A nurse is assessing a client who received IV conscious sedation for a colonoscopy. Which of the following findings indicated that the client is ready for discharge?
The client is restless.
The client shows a brisk response to stimulus.
The client shows a sluggish response to stimulus.
The client is cooperative and oriented.
The Correct Answer is D
A. Restlessness may indicate incomplete recovery or inadequate sedation reversal.
B. A brisk response to stimulus suggests the client is still in a mildly sedated state and not fully recovered.
C. A sluggish response to stimulus also indicates the client is not yet fully alert and oriented.
D. The client being cooperative and oriented is an indication of full consciousness and recovery from sedation, meeting discharge criteria.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","D"]
Explanation
A. A turning schedule every 4 hours is insufficient; repositioning should ideally be done every 2 hours to prevent pressure injuries.
B. Reducing skin exposure to moisture helps maintain skin integrity, especially in areas prone to breakdown due to moisture accumulation.
C. Powder is not recommended as it can lead to skin irritation and potential breakdown.
D. Elevating heels with pillows relieves pressure on areas that are susceptible to pressure injuries in immobilized clients.
E. Massaging erythematous bony prominences can damage capillaries and increase the risk of pressure injury formation.
Correct Answer is D
Explanation
A. Restlessness may indicate incomplete recovery or inadequate sedation reversal.
B. A brisk response to stimulus suggests the client is still in a mildly sedated state and not fully recovered.
C. A sluggish response to stimulus also indicates the client is not yet fully alert and oriented.
D. The client being cooperative and oriented is an indication of full consciousness and recovery from sedation, meeting discharge criteria.
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