A nurse is providing postmortem care for a client prior to the family viewing the body. Which of the following actions should the nurse take?

Raise the head of the client's bed to 30 degrees.

Cleanse the client's body while wearing sterile gloves

Remove the client's dentures and close their mouth

Apply surgical tape to the client's eyes

Answer and Explanation

The Correct Answer is A

After a patient dies, postmortem care includes preparing them for family viewing. The nurse should place the body in the supine position, with the arms at the sides and the head on a pillow. Then elevate the head of the bed 30 degrees to prevent discoloration from blood settling in the face .

The other options are not correct because:

b) The nurse should cleanse the client's body while wearing appropriate personal protective equipment (PPE) based on indications for isolation precautions, not necessarily sterile gloves.

c) If the patient wore dentures and your facility’s policy permits, gently insert them; then close the mouth

d) The nurse should close the eyes by gently pressing on the lids with their fingertips. If they don’t stay closed, place moist coton balls on the eyelids for a few minutes, and then try again to close them. Surgical tape is not mentioned as necessary .

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Correct Answer is B

Explanation

A nurse collecting data for a client following electroconvulsive therapy should expect that the client may experience confusion as an adverse eﬀect. Confusion is a common side eﬀect of electroconvulsive therapy and can last for minutes to hours after treatment.

The other options are not typical adverse eﬀects of electroconvulsive therapy.

a) Vomitingis not a typical adverse eﬀect of electroconvulsive therapy.

c) Incontinenceis not a typical adverse eﬀect of electroconvulsive therapy.

d) Tinnitusis not a typical adverse eﬀect of electroconvulsive therapy.

A. Collect 2 ml of sputum in an emesis basin B. Instruct the client to rinse with an antiseptic mouthwash prior to specimen collection C. Swab the oropharynx with a sterile swab D. Refrigerate the specimen until the time of transport to the laboratory

Correct Answer is D

Explanation

Answer: (D) Refrigerate the specimen until the time of transport to the laboratory

Rationale:

A) Collect 2 ml of sputum in an emesis basin: While it is important to collect an adequate volume of sputum, using an emesis basin is inappropriate for collecting a specimen for culture and sensitivity. Sputum must be collected in a sterile container to avoid contamination, ensuring the accuracy of the culture results.

B) Instruct the client to rinse with an antiseptic mouthwash prior to specimen collection: Using an antiseptic mouthwash before collecting a sputum specimen is not recommended, as it could contaminate the sample with antiseptic agents, potentially affecting the growth of microorganisms in the culture. The client should rinse with plain water instead.

C) Swab the oropharynx with a sterile swab: Swabbing the oropharynx is more appropriate for collecting a throat culture rather than a sputum specimen. Sputum collection requires the client to expectorate mucus from the lower respiratory tract, not from the oropharynx, to obtain an accurate sample for culture and sensitivity.

D) Refrigerate the specimen until the time of transport to the laboratory: Refrigerating the sputum specimen is crucial to preserve the integrity of the sample and inhibit the growth of contaminants before it is transported to the laboratory. This action helps ensure that the results of the culture and sensitivity test are accurate.

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A nurse is providing postmortem care for a client prior to the family viewing the body. Which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is collecting data for a client following electroconvulsive therapy. Which of the following adverse eﬀects should the nurse expect?

Correct Answer is B

Explanation

A nurse is collecting a sputum specimen from a client for culture and sensitivity. Which of the following actions should the nurse take?

Correct Answer is D

Explanation

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