While caring for a client, the nurse experiences a needle stick injury. Which of the following actions should the nurse cake first?
Complete an incident report.
Consent to postexposure treatment with antiretroviral medications
Request the risk manager obtain consent for HIV testing from the client.
Wash the site of injury with soap and water
The Correct Answer is D
A. Complete an incident report: While completing an incident report is important for documentation purposes, it should not be the first action taken after a needle stick injury. Immediate attention to the wound by washing it with soap and water takes precedence to minimize the risk of infection.
B. Consent to postexposure treatment with antiretroviral medications: Postexposure prophylaxis (PEP) with antiretroviral medications may be indicated after a needle stick injury, particularly if there is a risk of exposure to HIV or other bloodborne pathogens. However, obtaining consent for PEP should follow immediate wound care.
C. Request the risk manager obtain consent for HIV testing from the client: While HIV testing may be necessary for the client involved in the incident, it is not the nurse's responsibility to obtain consent for testing. The priority is to address the nurse's own immediate health and safety by cleaning the wound and seeking appropriate medical evaluation and treatment.
D. Wash the site of injury with soap and water: The first action the nurse should take after experiencing a needle stick injury is to immediately wash the site of the injury with soap and water. This helps reduce the risk of infection by removing any potentially infectious material from the wound.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. The AP's ability to complete the task without assistance: While it's important for the AP to be able to complete the task independently, this is not the only consideration when delegating tasks. The nurse should also consider whether the AP has the necessary knowledge and skill to perform the task safely and effectively.
B. The AP's rapport with clients: Although the AP's rapport with clients is valuable in providing care, it is not directly related to the ability to perform a delegated task. The nurse should prioritize delegation based on the AP's competency and skill level rather than their interpersonal skills.
C. The AP’s ability to prioritize: While the AP's ability to prioritize tasks is important in providing efficient care, it is not specifically related to the nurse's consideration when delegating tasks. Delegation decisions should primarily be based on the AP's knowledge and skill to perform the task safely and effectively.
D. The AP has the knowledge and skill to perform the task: This is the most appropriate consideration when delegating tasks. Ensuring that the AP has the necessary knowledge and skill to perform the delegated task safely and effectively is essential for patient safety and quality care. The nurse should assess the AP's competency and provide appropriate supervision and guidance as needed.
Correct Answer is ["B","D","E"]
Explanation
A. Fine hand tremors and pill rolling: These symptoms are more indicative of parkinsonism, which is another extrapyramidal side effect of antipsychotic medications but not specifically tardive dyskinesia.
B. Facial grimacing and eye blinking: Facial grimacing and eye blinking are classic signs of tardive dyskinesia. These involuntary movements of the face are often seen in patients who have been on antipsychotic medications for an extended period.
C. Urinary retention and constipation: Urinary retention and constipation are not typically associated with tardive dyskinesia. These symptoms may be related to other medication side effects or unrelated conditions.
D. Involuntary pelvic rocking and hip thrusting movements: These movements are characteristic of tardive dyskinesia. Involuntary pelvic rocking and hip thrusting can occur as part of the abnormal involuntary movements seen in tardive dyskinesia.
E. Tongue thrusting and lip smacking: Tongue thrusting and lip smacking are classic signs of tardive dyskinesia, particularly involving the orofacial region. These movements can be distressing for patients and may interfere with speech and eating.
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