Nokea
As a safety precaution against breakage of dentures the nurse should place ____ in the emesis basin before cleaning the dentures.
Correct Answer: water
Rationale: Water in the basin will break the fall of the dentures if they are dropped.
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The nurse assesses a red blister over the right superior iliac area of a patient. What stage is this decubitus injury?
- A. 1
- B. 2
- C. 3
- D. 4
Correct Answer: B
Rationale: A pressure injury demonstrating blisters is a stage 2 decubitus injury.
The nurse attempts to avoid a pressure injury for a bedridden patient by turning the patient frequently. What is the most favorable position for the nurse to move this patient into?
- A. Back-lying
- B. Full lateral
- C. 30-degree lateral
- D. Full prone
Correct Answer: C
Rationale: It is preferable to use the 30-degree lateral incline position.
When must the nurse remember to use an electric razor when shaving a patient?
- A. When a bleeding tendency is present
- B. When there is a risk for suicide
- C. When the facial hair is fine
- D. When speed is essential
Correct Answer: A
Rationale: A patient with a bleeding disorder should use an electric razor.
How should the nurse cleanse the meatal opening when performing male perineal care?
- A. From the meatus outward
- B. With an alcohol swab
- C. In a circular motion
- D. With a cotton-tipped applicator
Correct Answer: A
Rationale: The nurse should cleanse the meatal opening from the meatus outward.
A patient is recovering from a hemorrhoidectomy and experiences dizziness within 5 minutes, when taking a sitz bath. What action should the nurse implement?
- A. Cover the patient to prevent chilling.
- B. Stay with the patient until the full time for the bath has elapsed.
- C. Remove the patient from the sitz bath and return to bed.
- D. Assess vital signs every 5 minutes during the remainder of the sitz bath.
Correct Answer: C
Rationale: The patient may become dizzy during a sitz bath due to dilation of the large vessels in the abdomen. If this occurs, the patient should be removed from the sitz bath and returned to bed. Vital signs should be assessed until they return to normal.