A nurse is assisting in the use of a fracture bedpan for a client who is immobile due to a cast. Which of the following actions should the nurse take?
Hyperextend the client's back while the fracture pan is in place.
Keep the bed flat while the client is on the fracture pan.
Encourage the client to try to defecate for 20 min while on the fracture pan.
Place the shallow end of the fracture pan under the client's buttocks
The Correct Answer is D
A. Hyperextend the client's back while the fracture pan is in place: Hyperextending the client's back is not necessary and can cause discomfort or strain. The client's back should be kept in a neutral position.
B. Keep the bed flat while the client is on the fracture pan: Raising the head of the bed slightly can facilitate the client's positioning and defecation. It is not necessary to keep the bed completely flat.
C. Encourage the client to try to defecate for 20 minutes while on the fracture pan: Encouraging the client to try to defecate for a specific time frame is not necessary and may lead to discomfort or straining. The client should be allowed to take the time they need and not be rushed during this process.
D. Place the shallow end of the fracture pan under the client's buttocks: When using a fracture bedpan, the shallow end should be placed under the client's buttocks to allow for proper positioning. The higher, deeper end of the bedpan is positioned under the client's lower back.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason:
Injecting air into the short-acting insulin vial is the first action to be taken. When mixing short-acting and intermediate-acting insulins in the same syringe, the first step is to inject air into the short-acting insulin (clear) vial. This helps equalize the pressure within the vial, making it easier to withdraw the correct dose of insulin
Choice B reason:
Drawing up the desired dose of intermediate-acting insulin into the same syringe is incorrect because it is the last step to be taken.
Choice C reason:
Drawing up the desired dose of short-acting insulin into the syringe is incorrect because it is the third step to be taken.
Choice D reason:
Inject air into the intermediate-acting insulin (cloudy) vial is incorrect because it is the second step to be taken
Correct Answer is C
Explanation
Choice A reason:
Documenting the fluid infusion in the client's chart: While documenting the fluid infusion is important, assessing the client's vital signs should take priority to ensure their immediate safety and well-being.
Choice B reason:
Completing an incident report is incorrect Completing an incident report is a necessary step to document the error and initiate appropriate follow-up actions, but it should come after assessing the client's condition.
Choice C reason
Obtaining the client's vital signs is the correct answer. The correct first action for the nurse to take in this situation is to obtain the client's vital signs. Administering an excessive amount of IV fluid could potentially have adverse effects on the client's cardiovascular system, including fluid overload, electrolyte imbalances, and changes in blood pressure. Monitoring the client's vital signs will help assess their current condition and any potential complications resulting from the excess fluid administration.
Choice D reason
Reporting the incident to the unit manager is incorrect. Reporting the incident to the unit manager is important for organizational awareness and accountability, but the nurse's first responsibility is to assess the client's vital signs and address any potential complications.
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