A nurse is preparing to complete a sterile dressing change for a client's wound. Which of the following actions should the nurse take first?

Open the flap on the sterile kit nearest to the nurse and place the flap on the work surface.

Open the side flap of the sterile kit, allowing it to lie flat on the work surface.

Open the outermost flap of the sterile kit away from the nurse's body

Apply sterile gloves.

Answer and Explanation

The Correct Answer is C

The correct answer is C. Open the outermost flap of the sterile kit away from the nurse's body.

Rationale: The nurse should open the outermost flap of the sterile kit away from their body first, as this will prevent contamination of their clothing or hands by touching any part of

the inside surface or contents of the kit. The nurse should then open each side flap by grasping only its outer edge and pulling it toward them. The nurse should then open the flap nearest to them by grasping only its outer edge and pulling it toward them. The nurse should then apply sterile gloves before touching any part of the inside surface or contents of the kit.

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Correct Answer is C

Explanation

Choice A reason:

"You should administer the medication at bedtime." This statement is incorrect option. Administering methylphenidate at bedtime is not appropriate because it is a stimulant medication, and taking it in the evening could interfere with the child's ability to fall asleep and disrupt their sleep pattern.

Choice Breason:

"Your child should avoid foods containing tyramine. “This statement is incorrect option. Tyramine is not a concern with methylphenidate. Tyramine is associated with certain antidepressant medications, such as MAO inhibitors. Methylphenidate is not a MAO inhibitor, so there is no need for the child to avoid tyramine-containing foods.

Choice Creason:

"You should administer the medication after breakfast." This is the correct option. Administering methylphenidate after breakfast is a common practice because it allows the child to benefit from the medication during school hours when improved attention and focus are needed the most.

Choice Dreason:

"Your child should avoid excess sodium intake." This statement is an incorrect option. Excess sodium intake is not directly related to methylphenidate use. However, it is generally a good idea for anyone, including children, to have a balanced and healthy diet, which may include monitoring sodium intake. But it is not specifically tied to the administration of methylphenidate.

A. Ensure the client swallows each dose of medication. B. Limit the personal toiletries in the client's room to cologne. C. Keep the client's door shut when they are in the room. D. Observe the client's behavior every 2 hr.

Correct Answer is A

Explanation

The correct answer is A.

Ensure the client swallows each dose of medication. A client who recently attempted suicide is at high risk of another suicide attempt and needs closemonitoring and supervision. The nurse should ensure that the client swallows each dose of medication to prevent hoarding or overdosing on pills. The nurse should also remove any potential means of self-harm from the client's room, such as sharp objects, belts, cords, or cologne that contains alcohol. The nurse should keep the client's door open or use a window to observe them at all times, not just every 2 hours.

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A nurse is preparing to complete a sterile dressing change for a client's wound. Which of the following actions should the nurse take first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is teaching a parent of a school-age child who is to begin a daily dose of methylphenidate. Which of the following should the nurse include in the teaching?

Correct Answer is C

Explanation

A nurse is planning care for a client who recently attempted suicide. Which of the following actions should the nurse plan to take?

Correct Answer is A

Explanation

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