A nurse is providing preoperative care to a client who reports he has no one at home to help him after his outpatient surgery. Which of the following actions should the nurse take?

Assist with a referral to a home health care agency.

Call the provider about admitting the client to the facility overnight.

Give the client a list of home care assistants to contact.

Contact the next of kin to assist the client at home.

Answer and Explanation

The Correct Answer is A

A. Assist with a referral to a home health care agency is correct. If the client has no one to assist them at home after surgery, a home health care agency can provide the necessary support. This is a proactive solution to ensure the client has assistance for postoperative recovery, including monitoring for complications, assistance with mobility, and other care needs.

B. Calling the provider about admitting the client to the facility overnight is incorrect. Outpatient surgery is typically intended for clients who can recover at home, and there is no indication that the client requires overnight admission based solely on the lack of assistance at home.

C. Giving the client a list of home care assistants to contact is incorrect. While this could be helpful, it is the nurse's role to actively assist in arranging care. Referring the client to a list of names without offering concrete help may leave the client in a challenging situation.

D. Contacting the next of kin to assist the client at home is incorrect. Although contacting a relative may be an option, it may not be viable or practical for the client. Home health care offers a more reliable solution, as family members may not always be available to provide consistent care.

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Correct Answer is C

Explanation

A. Inspect the incision of a client who is postoperative following a leg amputation is incorrect. Inspecting an incision requires clinical assessment to identify signs of infection, dehiscence, or other complications, which should be performed by a licensed nurse.

B. Evaluate the need to suction the airway of a client who has a new tracheostomy is incorrect. Suctioning the airway of a client with a tracheostomy is a skilled task that requires assessment of the airway and airway management, which should be performed by a nurse.

C. Complete postmortem care for a client who has died is correct. Postmortem care, such as cleaning and preparing the body, is a task that can be delegated to an AP. The AP should not be involved in clinical assessments but can perform routine care under supervision.

D. Feed a client who has difficulty swallowing liquids following a stroke is incorrect. Feeding a client with swallowing difficulties requires careful monitoring and risk assessment for aspiration, which is outside the scope of tasks that can be delegated to an AP without proper training.

A. Tie the gown with the gloves on. B. Tuck the glove cuffs under the gown sleeves. C. Apply the gown before the gloves. D. Push the gown sleeves up to the elbows.

Correct Answer is C

Explanation

A. Tying the gown with the gloves on is incorrect. The correct order of donning personal protective equipment (PPE. is to apply the gown first, followed by gloves. Tying the gown after the gloves may compromise proper gown coverage.

B. Tucking the glove cuffs under the gown sleeves is incorrect. The glove cuffs should be pulled over the gown sleeves to ensure a secure, closed barrier between the gown and gloves, helping to prevent contamination.

C. Applying the gown before the gloves is correct. According to infection control guidelines, the gown should be worn first, followed by gloves. This technique ensures that the gown covers the sleeves properly and that the gloves are overlapping the gown cuffs, reducing the risk of contamination.

D. Pushing the gown sleeves up to the elbows is incorrect. Gown sleeves should remain down to cover the wrists to protect the forearms from contamination, especially when caring for a patient with Clostridium difficile, which requires contact precautions.

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A nurse is providing preoperative care to a client who reports he has no one at home to help him after his outpatient surgery. Which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is making client care assignments for an assistive personnel (AP). Which of the following tasks should the nurse assign to the AP?

Correct Answer is C

Explanation

A nurse is caring for a client who has Clostridium difficile. When applying a cover gown, which of the following techniques should the nurse use?

Correct Answer is C

Explanation

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