A nurse is preparing to obtain a postprandial blood glucose level from a client who has diabetes mellitus. Which of the following actions should the nurse take?
Clean the client's finger with hexachlorophene.
Apply the first drop of blood to the test strip.
Hold the client's finger in a dependent position.
Prick the central tip of the client's finger.
The Correct Answer is C
A. Clean the client's finger with hexachlorophene: Hexachlorophene is not recommended for cleaning the skin before blood glucose testing; a mild soap and water or an alcohol swab is typically used.
B. Apply the first drop of blood to the test strip: The first drop of blood is often not used due to potential contamination; the nurse should usually wipe away the first drop and use the second one.
C. Hold the client's finger in a dependent position: This is correct as holding the finger downward can help increase blood flow to the fingertip, facilitating easier blood collection.
D. Prick the central tip of the client's finger: Pricking the central tip can be painful; the sides of the fingertip are preferred for less discomfort and to avoid nerve endings.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Limit physical activity until bladder continence is achieved: Limiting physical activity is not recommended and can impact overall health. Encouraging regular activity may help improve bladder function and overall well-being.
B. Encourage the client to contract the abdominal muscles when they experience the urge to void: Contracting the abdominal muscles is not typically recommended for managing incontinence. The focus should be on bladder training and strengthening the pelvic floor muscles.
C. Instruct the client to void as soon as they feel the urge: This approach may not support bladder training, which aims to increase the time between voids to improve bladder control.
D. Instruct the client to void at scheduled times throughout the day: This is correct as scheduled voiding helps retrain the bladder, gradually increasing the intervals between voids and improving continence.
Correct Answer is A
Explanation
A. Dyspnea: This is correct as dyspnea (difficulty breathing) can be a sign of fluid overload, particularly when excess fluid accumulates in the lungs.
B. Pruritus: This is more indicative of an allergic reaction rather than fluid overload.
C. Fever: This is often associated with transfusion reactions or infection, not specifically fluid overload.
D. Bradycardia: This is less commonly associated with fluid overload and more often seen in other conditions or complications.
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