Nokea
Proper hair care is important for the patient's self-image. What is the proper water temperature when shampooing a patient's hair?
- A. 101°F (38.3°C)
- B. 105°F (40.5°C)
- C. 110°F (43.3°C)
- D. 120°F (48.8°C)
Correct Answer: C
Rationale: Water at 110°F (43.3°C) should be used to shampoo a patient's hair.
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The nurse is providing personal hygiene for a Hindu patient from India. What intervention should the nurse implement?
- A. Not serve meat
- B. Shampoo the patient's hair weekly
- C. Give a daily bath
- D. Cut nails monthly
Correct Answer: C
Rationale: A daily bath is part of the religious duty of Indian Hindus.
To prevent skin breakdown in a wheelchair-bound patient the nurse teaches the patient to shift the patient's weight every ____ minutes.
Correct Answer: 15
Rationale: People who are wheelchair-bound should shift their weight by pushing on the arms of their chair every 15 minutes to prevent skin breakdown.
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?
- A. Every 30 minutes
- B. Every 60 minutes
- C. Every 120 minutes
- D. Every 180 minutes
Correct Answer: C
Rationale: The bedfast patient should have a position change every 2 hours (120 minutes) because skin compromise can occur if there is unrelieved pressure during that amount of time.
The nurse is preparing to bathe a patient. What should the room temperature be set at?
- A. No warmer than 67°F (19.4°C)
- B. No cooler than 68°F (20°C)
- C. No cooler than 70°F (21.1°C)
- D. 75°F or warmer (23.8°C)
Correct Answer: B
Rationale: The recommended room temperature is 68° to 74°F (20° to 23.3°C).
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.