A nurse administered an IM injection to a client. Which of the following actions should the nurse take to reduce the risk of a needlestick injury?

Place a cap holder securely on the used needle before disposal.

Recap the needle for disposal later.

Dispose of the used needle immediately in a sharps container.

Detach the used needle and dispose of it promptly.

Answer and Explanation

The Correct Answer is C

A.   Placing a cap holder on the used needle before disposal does not prevent needlestick injuries and may increase the risk of accidental puncture.
B.   Recapping the needle for disposal later increases the risk of needlestick injuries. It is recommended to avoid recapping needles whenever possible.
C.   The immediate disposal of the used needle in a sharps container reduces the risk of needlestick injuries by eliminating the need for handling the needle after use.
D.   Detaching the used needle and disposing of it promptly is appropriate, but it should be done directly into a sharps container to minimize the risk of needlestick injuries.

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Correct Answer is C

Explanation

A. An increase in calf size can be a sign of deep-vein thrombosis (DVT), but it is not specific to
DVT and can occur with other conditions such as edema.
B. Capillary refill of 2 seconds is within the expected range and is not indicative of DVT.
C. A palpable cord-like vein is a classic sign of DVT and should be further assessed and reported for appropriate intervention.
D. An extremity feeling cool to the touch can be a sign of impaired circulation but is not specific to DVT and can occur with other vascular conditions.

A. Instruct the client to report the theft to the police. B. Report the possible abuse to adult protective services. C. Ask the client if there is another family member they can call for financial help. D. Restrict visitation for the client's family until discharge.

Correct Answer is B

Explanation

A. Instructing the client to report the theft to the police might be appropriate in cases of theft, but the nurse's primary responsibility is to ensure the safety and well-being of the client. Reporting
to the authorities can be pursued after ensuring the client's immediate safety.

B. Reporting the possible abuse to adult protective services is the appropriate action when financial exploitation or abuse is suspected. Adult protective services can investigate the situation and provide support and resources to ensure the client's safety.
C. Asking the client if there is another family member they can call for financial help is a valid consideration, but it does not address the potential abuse or exploitation of the client's finances.
D. Restricting visitation for the client's family until discharge is not appropriate without further assessment and intervention. It may also isolate the client from potential sources of support and assistance.

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A nurse administered an IM injection to a client. Which of the following actions should the nurse take to reduce the risk of a needlestick injury?

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Naxlex Comprehensive Predictor Exams

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