A male patient informs the nurse that he prefers not to have female assistive personnel (AP) involved in his care. Which response should the nurse provide?

“I can arrange for a male AP to assist with your personal hygiene care.”

“Could you explain why you prefer not to have a female AP assigned to your care?”

“The AP assigned to you is highly competent and has experience caring for male patients.”

“I will inform the charge nurse about your request to have only male staff members assigned to your care.”

Answer and Explanation

The Correct Answer is A

Choice A rationale:

Respects patient autonomy: This response directly addresses the patient's preference and demonstrates respect for their right to make decisions about their own care. It empowers the patient by offering a solution that aligns with their stated wishes.

Promotes patient comfort: By accommodating the patient's preference, the nurse can help to create a more comfortable and trusting environment, which can lead to better patient outcomes.

Protects patient privacy: Personal hygiene care often involves exposure of sensitive body parts and can be a source of embarrassment or anxiety for some patients. Ensuring that the patient is comfortable with the gender of the caregiver helps to protect their privacy and dignity.

Demonstrates cultural sensitivity: While not explicitly stated in the question, it's possible that the patient's preference is rooted in cultural or religious beliefs. Being sensitive to these factors is essential for providing culturally competent care.

Provides a practical solution: This response offers a concrete solution that can be easily implemented, ensuring that the patient's needs are met in a timely and efficient manner.

Choice B rationale:

May be perceived as intrusive: Asking the patient to explain their reasoning could make them feel uncomfortable or defensive. It's important to respect the patient's right to privacy and not pressure them to disclose personal information.

Could delay care: While understanding the patient's reasons may be helpful in some cases, it's not essential for providing appropriate care. Delaying care to gather this information could potentially compromise the patient's well-being.

Choice C rationale:

Dismisses patient's concerns: This response fails to acknowledge the patient's preference and could make them feel unheard or disrespected. It's important to validate the patient's feelings and concerns, even if you don't fully understand them.

May not address underlying issues: The patient's preference may be based on factors that are not related to the AP's competence or experience. Simply stating the AP's qualifications is unlikely to resolve the patient's concerns.

Choice D rationale:

Defers responsibility: While informing the charge nurse may be necessary for logistical reasons, it's important for the nurse to take ownership of the situation and address the patient's concerns directly. Deferring to another staff member could make the patient feel like their concerns are not being taken seriously.

May delay care: Involving additional staff members could potentially delay the patient's care. It's more efficient to address the patient's preference directly, if possible.

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Correct Answer is B

Explanation

Choice A rationale:

Metabolic alkalosis is characterized by a high pH (above 7.45), high bicarbonate (HCO3-) levels, and normal or low PaCO2. The patient's ABGs show a low pH (7.26), low bicarbonate (14 mEq/L), and low PaCO2 (30 mm Hg), which are not consistent with metabolic alkalosis.

Choice C rationale:

Respiratory alkalosis is characterized by a high pH (above 7.45), low PaCO2, and normal or slightly elevated bicarbonate levels. The patient's ABGs do show a low PaCO2, but the pH is low (acidic) and the bicarbonate is low, which are not consistent with respiratory alkalosis.

Choice D rationale:

Respiratory acidosis is characterized by a low pH (below 7.35), high PaCO2, and normal or slightly elevated bicarbonate levels. The patient's ABGs do show a low pH, but the PaCO2 is also low, which is not consistent with respiratory acidosis.

Rationale for the correct answer, B:

Metabolic acidosis is characterized by a low pH (below 7.35), low bicarbonate levels, and normal or low PaCO2. The patient's ABGs are consistent with metabolic acidosis because they show a low pH (7.26), low bicarbonate (14 mEq/L), and low PaCO2 (30 mm Hg).

Acute kidney injury is a common cause of metabolic acidosis. The kidneys play a vital role in regulating acid-base balance by excreting acids and reabsorbing bicarbonate. When the kidneys are damaged, they are unable to excrete acids effectively, leading to an accumulation of acids in the blood and a decrease in bicarbonate levels.

Additional Information:

It's important to note that the patient's low PaCO2 is likely a compensatory mechanism for the metabolic acidosis. In response to acidosis, the respiratory system tries to increase ventilation to blow off more carbon dioxide, which helps to raise the pH. However, this compensatory mechanism is often not enough to fully correct the acidosis.

A. Recap needles and place them in a wastebasket. B. Do not recap the needle on an ABG specimen. C. Place uncapped needles in a puncture-proof container after use. D. Break needles in half before putting them in the sharps disposal box.

Correct Answer is C

Explanation

Choice A rationale:

Recapping needles is a dangerous practice that significantly increases the risk of needlestick injuries.

The act of recapping involves directing the sharp end of the needle towards one's hand, creating a high likelihood of accidental puncture.

Even experienced healthcare professionals are susceptible to needlestick injuries during recapping.

Wastebaskets are not designed for the safe disposal of sharps and can easily be punctured, leading to potential exposure to bloodborne pathogens.

Choice B rationale:

While it is true that needles should not be recapped on ABG specimens, this option does not address the broader issue of safe needle disposal in general.

Focusing solely on ABG specimens could lead to the misconception that recapping is acceptable for other types of needles.

Choice D rationale:

Breaking needles in half is not recommended as a standard practice for needle disposal.

This action can create sharp fragments that are difficult to handle and can still cause injuries.

Sharps disposal containers are designed to safely contain intact needles and should be used as the primary method of disposal.

Choice C rationale:

Placing uncapped needles directly into a puncture-proof container is the safest and most recommended practice for needle disposal.

These containers are specifically designed to prevent needlestick injuries by shielding the sharps from accidental contact. They are typically made of hard plastic or metal and are clearly labeled for biohazard waste.

Using puncture-proof containers consistently for all needle disposal significantly reduces the risk of needlestick injuries among healthcare workers.

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A male patient informs the nurse that he prefers not to have female assistive personnel (AP) involved in his care. Which response should the nurse provide?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a patient who has acute kidney injury.The patient’s ABGs are: pH: 7.26, PaCO2: 30 mm Hg, HCO3: 14 mEq/L. Which of the following acid-base imbalances should the nurse identify the patient is experiencing?

Correct Answer is B

Explanation

A nurse is reinforcing teaching with a group of newly licensed nurses about preventing needlestick injuries. Which of the following actions should the nurse recommend?

Correct Answer is C

Explanation

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