A nurse is preparing to perform a capillary blood glucose test for a client who has type 1 diabetes mellitus. Which of the following actions should the nurse take first?

Cleanse the client's finger with an antiseptic swab.

Hold the client's finger in a dependent position.

Wipe away the first drop of blood.

Place the lancet on the side of the selected finger.

Answer and Explanation

The Correct Answer is A

A) Cleanse the client's finger with an antiseptic swab: The first step in performing a capillary blood glucose test is to cleanse the client’s finger with an antiseptic swab. This reduces the risk of infection and ensures that any contaminants on the skin do not affect the accuracy of the blood glucose reading.

B) Hold the client's finger in a dependent position: Holding the finger in a dependent position can help increase blood flow, but this step is taken after cleansing the finger. The priority is to first clean the area to minimize the risk of infection.

C) Wipe away the first drop of blood: Wiping away the first drop of blood is done to avoid contamination from interstitial fluid and to ensure a more accurate reading. However, this action occurs after the blood sample is obtained, not before the test begins.

D) Place the lancet on the side of the selected finger: While placing the lancet on the side of the finger is important for minimizing discomfort and obtaining an adequate blood sample, it follows the initial steps of cleaning the finger and preparing for the blood draw.

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Correct Answer is D

Explanation

A) Drowsiness: While drowsiness can be a symptom of elevated magnesium levels, it is not the most critical finding to report immediately. Drowsiness can be observed with other conditions as well.

B) Diminished patellar reflexes: This can be indicative of hypermagnesemia, but it is a less immediate concern compared to other symptoms. Monitoring reflexes is important, but not the priority.

C) Generalized muscle weakness: Muscle weakness is a common symptom of elevated magnesium levels, but it is less urgent compared to cardiac issues. Although important, it does not pose an immediate risk like bradycardia.

D) Bradycardia: Elevated magnesium levels can cause serious cardiac complications, including bradycardia. This can be life-threatening and requires prompt attention to prevent severe outcomes, making it the priority to report to the provider.

A. Provide a detailed account of the feelings and sounds the client will experience. B. Obtain a prescription for clonazepam. C. Obtain a prescription for ziprasidone. D. Inform the client that the time spent in the MRI machine will only be 5 min.

Correct Answer is B

Explanation

A) Provide a detailed account of the feelings and sounds the client will experience:
While explaining the procedure can be helpful, it might increase anxiety for someone with claustrophobia by focusing on potentially distressing details. It's more effective to use relaxation techniques or medications to manage acute anxiety.

B) Obtain a prescription for clonazepam:
Clonazepam, a benzodiazepine, can help reduce anxiety and is often used to manage claustrophobia during procedures like an MRI. This medication can help the client stay calm and more comfortable during the scan.

C) Obtain a prescription for ziprasidone:
Ziprasidone is an antipsychotic medication and is not typically used for managing situational anxiety or claustrophobia. Using an appropriate anxiolytic like clonazepam is more effective in this context.

D) Inform the client that the time spent in the MRI machine will only be 5 min:
This statement is misleading as MRI scans usually take longer than 5 minutes. Providing inaccurate information can undermine trust and increase anxiety if the procedure takes longer than stated.

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A nurse is preparing to perform a capillary blood glucose test for a client who has type 1 diabetes mellitus. Which of the following actions should the nurse take first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Explanation

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Correct Answer is B

Explanation

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