A nurse is considering placing wrist restraints on a client who has cognitive deficits and has pulled out their IV catheter. Before using wrist restraints, which of the following actions must the nurse take first?

Obtain a prescription for restraints from the provider.

Document the indications for using wrist restraints.

Explain the procedure to the client and their family.

Attempt less restrictive alternatives.

Answer and Explanation

The Correct Answer is D

A.   While a prescription may be necessary, attempting less restrictive alternatives should be the first action.
B.   Documentation is important but should not precede attempting less restrictive alternatives.
C.   Education about the use of restraints is important but should follow attempts at less restrictive alternatives.
D.   The nurse should exhaust all possible alternatives to restraints before considering their use, in line with the principle of least restrictive intervention.

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Correct Answer is B

Explanation

A. Logrolling is primarily used to move clients without twisting the spine or causing friction on pressure areas, rather than specifically to prevent friction.
B. Logrolling is a technique used to maintain the alignment of the client's spine while turning them, reducing the risk of injury, particularly to the spinal cord.

C. Clients are typically instructed to cross their arms over their chest during logrolling to help maintain alignment and protect their arms.
D. While raising the head of the bed may be necessary for certain procedures or to assist with positioning, it is not specifically required for logrolling.

A. Sore throat B. Urinary frequency C. Tinnitus D. Urticaria

Correct Answer is D

Explanation

A. A sore throat is not typically associated with a mild allergic reaction to antibiotics.

B. Urinary frequency is not typically associated with a mild allergic reaction to antibiotics.
C. Tinnitus is not typically associated with a mild allergic reaction to antibiotics.

D. Urticaria, or hives, is a common manifestation of a mild allergic reaction to antibiotics.

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A nurse is considering placing wrist restraints on a client who has cognitive deficits and has pulled out their IV catheter. Before using wrist restraints, which of the following actions must the nurse take first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is teaching a client about logrolling while in bed. Which of the following information should the nurse include in the teaching?

Correct Answer is B

Explanation

A nurse is assessing a client who recently started taking an antibiotic. The nurse should identify that which of the following findings is an indication of a mild allergic reaction?

Correct Answer is D

Explanation

A charge nurse is observing a staff nurse performing a wound irrigation for a client who has a pressure injury. Which of the following actions by the staff nurse indicates an understanding of the procedure?

A nurse is assessing a client's abdomen. In what order should the nurse complete the steps of the assessment? (Move the steps into the box on the right, placing them in the order of performance. Use all the steps.)

A nurse is caring for a client who has dysphagia. When assisting the client during breakfast, which of the following actions by the client indicates the nurse should intervene?

A nurse is assessing an older adult client's perception of sexuality. Which of the following statements made by the client indicates a need for intervention?

A nurse is preparing to document in the client's medical record. The nurse should identify that which of the following abbreviations are specified by The Joint Commission for placement on a facility's Do Not Use list? (Select all that apply.)

A nurse is administering a medication to a client. The nurse identifies the client has an allergy to the medication after it has been administered. Which of the following actions should the nurse take?

A nurse is teaching a client who can only bear weight on one leg how to ambulate using crutches. Which of the following crutch gaits should the nurse plan to instruct the client to use?

A nurse is preparing to administer prescribed medications to a client. According to the rights of medication administration, when should the nurse compare the medication administration record against the medication container? (Select all that apply.)