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While performing a routine assessment, a nurse notices fraying on the electrical cord of a client’s continuous passive motion (CPM) device.

Which of the following actions should the nurse take first?

A.

Report the defect to the equipment maintenance staff.

B.

Remove the device from the room.

C.

Initiate a requisition for a replacement CPM device.

D.

Ensure the device inspection sticker is current.

Answer and Explanation

The Correct Answer is B

The correct answer is b. Remove the device from the room.

Choice A rationale:

  • Reporting the defect to the equipment maintenance staff is essential, but it's not the immediate priority. The primary concern is to eliminate the safety hazard posed by the frayed cord to prevent potential harm to the client and others.
  • Delaying the removal of the device could lead to electrical shock, fire, or other serious consequences.
  • Therefore, removing the device from the room takes precedence over reporting the defect.

Choice B rationale:

  • Removing the device from the room is the most appropriate first action because it:
    • Eliminates the immediate safety hazard.
    • Prevents potential harm to the client and others.
    • Protects the device from further damage.
    • Ensures the safety of the environment.
    • Demonstrates the nurse's prioritization of patient safety.

Choice C rationale:

  • Initiating a requisition for a replacement CPM device is necessary to ensure the client's continued treatment.
  • However, it's not the first action because it doesn't address the immediate safety concern.
  • The nurse should first remove the faulty device and then initiate the process for obtaining a replacement.

Choice D rationale:

  • Ensuring the device inspection sticker is current is a vital part of equipment maintenance.
  • However, it's not relevant to the immediate safety issue of the frayed cord.
  • The presence of a current inspection sticker doesn't guarantee the device's safety or functionality at that moment.
  • The nurse must prioritize removing the hazard and then follow up with appropriate documentation and reporting.


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Related Questions

Correct Answer is D

Explanation

Choice A reason:

"I try to respond to the baby quickly so she doesn't cry very long." This statement is incorrect because it indicates the parent's sensitivity to the baby's needs and responsiveness to the baby's cues, which are positive signs of appropriate caregiving.

Choice B reason:

"I have several friends who come by to help out with the baby." This statement is incorrect because having a support system in the form of friends who help with the baby is a positive factor that can reduce stress and promote a healthy postpartum period.

Choice C reason:

"I want to meet other parents to see if they are going through the same things." This statement is incorrect because seeking social support and connecting with other parents can be beneficial in reducing feelings of isolation and stress during the postpartum period.

Choice D reason:

"I think the baby should be sleeping through the night by now is the correct statement "I think the baby should be sleeping through the night by now," as a manifestation of increased risk for child abuse. This statement may indicate unrealistic expectations or frustration from the parent regarding the baby's sleep patterns.

It is common for newborns to wake frequently during the night for feeding and care, and their sleep patterns can vary significantly in the early weeks and months of life. Unrealistic expectations or frustration about the baby's sleep habits can contribute to increased stress for the parent, which might increase the risk of child abuse or neglect.

Correct Answer is D

Explanation

The correct answer is Choice d. Positioning both hands on the grips with his elbows slightly flexed.

Choice A rationale:

  • Moving both crutches with the stronger leg forward first is incorrect for a three-point gait.This describes a two-point gait,which is used when a client can bear weight on both legs.In a three-point gait,the client bears weight on the unaffected leg and the crutches,not the stronger leg.
  • This action would put excessive weight on the affected leg and could potentially compromise healing or cause further injury.

Choice B rationale:

  • Supporting his body weight while leaning on the axillary crutch pads is also incorrect.This can lead to nerve damage in the armpits and should be avoided.
  • The weight should be distributed through the hands and wrists,not the armpits.

Choice C rationale:

  • Stepping with his affected leg first when going up stairs is incorrect and potentially dangerous.The client should lead with the stronger leg when going up stairs to maintain balance and control.

Choice D rationale:

  • Positioning both hands on the grips with his elbows slightly flexed is the correct action for using crutches with a three-point gait.This allows for proper weight distribution,balance,and control of the crutches.
  • It also helps to prevent fatigue and strain in the arms and shoulders.

Key points to remember about the three-point gait:

  • Weight is borne on the unaffected leg and the crutches,not the affected leg.
  • The crutches and the unaffected leg move forward together,followed by the affected leg.
  • The client should look ahead,not down at their feet.
  • The client should take small,even steps.
  • The client should rest as needed.

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