The nurse is caring for an unconscious patient with a risk for skin impairment. How often will the nurse plan to change the position of this patient?
Every 30 minutes
Every 180 minutes
Every 60 minutes
Every 120 minutes
The Correct Answer is D
A. Changing the patient's position every 30 minutes can help prevent pressure sores but this is such a short interval. The recommended interval is at least every 2 hours.
B. Every 180 minutes (or every 3 hours) is too long of an interval between position changes for a patient at risk for skin impairment. Prolonged pressure on bony
prominences increases the risk of pressure ulcer development.
C. Every 60 minutes (or every hour) is more frequent than every 180 minutes but may
still not be sufficient for preventing pressure ulcers in an unconscious patient with limited mobility.
D. For an unconscious patient at risk for skin impairment, it is recommended to reposition the patient at least every two hours to prevent pressure ulcers and skin breakdown. This frequency is a balance between providing adequate skin protection and minimizing the risk of injury to the patient or strain to the healthcare provider.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. The first priority in any emergency situation is to ensure personal safety. The nurse should immediately walk to a safe area, away from the smoke and potential danger,
before taking further action.
B. While closing doors can help contain smoke and fire, personal safety takes
precedence. The nurse should prioritize evacuating to a safe location before attempting to close doors.
C. Wrapping clients in blankets may not be appropriate in this situation, as it does not address the immediate threat posed by the smoke and potential fire. Ensuring personal safety is the priority.
D. While staying close to the ground can reduce exposure to smoke and toxic fumes in some situations, it is not the first action to take. Evacuating to a safe area is the most
important step to protect oneself from harm.
Correct Answer is B
Explanation
A. Keeping the back bent while lowering the patient is not the most appropriate postion.
B. when a patient begins to fall, it is important to control the descent to minimize injury.
The nurse should widen their stance, bring the patient's body close to provide support, bend their knees, and use the strength of their thighs to lower the patient to the ground safely.
C. Keeping the knees straight while lowering the patient increases the risk of strain or injury to the nurse's back.
D. Holding the patient upright may not be feasible if the patient is already falling, and attempting to do so may result in injury to both the patient and the nurse.
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