A nurse is preparing to set up a sterile field to change a sterile dressing on a client's abdominal wound. Identify the sequence of steps the nurse should take. (Placethem in the order of performance. Use all the steps.)
Open the innermost lower flap of the sterile kit while standing away from the sterile field.
Open each side flap of the sterile kit individually while pulling to the side.
Open the outside cover of the sterile kit and remove the dust cover.
Grasp the outermost flap of the sterile kit while opening away from the body.
Prepare a dry work surface above the waist level.
The Correct Answer is E,C,D,B,A
Choice E Reason:
Preparing a dry work surface above the waist level. It's crucial to start by selecting and preparing an appropriate area for setting up the sterile field. This surface needs to be clean, dry, and above the waist level to maintain sterility and prevent contamination.
Choice C Reason:
Opening the outside cover of the sterile kit and remove the dust cover. This step involves opening the sterile kit without touching the inside contents to maintain sterility. Removing the outer cover exposes the sterile packaging and prepares for further steps.
Choice D Reason:
Grasping the outermost flap of the sterile kit while opening away from the body. By carefully opening the outermost flap, the nurse ensures that the sterile contents remain protected. Opening away from the body helps prevent accidental contamination from clothing or movements.
Choice B Reason:
Opening each side flap of the sterile kit individually while pulling to the side. Sequentially opening the side flaps maintains the sterile field and allows access to the inner contents without compromising sterility.
Choice A Reason:
Opening the innermost lower flap of the sterile kit while standing away from the sterile field. This final step involves accessing the innermost contents of the sterile kit while maintaining a safe distance to avoid accidental contamination. It ensures the contents within the sterile field remain protected until needed for the dressing change.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A Reason:
“I understand that you decided not to receive blood products.” This response shows empathy and acknowledges the client's decision without judgment. It respects the client's autonomy and decision-making capacity.
Choice B Reason:
“Not receiving blood will slow down your memory.” This statement introduces a potential consequence that may not be accurate or relevant to the client's decision. It is important to provide information, but scare tactics or inaccurate statements may not be helpful.
Choice C Reason:
“Why are you refusing to receive blood products?” While understanding the client's rationale is essential, the initial response should convey empathy and acceptance. Asking why may be appropriate later in the conversation, but starting with understanding is crucial.
Choice D Reason:
“You need to talk with your doctor about this.” While involving the doctor is important, it's essential to address the client's feelings and decisions directly. The nurse can play a supportive role in facilitating communication between the client and the healthcare team.
Correct Answer is C
Explanation
Choice A Reason:
Turning the hearing aid off for 5 min is inappropriate. Turning off the hearing aid may not address the underlying issue of feedback. Adjusting the volume or checking for proper placement is more appropriate.
Choice B Reason:
Cleaning the hearing aid with isopropyl alcohol is inappropriate. While cleaning the hearing aid is important for maintenance, using isopropyl alcohol may damage certain components. It's generally recommended to use a specialized cleaning solution recommended by the hearing aid manufacturer.
Choice C Reason:
Decreasing the volume on the hearing aid is appropriate. The whistling sound, also known as feedback, can occur when the volume is set too high. Lowering the volume should help alleviate the feedback and improve the client's experience with the hearing aid.
D. Soak the hearing aid in warm water.
Soaking a hearing aid in water is not recommended, as it can damage the electronic components. Hearing aids are sensitive to moisture, and water exposure can lead to malfunction.
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