During new employee orientation, a nurse is explaining how to prevent IV infections. Which of the following statements by an orientee indicates understanding of the preventive strategies?

"As long as I am working with the same client, I can use the same IV catheter for my second insertion attempt."

“I will replace any IV catheter when I suspect contamination during insertion."

“I will leave the IV catheter in place after the client completes the course of IV antibiotics."

“If my client needs to use the rest room, it would be safer to disconnect their IV infusion as long as I clean the injection port thoroughly with an antiseptic swab."

Answer and Explanation

The Correct Answer is B

A.   Using the same IV catheter for a second insertion attempt is not advisable. Once an IV catheter has been inserted, it should not be reused or reinserted in the same or a different site. If the initial insertion fails or if the catheter needs to be repositioned, a new sterile catheter should be used.
B.   If there is any suspicion of contamination during the insertion of an IV catheter, it is important to replace the catheter to prevent infection. This is crucial for maintaining sterility and reducing the risk of introducing pathogens into the patient’s bloodstream.
C.   The IV catheter should be removed once the course of IV antibiotics or any other IV therapy is completed, unless there is a specific medical reason to keep it in place. Leaving the catheter in place unnecessarily increases the risk of infection and other complications.
D.   Disconnecting the IV infusion for a client to use the restroom is not typically recommended as a standard practice. Disconnecting can introduce risks of infection and requires thorough cleaning and handling. Instead, a safer practice is to secure the IV line and allow the client to use the restroom while keeping the infusion running, or use a specialized catheter with a secure, closed system.

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Correct Answer is B

Explanation

A. Increasing sodium intake would exacerbate hypernatremia, not correct it. Hypernatremia is characterized by an excess of sodium in the blood, so the goal of treatment is to lower sodium levels, not increase them.
B. Infusing hypotonic IV fluids, such as 0.45% NaCl or D5W (5% dextrose in water), helps to dilute the high sodium concentration in the blood and can assist in correcting hypernatremia. Hypotonic fluids move water into cells and help balance the sodium levels by promoting hydration and lowering the sodium concentration.
C. Sodium polystyrene sulfonate (Kayexalate) is used to treat hyperkalemia (elevated potassium levels), not hypernatremia. It works by exchanging potassium for sodium in the gastrointestinal tract and would not address hypernatremia.
D. Implementing a fluid restriction is generally not the best approach for treating hypernatremia. In fact, fluid restriction could worsen hypernatremia by limiting the client's fluid intake and not addressing the sodium imbalance. The primary goal in hypernatremia is usually to rehydrate the patient with appropriate fluids.

A. "You should be flat on your back when you perform purse-lipped breathing" B. "You should inhale through your nose and exhale through your mouth during purse-lipped breathing." C. Your inspiration should be longer than expiration during purse-lipped breathing" D. "You should cough forcefully during exhalation when you are purse-lipped breathing"

Correct Answer is B

Explanation

A. Pursed-lip breathing does not require a specific body position, but it is often more comfortable and effective when the patient is in a semi-Fowler’s position (elevated head of the bed) or sitting upright. Being flat on the back might actually make breathing more difficult for some patients with COPD.
B. The technique involves inhaling slowly through the nose and exhaling through pursed lips, which creates a slight resistance during expiration. This helps to keep the airways open longer, reduce airway collapse, and improve oxygen exchange. Proper inhalation and exhalation technique are key components of effective pursed-lip breathing.
C. In pursed-lip breathing, expiration should be longer than inspiration. The recommended pattern is to inhale slowly through the nose for about 2 counts and then exhale slowly through pursed lips for about 4 counts. The extended expiration phase helps to remove trapped air from the lungs and improves overall ventilation.
D. Coughing forcefully is not a part of pursed-lip breathing. Pursed-lip breathing focuses on controlled breathing to improve airflow and ease breathing. Coughing can be done separately if needed, but it is not a component of the pursed-lip breathing technique.

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During new employee orientation, a nurse is explaining how to prevent IV infections. Which of the following statements by an orientee indicates understanding of the preventive strategies?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is planning care for a client who has hypernatremia. Which of the following actions should the nurse include in the plan of care?

Correct Answer is B

Explanation

A nurse is teaching a client who has COPD about purse-lipped breathing. Which of the following statements should the nurse make?

Correct Answer is B

Explanation

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