Nokea
Your patient has multiple body piercings with jewelry in place. He has been in a motor vehicle accident and is scheduled for an MRI of his left arm and left leg. Which question will you ask this patient?
- A. Do I have your permission to remove the jewelry from your piercings before your MRI?
- B. Are the metals in your jewelry nonmagnetic stainless steel or titanium?
- C. You understand that you will need to remove all of the jewelry from your piercings before you go for an MRI, don't you?
- D. How long has the jewelry in your piercings been in place?
Correct Answer: B
Rationale: MRI machines use strong magnetic fields, and nonmagnetic metals like certain stainless steels or titanium are safe. Asking about the metal type ensures safety during the MRI, as magnetic metals can cause injury or imaging artifacts.
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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.
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.
Label the following bed positions:
- A. Fowler's position
- B. Trendelenburg position
- C. Supine position
- D. Prone position
- E. Lateral position
- F. Sims' position
- G. Reverse Trendelenburg position
Correct Answer: A,B,C
Rationale: Common bed positions include Fowler's (head elevated), Trendelenburg (head lower than feet), and Supine (lying flat on back). These are standard positions used in patient care for comfort, breathing, or procedural needs.
Your patient is slightly confused. He has activity orders to be up in the chair three times per day. He is unstable on his feet when he walks or stands for more than a few minutes. What type of bath will you plan to give this patient?
- A. Bed bath
- B. Assisted or help bath
- C. Tub bath
- D. Shower
Correct Answer: B
Rationale: Given the patient's confusion and instability when standing for extended periods, an assisted or help bath is appropriate. This allows the nurse to provide support while the patient participates in bathing, accommodating their activity orders while ensuring safety. A bed bath is too restrictive, and a tub bath or shower poses a fall risk.
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.