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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A) Limit intake of nuts and legumes: This is incorrect. Nuts and legumes are essential components of a vegan diet, providing important protein, healthy fats, and other nutrients. They should not be limited.
B) Choose foods high in vitamin B12: This is the correct answer. Vitamin B12 is primarily found in animal products, so vegans must seek fortified foods (such as plant-based milks and cereals) or consider supplements to meet their B12 needs, as deficiency can lead to serious health issues.
C) Choose high-fat cheese as a meat substitute: This is misleading. Vegans do not consume cheese, as it is an animal product. Instead, they should look for plant-based alternatives to meet their dietary needs.
D) Limit intake of foods high in vitamin C: This is incorrect. Foods high in vitamin C, such as fruits and vegetables, are encouraged in a vegan diet for overall health and to support the immune system. There is no reason to limit these foods.
Correct Answer is C
Explanation
A. Metallic taste in mouth: This is not a commonly reported adverse effect of sertraline. While some medications may cause changes in taste, it is not characteristic of SSRIs like sertraline.
B. Increased urinary frequency: This is not a typical adverse effect associated with sertraline. While changes in urinary patterns can occur with some medications, it is not specifically noted for sertraline.
C. Excessive sweating: This is a recognized adverse effect of sertraline and other SSRIs. Patients may experience increased sweating, which can be uncomfortable and distressing.
D. Dry cough: This is not a common side effect of sertraline. While some medications may lead to respiratory side effects, it is not typical for SSRIs like sertraline to cause a dry cough.
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