Nokea
You are providing personal care to a patient with diabetes. Her toenails are a bit long. What will you do?
- A. Do nothing to her toenails because you could cause her to have an infection if you damage her toes.
- B. Clip her toenails carefully straight across but do not file them.
- C. Clip her toenails carefully in a rounded shape to help prevent ingrown toenails.
- D. File her toenails straight across but do not clip them.
Correct Answer: A
Rationale: Patients with diabetes are at high risk for infections due to poor wound healing. Cutting or filing toenails can cause microtrauma, leading to infections. It is safer to refer toenail care to a podiatrist to avoid complications.
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A patient has an IV containing heparin to prevent his blood from clotting. You are assisting him with personal care. Which action will you take?
- A. Shave him with a disposable razor in the direction of hair growth.
- B. Shave him with an electric razor in the direction of hair growth.
- C. Shave him with an electric razor, moving in circular motions over the beard.
- D. Delay shaving this patient until the IV heparin is discontinued.
Correct Answer: B
Rationale: Heparin increases bleeding risk, so an electric razor is safer than a disposable razor to avoid cuts. Shaving in the direction of hair growth minimizes irritation. Circular motions are less effective and may increase skin trauma. Delaying shaving is unnecessary if an electric razor is used.
It is important to stay with a patient during the first bath or shower after surgery because the patient may
- A. Be unsteady while standing and sitting.
- B. Have an increase in pain when moving about.
- C. Cause the incision to open up when getting in the water.
- D. Experience vasodilation and become dizzy or faint.
Correct Answer: A,D
Rationale: Post-surgical patients may be weak or unsteady due to anesthesia effects or reduced mobility, increasing the risk of falls. Vasodilation from warm water can also cause dizziness or fainting, especially in a weakened state. While pain may increase with movement, it is not the primary concern for supervision, and incisions are unlikely to open from bathing alone.
When you provide oral care to an unconscious patient, you will
- A. Position the patient on the left or right side with the bed flat.
- B. Use lemon glycerin swabs to clean the patient's lips and gums.
- C. Assess the mouth for lesions and sores.
- D. Use plenty of water to rinse the toothpaste from the teeth and gums.
- E. Keep a suction device on and ready for use.
Correct Answer: A,C,E
Rationale: For an unconscious patient, positioning on the side with the bed flat prevents aspiration during oral care. Assessing the mouth for lesions ensures proper care and identifies issues. A suction device is essential to remove fluids and prevent choking. Lemon glycerin swabs can dry the mucosa, and rinsing with water is avoided to prevent aspiration.
You are caring for a patient with a nasogastric tube who is unable to take food or fluids by mouth. How often will you perform oral care for this patient?
- A. Unnecessary because the patient is not eating or drinking anything
- B. Every 2 hours
- C. Every 4 hours
- D. Every 8 hours
Correct Answer: B
Rationale: Patients with nasogastric tubes are at risk for dry mouth and oral infections due to lack of oral intake and tube irritation. Oral care every 2 hours helps maintain oral hygiene, prevent infections, and ensure patient comfort.
You are preparing to assist a conscious patient with oral care. The patient has had a stroke, causing partial paralysis of his throat. Once the toothpaste, toothbrush, water, and emesis basin are set up on the overbed table, what will you do?
- A. Instruct the patient to brush her teeth and spit into the emesis basin, then leave the room.
- B. Ask a family member to assist the patient if she needs help while you are out of the room.
- C. Brush the patient's teeth for her, then instruct her to rinse her mouth with water and mouthwash while you prepare for the partial bath.
- D. Stay with the patient in case she chokes while performing oral care, and assist her as needed.
Correct Answer: D
Rationale: Due to partial throat paralysis from the stroke, the patient is at risk of choking or aspiration during oral care. Staying with the patient ensures safety and allows assistance as needed, preventing complications.