A nurse is caring for a patient with a BMI of.
Appropriate nursing interventions include:

Hourly vital signs.

Implementing all fall risk precautions.

Utilizing bariatric bed and trapeze bar.

Supine positioning.

Answer and Explanation

The Correct Answer is C

A patient with a BMI of 38 is considered to have obesity, which means they have excess body fat that may impair their mobility and increase their risk of complications such as pressure ulcers, infections, and respiratory problems. A bariatric bed is designed to accommodate the weight and size of obese patients, and a trapeze bar can help them change positions and transfer to a chair or wheelchair.

These interventions can promote comfort, safety, and independence for the patient.

Choice A is wrong because hourly vital signs are not necessary for a patient with obesity unless they have other conditions that warrant frequent monitoring.

Choice B is wrong because implementing all fall risk precautions may be excessive and restrictive for a patient with obesity who is otherwise stable and alert.

Choice D is wrong because supine positioning can compromise the patient’s breathing and circulation, and increase the risk of pressure ulcers and aspiration.

The patient should be encouraged to change positions frequently and elevate the head of the bed when lying down.

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Correct Answer is D

Explanation

McBurney’s point is located one-third of the distance from the right anterior superior iliac spine to the umbilicus. This is where the base of the appendix is attached to the cecum, which is part of the large intestine. When the appendix becomes inflamed or infected, it causes pain in this area.

Choice A is wrong because the left lower quadrant is where the sigmoid colon and part of the small intestine are located.

These organs are not related to appendicitis.

Choice B is wrong because the left upper quadrant is where the stomach, spleen, and part of the pancreas are located.

These organs are also not related to appendicitis.

Choice C is wrong because the right upper quadrant is where the liver, gallbladder, and part of the small intestine are located. These organs can cause pain in this area if they have problems, but not appendicitis

A. Urinary catheterization. B. Malnutrition. C. Multiple caregivers. D. Chlorhexidine washes.

Correct Answer is A

Explanation

Urinary catheterization is a common cause of health care-associated infections (HAIs), which are infections that patients get while receiving medical treatment in a health care facility. Urinary catheterization involves inserting a tube into the bladder to drain urine, which can introduce bacteria into the urinary tract and cause infections.

Choice B is wrong because malnutrition is not a direct cause of HAIs, although it can weaken the immune system and increase the risk of infections.

Choice C is wrong because multiple caregivers are not a direct cause of HAIs, although they can increase the exposure to different pathogens and cross contamination if they do not follow proper hygiene and infection control practices.

Choice D is wrong because chlorhexidine washes are not a cause of HAIs, but rather a preventive measure to reduce the risk of HAIs by disinfecting the skin and mucous membranes.

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A nurse is caring for a patient with a BMI of. Appropriate nursing interventions include:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

In individuals who have appendicitis, the pain will typically localize to McBurney’s point. Which quadrant of the abdomen is McBurney’s point found?

Correct Answer is D

Explanation

A nurse is preparing an in-service presentation about preventing health care associated infections (HAIs). The nurse should include which of the following as a common cause of these infections?

Correct Answer is A

Explanation

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A nurse is caring for a patient with a BMI of.
Appropriate nursing interventions include: