child. Puncturing the center of the fingertip can be more painful and may not yield a sufficient blood sample.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale:
This statement reflects an accurate understanding of varicella (chickenpox) transmission and infection control. The lesions of varicella contain the virus and are contagious until they have crusted over. Allowing the child to go to the playroom only after the lesions have crusted helps prevent the spread of the virus to other individuals.
Choice B rationale:
This statement is incorrect because waiting for the crusts to fall off the lesions before bathing the child is not necessary. In fact, keeping the lesions clean and maintaining proper hygiene through gentle bathing can help prevent secondary bacterial infections.
Choice C rationale:
This statement is incorrect because bedrest for 3 days is not necessary for a child with varicella. While it's important to minimize contact with others during the contagious phase, physical activity can be gradually resumed as long as the lesions have crusted to prevent transmission.
Choice D rationale:
This statement is incorrect. Once a person has had chickenpox (varicella), they develop immunity to the virus and do not need to wear a mask when visiting someone with active varicella. This is because they are already immune to the virus due to their prior infection.
Correct Answer is A
Explanation
Choice A rationale:
After a tonic-clonic seizure, it's common for the person to inadvertently bite their tongue, cheeks, or lips during the convulsive movements. Checking the mouth for any signs of bleeding or injuries is essential to ensure the person's safety and provide appropriate care.
Choice B rationale:
Placing the child's head in a hyperextended position is not recommended after a seizure. In fact, it's important to keep the person's head and neck in a neutral position to prevent potential injury. Hyperextending the neck could lead to strain or other complications.
Choice C rationale:
Giving the child a drink of water immediately after a seizure is not necessary and might be unsafe. The child may still be disoriented or have difficulty swallowing immediately after the seizure. It's best to ensure the child's safety and monitor their condition before offering any fluids.
Choice D rationale:
Administering naloxone intramuscularly is not indicated for a tonic-clonic seizure. Naloxone is an opioid antagonist used to reverse the effects of opioid overdose. Seizures have a different underlying cause, and administering naloxone would not be effective or appropriate in this context.
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