A nurse is reviewing safety precautions with an assistive personnel (AP) about repositioning a client who has a pressure ulcer. Which of the following actions suggested by the AP indicates an understanding of the procedure?

Use an air-assisted device.

Position the bed in reverse Trendelenburg.

Elevate the head of bed to a 45° angle.

Lower the bed close to the ground.

Answer and Explanation

The Correct Answer is A

A. Use an air-assisted device.

Using an air-assisted device, such as a hover mat or air mattress, is an appropriate measure when repositioning a client with a pressure ulcer. These devices help reduce friction and shear forces, minimizing the risk of further skin breakdown. It also aids in maintaining the skin's integrity during movement, making it a suitable choice for the prevention of pressure ulcers.

B. Position the bed in reverse Trendelenburg:

Positioning the bed in reverse Trendelenburg involves raising the foot of the bed higher than the head. This position is not specifically related to pressure ulcer prevention or repositioning. It may be used for other medical reasons, but it does not directly address the issue of pressure ulcer care.

C. Elevate the head of bed to a 45° angle:

While elevating the head of the bed is commonly used for various reasons, including respiratory support or preventing aspiration, it may not be directly related to the repositioning of a client with a pressure ulcer. The angle mentioned (45°) is not specifically associated with pressure ulcer care.

D. Lower the bed close to the ground:

Lowering the bed close to the ground may be a safety measure to prevent injuries from falls, but it does not address the specific needs of repositioning a client with a pressure ulcer. The focus in pressure ulcer care is typically on using appropriate devices and techniques to minimize friction and pressure on vulnerable areas of the skin.

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Correct Answer is C

Explanation

A. While reporting the fire details to the facility emergency extension is important, the immediate action to ensure the safety of everyone in the facility is to activate the fire alarm. Activating the fire alarm alerts the entire facility to the presence of a fire and initiates the appropriate emergency response.

B. Closing the door to the client's room is a secondary action and can be done after activating the fire alarm. However, the priority is to activate the fire alarm to quickly notify others about the potential danger.

C. Activating the fire alarm is the immediate action to take in the event of a fire. This step ensures that the fire response team is alerted, and appropriate emergency measures are initiated promptly.

D. Turning off electrical equipment can be a safety measure, but it is not the first priority when there is an active fire. Activating the fire alarm and ensuring the evacuation of individuals from the area take precedence.

A. Agree on a desired outcome. B. Collect the relevant facts. C. Examine personal values. D. Create a plan of action.

Correct Answer is B

Explanation

A. Agree on a desired outcome:

Before agreeing on a desired outcome, it is important to collect relevant facts and information about the situation. Understanding the specifics of the case is crucial for making informed decisions.

B. Collect the relevant facts:

This is the correct answer. Gathering information and understanding the facts surrounding the situation is the initial step in addressing any ethical dilemma. This includes understanding the nature of the medical treatment, reasons for refusal, and potential consequences for the child.

C. Examine personal values:

While personal values are important to consider, examining personal values typically comes later in the ethical decision-making process. The nurse first needs to understand the facts and the context of the situation.

D. Create a plan of action:

Creating a plan of action should be based on a thorough understanding of the situation, including the relevant facts and considerations. It is a step that follows the collection of information.

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A nurse is reviewing safety precautions with an assistive personnel (AP) about repositioning a client who has a pressure ulcer. Which of the following actions suggested by the AP indicates an understanding of the procedure?

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