A nurse is planning postoperative care for a client who is having a thoracotomy with a chest tube placement. Which of the following pieces of equipment should the nurse plan to have at the client's bedside?
Wire cutters
Tracheostomy tray
Padded clamp
Sand bag
The Correct Answer is C
A. Wire cutters – These are used in clients with wired jaws, not for chest tube management.
B. Tracheostomy tray – This is necessary for airway emergencies but is not specific to chest tube management.
C. Padded clamp – This is the correct answer because a padded clamp is used to assess for air leaks, check chest tube patency, or temporarily clamp the tube if needed during troubleshooting or before removal.
D. Sand bag – A sandbag is not necessary for a client with a chest tube; it is more commonly used for stabilizing orthopedic injuries.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Place the client on an air mattress – While air mattresses help prevent pressure ulcers, they do not directly address mobility needs in the immediate postoperative period.
B. Rewrap the bandage every 8 hr in a circular pattern – The bandage should be reapplied more frequently (every 4–6 hr) using a figure-eight pattern to prevent restriction of circulation.
C. Turn the client every 4 hr while in bed – Clients should be turned at least every 2 hr to prevent pressure ulcers and improve circulation.
D. Instruct the client to use an overbed trapeze to move around in bed – This is the best intervention because it allows the client to reposition independently, reducing the risk of skin breakdown and enhancing mobility.
Correct Answer is B
Explanation
Rationale:
A. Call the nurse who made the error to discuss the medication error – This is not the appropriate action. The focus should be on client safety and proper reporting, not on discussing the error with the previous nurse.
B. File an incident report within 24 hr – This is the correct action. Incident reports should be completed promptly to document the error and ensure proper follow-up.
C. Notify the facility's pharmacist within 1 hr of the incident – While the pharmacist may be informed if a medication reversal or adjustment is needed, this is not the primary action to take.
D. Place an incident report in the client’s medical record – Incident reports are internal documents and should not be placed in the medical record to avoid legal concerns.
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