A nurse is caring for a client who is experiencing Increased Intracranial pressure following a head Injury. In which of the following positions should the nurse place the client?
Sims
Supine
Left lateral
Low-Fowler's
The Correct Answer is D
A. The Sims position is a lateral position used for procedures such as rectal examinations and enemas and is not typically indicated for managing increased intracranial pressure.
B. The supine position may worsen increased intracranial pressure by increasing venous return and intracranial pressure.
C. The left lateral position may be used in specific circumstances, such as to relieve pressure on the vena cava in pregnancy, but it is not typically indicated for managing increased intracranial pressure.
D. Positioning the client in Low-Fowler's position (with the head of the bed elevated approximately 15-30 degrees) helps facilitate venous drainage from the brain, thereby reducing intracranial pressure. This position promotes optimal cerebral perfusion and helps manage increased intracranial pressure.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A: Changing the TPN bag and tubing every 24 hours is standard practice to prevent infection, so this action is appropriate.
B: Checking glucose levels every 6 hours is necessary because TPN can significantly affect blood glucose levels.
C: Gradually increasing the TPN rate is a standard procedure to monitor tolerance to the infusion.
D: This indicates a need for intervention. TPN lines should not be used for any other infusions to prevent contamination and interactions between the nutrition formula and medications.
Correct Answer is B
Explanation
A. While documentation of sensitive material may be a responsibility of the charge nurse, it does not directly relate to educating a newly licensed nurse about the facility's computerized documentation system.
B. Securing client information through measures like installing a firewall is crucial in a computerized documentation system to maintain confidentiality and prevent unauthorized access or data breaches.
C. While password change frequency is an important aspect of maintaining system security, it is not the most critical information to convey to a newly licensed nurse regarding the documentation system.Most facilities require more frequent password changes to enhance security, such as every 60 to 90 days, to mitigate the risk of unauthorized access and potential breaches.
D. Providing access to all client records would violate privacy and security protocols and is not an accurate representation of how the documentation system operates.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.