A client who had emergency gallbladder surgery yesterday is getting ready to be discharged.
The nurse knows that the client speaks very little English. When teaching wound care, which method should the nurse use to evaluate the client's understanding of self-care at home?

Have the client demonstrate prescribed wound care.

Provide written instructions in the client's native language.

After each instruction, ask the client if he/she understands.

Have an interpreter repeat the wound care instructions.

Answer and Explanation

The Correct Answer is A

The best way to evaluate the client’s understanding of self-care at home is to have the client demonstrate prescribed wound care.

This allows the nurse to directly observe the client’s ability to perform the necessary tasks and provide feedback and clarification as needed.

Choice B, providing written instructions in the client’s native language, may be helpful but does not allow the nurse to directly evaluate the client’s understanding.

Choice C, asking the client if he/she understands after each instruction, may not be effective if the client is not comfortable expressing confusion or misunderstanding.

Choice D, having an interpreter repeat the wound care instructions, may be helpful but still does not allow for direct observation of the client’s ability to perform the necessary tasks.

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Correct Answer is A

Explanation

The priority intervention for a patient with persistent STIs and risky behaviors is to recommend consistent use of latex condoms.

According to the USPSTF, behavioral counseling is recommended for all sexually active adolescents and for adults who are at increased risk for sexually transmitted infections (STIs)1.

This includes providing information on common STIs and STI transmission, aiming to increase motivation or commitment to safer sex practices, and providing training in condom use1.

Choice B is not the answer because annual infection screening is important but not the priority intervention.

Choice C is not the answer because while it’s true that some infections may have no initial symptoms, this is not a priority intervention.

Choice D is not the answer because while advising that alcohol intake may lead to risky behaviors is important, it’s not the priority intervention.

A. Remind the UAP to locate the thermometer before gently inserting the ear. B. Demonstrate the correct technique for pulling the client's auricle up and back. C. Advise the UAP to hold the thermometer securely in place to obtain the measurement. D. Use positive reinforcement to affirm that the procedure being performed correctly.

Correct Answer is D

Explanation

The UAP is correctly pulling the client’s auricle up and back and preparing to insert the thermometer1.

Choice A is incorrect because it is not necessary to remind the UAP to locate the thermometer before gently inserting it into the ear.

Choice B is incorrect because the UAP is already demonstrating the correct technique for pulling the client’s auricle up and back1.

Choice C is incorrect because it is not necessary to advise the UAP to hold the thermometer securely in place to obtain the measurement.

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A client who had emergency gallbladder surgery yesterday is getting ready to be discharged. The nurse knows that the client speaks very little English. When teaching wound care, which method should the nurse use to evaluate the client's understanding of self-care at home?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

What's the priority intervention for a patient with persistent STIs and risky behaviors?

Correct Answer is A

Explanation

The nurse observes a new employee, an uncertified nursing assistant (UAP), checking the temperature using a tympanic thermometer. The UAP pulls the client's auricle up and back and prepares to insert the thermometer. Which action should the nurse implement?

Correct Answer is D

Explanation

A client is in contact isolation due to a stage IV coccyx wound infected with MRSA. The nurse plans interventions to prevent multiple infections. Which intervention is most appropriate to prevent the spread of MRSA to others?

Which descriptions of stool warrant additional follow-up by the nurse? (Select all that apply.).

After a long bed rest, a client with a Foley catheter and wrist restraints has repeatedly removed the antibiotic (G) tube and NG tube. At checking the restraints, which action is most important for the nurse to take?

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A healthcare organization requires nurses to chart by exception. Which assessment should the nurse document?

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How should the nurse document the finding of pain, numbness, and tingling sensations in the lower legs?

A client who had emergency gallbladder surgery yesterday is getting ready to be discharged.
The nurse knows that the client speaks very little English. When teaching wound care, which method should the nurse use to evaluate the client's understanding of self-care at home?