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A home health nurse is teaching a client about home safety. Which of the following statements by the client indicates an understanding of the teaching? (Select all that apply.)

"I need to check my medications for expiration dates."

"I need to have a fire escape plan with my family."

“1 need to set my hot water heater to 140 degrees Fahrenheit."

“1 will apply tape over frayed areas of electrical cords."

“1 will use the grab bars when getting in and out of the bathtub."

Answer and Explanation

Correct Answer : A,B,E

Choice A reason:

Checking medication expiration dates is important to ensure that medications are safe and effective.

Choice B reason:

Having a fire escape plan is crucial in case of emergencies such as fires. It's important for the client and their family to know how to evacuate the home safely.

Choice C reason:

Setting the hot water heater to 140 degrees Fahrenheit is too hot and can lead to scalding. The recommended temperature is typically around 120 degrees Fahrenheit to prevent burns.

Choice D reason:

Applying tape to frayed electrical cords is not a safe practice. Frayed cords should be replaced to avoid electrical hazards.

Choice E reason:

Using grab bars when getting in and out of the bathtub can prevent slips and falls, especially in a potentially slippery environment.

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Correct Answer is C

Explanation

Choice A reason:
The cephalic vein on the back of the right hand is incorrect because it might still involve the same arm as the mastectomy site, and it is important to avoid this side.
Choice B reason:
The radial vein on the left wrist is incorrect because it is not on the opposite side of the mastectomy and could increase the risk of lymphedema.
Choice C reason:
The basilic vein in the right antecubital fossa is the appropriate answer. When inserting an IV catheter for a client who has undergone a right mastectomy, it is generally advisable to avoid the arm on the same side as the mastectomy due to the risk of lymphedema and impaired lymphatic drainage. The basilic vein in the right antecubital fossa (the inner bend of the right elbow) would be a suitable choice in this case, as it is on the opposite side of the mastectomy.
Choice D reason:
The cephalic vein in the left distal forearm is on the same side as the mastectomy and should be avoided to reduce the risk of complications.

A. Percuss all four quadrants of the abdomen to measure sound quality. B. Provide adequate lighting to inspect the abdomen. C. Listen to the abdominal arteries using the bell of a stethoscope. D. Check for areas of tenderness by pressing fingers 1.3 cm (0.5 in) into the abdomen. E. Locate liver and spleen borders by pressing hands 2.5 to 7.5 cm (1 to 3 in) into the abdomen.

Correct Answer is B, C, E, D, A

Explanation

B. Provide adequate lighting to inspect the abdomen: Adequate lighting is important to ensure that the nurse can clearly see and assess the client's abdominal area. This step helps identify any visible abnormalities, such as skin changes, scars, masses, or distention.

C. Listen to the abdominal arteries using the bell of a stethoscope: Listening to the abdominal arteries helps the nurse assess blood flow and detect any abnormal vascular sounds, such as bruits or murmurs. This step provides information about vascular health and potential issues related to blood flow.

E. Locate liver and spleen borders by pressing hands 2.5 to 7.5 cm (1 to 3 in) into the abdomen: Palpating and locating the liver and spleen borders help assess the size and position of these organs. It can help identify hepatomegaly (enlarged liver) or splenomegaly (enlarged spleen), which could indicate various underlying conditions.

D. Check for areas of tenderness by pressing fingers 1.3 cm (0.5 in) into the abdomen: Palpating the abdomen for tenderness helps identify areas of discomfort or pain. It can provide information about potential inflammation, organ enlargement, or other sources of discomfort.

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A home health nurse is teaching a client about home safety. Which of the following statements by the client indicates an understanding of the teaching? (Select all that apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is preparing to insert an IV catheter for a client following a right mastectomy. Which of the following veins should the nurse select when initiating IV therapy?

Correct Answer is C

Explanation

A nurse is preparing to perform a physical assessment of a client's abdomen. Identify the sequence in which the nurse should perform the following steps. (Move the steps into the box on the right, placing them in the order of performance. Use all the steps.)

Correct Answer is B, C, E, D, A

Explanation

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