A nurse is preparing to perform a sterile dressing change. Which of the following actions should the nurse take when setting up the sterile field?

Place the sterile dressing within 1.25 cm (0.5 in) of the edge of the sterile field.

Open the outermost flap of the sterile kit toward the body.

Place the cap from the solution sterile side up on a clean surface.

Set up the sterile field 5 cm (2 in) below waist level.

Answer and Explanation

The Correct Answer is C

A. Place the sterile dressing within 1.25 cm (0.5 in) of the edge of the sterile field: This action is not appropriate, as sterile items should be placed at least 2.5 cm (1 in) away from the edge of the sterile field to maintain sterility and prevent contamination.

B. Open the outermost flap of the sterile kit toward the body: The correct practice is to open the outermost flap away from the body. This technique helps prevent any contaminants from the nurse's clothing or body from falling into the sterile field.

C. Place the cap from the solution sterile side up on a clean surface: This is the correct action. By placing the cap sterile side up, the nurse minimizes the risk of contamination to the sterile solution and maintains the integrity of the sterile field.

D. Set up the sterile field 5 cm (2 in) below waist level: Setting up a sterile field below waist level increases the risk of contamination, as it may come into contact with non-sterile surfaces. The sterile field should be set up at waist level or higher to maintain sterility.

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Correct Answer is D

Explanation

A. Enhanced mood: While a better mood can be beneficial for overall well-being, it is not a direct measure of donepezil's effectiveness, which primarily targets cognitive function.

B. Increased food intake: Improved appetite may occur, but it is not a primary indication of the effectiveness of donepezil, which focuses on cognitive enhancement.

C. Can perform ADLs independently: Although increased independence in activities of daily living (ADLs) is positive, it may not solely be attributed to donepezil, as various factors affect a person's ability to perform ADLs.

D. Improved short-term memory: This is the most direct indicator of donepezil's effectiveness, as the medication is designed to improve cognitive function, particularly in individuals with Alzheimer’s disease or other types of dementia. Enhanced short-term memory directly reflects the intended therapeutic effect of the medication.

A. "I can hold my cell phone on the same side of my body as the ICD." B. "I will avoid using my microwave oven at home because of the ICD." C. "I will wear loose clothing over my ICD." D. "I will soak in the tub rather than showering."

Correct Answer is C

Explanation

A) "I can hold my cell phone on the same side of my body as the ICD.": This statement shows a misunderstanding of safety precautions. Clients with an ICD should keep their cell phones on the opposite side of their body from the device to prevent any potential interference.

B) "I will avoid using my microwave oven at home because of the ICD.": This statement indicates a misunderstanding, as microwaves are generally safe to use with an ICD. The concern is primarily with larger electrical devices or magnets that could interfere with the ICD.

C) "I will wear loose clothing over my ICD.": This statement demonstrates understanding. Wearing loose clothing helps to avoid irritation at the implantation site and does not restrict the function of the ICD, making it an appropriate choice for post-discharge care.

D) "I will soak in the tub rather than showering.": This statement reflects a misunderstanding, as soaking in a tub could pose a risk of water entering the incision site, especially during the healing period. Clients are typically advised to shower instead and avoid submerging the device until cleared by their healthcare provider.

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A nurse is preparing to perform a sterile dressing change. Which of the following actions should the nurse take when setting up the sterile field?

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Naxlex Comprehensive Predictor Exams

A nurse in a long-term care facility is providing care for a client who has been receiving donepezil. Which of the following findings indicates that the medication is effective?

Correct Answer is D

Explanation

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Correct Answer is C

Explanation

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