A nurse is observing an assistive personnel insert an intermittent urinary catheter. Which of the following observed actions would require intervention and further education?

The assistive personnel holds sterile objects above the waist level

The assistive personnel handles the catheter with sterile gloves

The assistive personnel opens the sterile package towards them

The assistive personnel avoids talking over the sterile field

Answer and Explanation

The Correct Answer is C

A. The assistive personnel holds sterile objects above the waist level: This is correct sterile technique because holding objects above waist level helps maintain sterility by preventing contamination from below or the patient’s environment.

B. The assistive personnel handles the catheter with sterile gloves: Using sterile gloves to handle the catheter is essential to prevent introducing pathogens and maintain a sterile field.

C. The assistive personnel opens the sterile package towards them: Opening a sterile package towards oneself increases the risk of contaminating the sterile contents by accidentally touching or breathing on them. The correct technique is to open the package away from the body.

D. The assistive personnel avoids talking over the sterile field: Avoiding talking over the sterile field prevents contamination from respiratory droplets and is an important infection control measure.

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Correct Answer is C

Explanation

A. act more quickly than those administered subcutaneously or intramuscularly: Oral medications generally take longer to act because they must be absorbed through the gastrointestinal tract and metabolized before reaching systemic circulation.

B. are most commonly absorbed in the stomach: Most oral medications are absorbed primarily in the small intestine due to its larger surface area and favorable pH, rather than in the stomach.

C. are partially metabolized by the liver before reaching their intended site: This is known as the first-pass effect or first-pass metabolism. After absorption in the GI tract, oral medications enter the hepatic portal circulation and pass through the liver, where some of the drug is metabolized and inactivated before reaching systemic circulation.

D. should always be taken with food: Some medications require food to reduce gastric irritation or enhance absorption, but not all oral medications must be taken with food; instructions vary by drug.

A. determine the amount of protein binding of the drug. B. determine if the blood concentration is at a level to produce beneficial effects. C. measure the distribution of the drug throughout the body. D. measure the first pass effect.

Correct Answer is B

Explanation

A. determine the amount of protein binding of the drug: Protein binding affects the drug’s activity and distribution, but peak and trough levels specifically measure blood concentration, not protein binding.

B. determine if the blood concentration is at a level to produce beneficial effects: Peak and trough levels are used to ensure the drug concentration stays within a therapeutic range—high enough to be effective but low enough to avoid toxicity. This monitoring is crucial for drugs with narrow therapeutic windows.

C. measure the distribution of the drug throughout the body: Drug distribution refers to how a drug spreads to tissues and organs, which is not directly assessed by peak and trough blood levels.

D. measure the first pass effect: The first pass effect relates to drug metabolism by the liver before reaching systemic circulation, which is not evaluated by peak and trough drug level measurements.

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A nurse is observing an assistive personnel insert an intermittent urinary catheter. Which of the following observed actions would require intervention and further education?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Medications that are taken by mouth (swallowed)

Correct Answer is C

Explanation

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Correct Answer is B

Explanation

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