A client with limited mobility requires assistance with bathing. Which of the following actions should the nurse prioritize to ensure the client's safety during the bath?
Use a washcloth instead of a sponge.
Position the client in a semi-Fowler's position.
Add bath oils to the water for skin hydration.
Ensure the water temperature is appropriate.
The Correct Answer is D
A. Using a washcloth instead of a sponge can help with hygiene but does not directly ensure the client’s safety during bathing.
B. Positioning the client in a semi-Fowler’s position can enhance comfort and reduce aspiration risk but may not address immediate safety concerns such as burns.
C. Adding bath oils may improve skin hydration but can make the bathing surface slippery, potentially increasing the risk of falls.
D. Ensuring the water temperature is appropriate is the priority for safety. Water that is too hot can cause burns, while water that is too cold can cause discomfort or stress, making temperature control the most critical step to protect the client during bathing.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Using a towel to turn off the water prevents recontamination of the hands after washing. This is an essential step to maintain hand hygiene after performing proper washing.
B. Drying hands with a reusable towel can reintroduce pathogens from previous users; disposable paper towels are preferred for infection control.
C. Using hot water is unnecessary and can cause skin irritation; lukewarm or cool water is effective when combined with proper hand-washing technique.
D. Washing hands for only 10 seconds is insufficient; the recommended duration is at least 20 seconds to effectively remove pathogens.
Correct Answer is ["B","C","E"]
Explanation
A. Data contained in a client's medical record cannot be shared with all employees; access is limited to those directly involved in the client’s care, in accordance with HIPAA and confidentiality regulations.
B. Documentation should be organized and completed in a timely fashion to ensure accurate, clear, and current information is available for other healthcare providers and for legal purposes.
C. A medical record can be used as evidence in a court of law, so entries must be factual, objective, and precise to accurately reflect care provided.
D. Documentation should be objective and factual, not include the nurse’s personal interpretations or assumptions, as subjective interpretations can be misleading or legally problematic.
E. Information recorded must be accurate and complete to reflect the client’s condition, interventions, and responses, supporting continuity of care and protecting the nurse legally and professionally.
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