A nurse is measuring an adult client's tympanic temperature. Which of the following actions should the nurse take?
Use a cotton-tipped applicator to remove cerumen.
Insert the probe snugly into the ear canal and press scan.
Pull the pinna downward and backward.
Hold the probe flat against the forehead and press scan.
The Correct Answer is B
A. Use a cotton-tipped applicator to remove cerumen:
Inserting objects like cotton-tipped swabs into the ear canal is unsafe and can cause damage; not recommended for clearing earwax before temperature measurement.
B. Insert the probe snugly into the ear canal and press scan:
This is the correct method to ensure an accurate tympanic temperature reading.
C. Pull the pinna downward and backward:
This is correct for children under 3 years, not for adults.
D. Hold the probe flat against the forehead and press scan:
This technique is for a temporal artery thermometer, not tympanic.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Massage reddened areas during dressing changes:
Massaging reddened or compromised skin can worsen tissue damage and increase the risk of further injury.
B. Apply a heat lamp twice a day:
Heat lamps are not recommended and may dry out the wound bed or burn healing tissue.
C. Cleanse with 0.9% sodium chloride irrigation:
Normal saline is gentle and effective for cleaning granulating tissue without causing damage or cytotoxic effects.
D. Cleanse with povidone-iodine solution:
Povidone-iodine is cytotoxic and can impair wound healing, especially to new granulating tissue.
Correct Answer is C
Explanation
A. Decrease the temperature in the client’s room:
This would worsen hypothermia. The room should be warm.
B. Place a cooling fan near the client:
Cooling is used for fevers, not hypothermia.
C. Place a warming blanket over the client:
This is a first-line intervention for mild hypothermia. It helps raise the core temperature.
D. Request a prescription for an antipyretic medication:
Antipyretics are used to reduce fever, not to treat hypothermia.
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