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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A) Keep client in semi-Fowler's position with right extremity flat: Keeping the client in a semi-Fowler's position with the extremity flat is not appropriate for managing a compound fracture. Elevating the affected limb, if possible, helps reduce swelling and pain, but the position should also consider overall stability and comfort.
B) Manage pain with oral opioids every 6 hr: Oral opioids are not the best choice for immediate pain management in an emergency setting, especially with a compound fracture. Intravenous pain medications are typically more effective for acute, severe pain in such situations and can provide quicker relief.
C) Check capillary refill hourly for the first 24 hr: Checking capillary refill is important to assess blood flow and perfusion, but hourly checks for 24 hours may not be necessary and can be overly frequent unless specific concerns arise. Monitoring should be based on clinical judgment and the client's condition.
D) Apply a compression dressing over the fracture site: Applying a compression dressing over the fracture site can help control bleeding and stabilize the area. Compound fractures involve an open wound, so controlling bleeding while minimizing the risk of infection is crucial. This intervention is essential in managing the initial trauma before more definitive surgical treatment.
Correct Answer is D
Explanation
A) Irrigate the affected ear with hydrogen peroxide: Irrigating the ear with hydrogen peroxide is not recommended post-myringotomy. This can cause irritation or infection at the surgical site, which could impede healing and potentially worsen the condition.
B) Drink liquids through a straw: Drinking liquids through a straw can create pressure changes in the ear, which is not advisable post-myringotomy. These pressure changes might affect the healing process of the ear.
C) Swimming is permitted after 1 week: Swimming is typically restricted for a longer period post-myringotomy to prevent water from entering the ear, which can lead to infection or interfere with the healing process.
D) Air travel is allowed after 3 weeks: Air travel restrictions are generally recommended for a few weeks post-myringotomy due to pressure changes that occur during flight, which can affect the ear's healing process. Waiting for 3 weeks allows the surgical site to heal sufficiently, reducing the risk of complications from pressure changes.
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