While performing hygiene care for a client, a nurse notices a frayed electrical cord on the client’s electronic blood pressure monitor.
Which of the following actions should the nurse take first?
Remove the device from the room.
Access the facility’s maintenance protocol.
Report defective equipment.
Request a replacement device.
The Correct Answer is A
This is because a frayed electrical cord can pose a serious risk of electric shock or fire to the client and the nurse.
The nurse should act quickly to eliminate the hazard and ensure the safety of the client and others.
Choice B is wrong because accessing the facility’s maintenance protocol is not the first action the nurse should take.
The nurse should prioritize removing the device from the room before following any protocol.
Choice C is wrong because reporting defective equipment is not the first action the nurse should take.
The nurse should prioritize removing the device from the room before reporting it to the appropriate authority.
Choice D is wrong because requesting a replacement device is not the first action the nurse should take.
The nurse should prioritize removing the device from the room before requesting a new one.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
The correct answer is choice C. “I will assist you in any way I can during this process.” This response shows sensitivity and respect for the client’s family and their cultural or religious beliefs. Postmortem care involves caring for a deceased patient’s body with dignity and in a manner that is consistent with the patient’s and family’s wishes.The nurse should offer to assist the family in performing the postmortem care if they request to do so.
Choice A is wrong because the family does not need to sign a release form to perform the postmortem care themselves.
There is no legal requirement for this.
Choice B is wrong because a licensed health care worker does not have to perform postmortem care.
The family can perform the care themselves if they wish, with or without the assistance of a health care worker.
Choice D is wrong because postmortem care takes place before the client leaves the facility, not after.
Postmortem care should be provided as soon as possible to prevent tissue damage or disfigurement.
Correct Answer is C
Explanation
According to the CDC1, chlorine bleach is an effective disinfectant for killing C. difficile spores on environmental surfaces.
It should be used in a 1:10 dilution of household bleach and water, freshly mixed daily.
Chlorine bleach can also kill other pathogens that may be present in the room of a client with C. difficile infection.
Choice A is wrong because chlorhexidine is not effective against C. difficile spores.
Chlorhexidine is an antiseptic that can be used for hand hygiene and surgical asepsis, but it does not kill spores.
Choice B is wrong because isopropyl alcohol is also not effective against C. difficile spores.
Alcohol-based hand sanitizers are not sufficient for preventing the spread of C. difficile, and soap and water should be used instead.
Choice D is wrong because triclosan is a type of antibacterial agent that is commonly found in some consumer products, such as soap and toothpaste. However, triclosan has no activity against C. difficile spores.
Triclosan may also contribute to antibiotic resistance and has potential adverse effects on human health and the environment.
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