A nurse is initiating seizure precautions for a client who has a seizure disorder. Which of the following equipment should the nurse make sure is readily available at the client's bedside?
Vest restraint
Tongue blade
Oxygen setup
Neck brace
Neck brace
The Correct Answer is C
A. Vest restraints are not appropriate for seizure precautions. Restraints are generally not recommended as the primary intervention for seizure management.
B. The use of tongue blades during a seizure is not recommended and could pose a risk of injury.
C. Oxygen setup is crucial for managing a client during and after a seizure to ensure proper oxygenation.
D. Neck brace is not necessary for seizure precautions and may pose a risk during a seizure episode.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. The frequency of previous vital sign measurements may be important but is not the most critical information to communicate during a transfer.
B. The effectiveness of the last dose of pain medication is crucial information for the receiving facility to manage the client's pain appropriately.
C. The number of family members who have visited is important for emotional support but may not be the priority for the receiving facility.
D. The time of the client's last bath is relevant but may not be as critical as information related to pain management during the hand-off report.
Correct Answer is C
Explanation
A) Purulent drainage is indicative of pus, which is associated with infection and is typically thick and yellow, green, or brown.
B) Serous drainage is clear, thin, and watery, and is generally considered normal in the early stages of healing.
C) Sanguineous drainage, which is the correct answer, refers to drainage that contains or is mixed with blood, making it appear blood-tinged, and is expected in a fresh incision or one that is healing by secondary intention.
D) Hyperemia is not a type of drainage but a term that describes increased blood flow to an area of the body, resulting in redness. Therefore, the nurse should document the finding as sanguineous, which accurately describes blood-tinged drainage.
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