A nurse is preparing an in-service for an annual skills fair at a community medical facility about fire safety. Place the steps in the order in which they should be performed in the case of a fire emergency. (Move the steps, placing them in the selected order of performance. Use all the steps.)

Pull the fire alarm.

Extinguish the fire.

Confine the fire.

Rescue the clients.

Answer and Explanation

The Correct Answer is D,A,C,B

A: Pulling the fire alarm is essential to alert others to the fire and initiate the emergency response. However, it should follow the immediate rescue of clients.

B: Extinguishing the fire is important but should be done after ensuring the safety of clients and confining the fire.

C: Confining the fire helps prevent it from spreading and should be done after pulling the fire alarm.

D: Rescuing the clients is the first priority to ensure their safety. Clients should be moved to a safe area away from the fire.

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Correct Answer is C

Explanation

The correct answer is C.

A: Consulting a dietitian is a beneficial order for a patient with a pressure ulcer. Proper nutrition, especially adequate protein intake, is crucial for wound healing. A dietitian can help ensure the patient receives the necessary nutrients to support tissue repair and recovery.

B: Applying a hydrogel dressing is appropriate for a clean, granulating Stage II pressure ulcer. Hydrogel dressings maintain a moist wound environment, which promotes healing and provides pain relief. They are suitable for wounds with minimal to moderate exudate.

C: Cleaning the wound with hydrogen peroxide is not recommended for a healing pressure ulcer. Hydrogen peroxide can damage healthy granulating tissue and delay the healing process. It is better to use saline or a wound cleanser that does not harm the new tissue.

D: Using a low-air-loss therapy unit is beneficial for patients with pressure ulcers. These units help reduce pressure on the skin, improve circulation, and prevent further skin breakdown. They are an effective part of pressure ulcer management.

A. Blood pressure 178/90 mm Hg B. Jugular vein distention C. Heart rate 50 D. Skin tenting present

Correct Answer is D

Explanation

A: Blood pressure of 178/90 mm Hg indicates hypertension, not dehydration. Dehydration typically leads to low blood pressure due to reduced blood volume.

B: Jugular vein distention is associated with fluid overload or heart failure, not dehydration. Dehydration usually results in flat neck veins.

C: A heart rate of 50 beats per minute is bradycardia and is not typically associated with dehydration. Dehydration often causes an increased heart rate (tachycardia) as the body tries to maintain adequate circulation.

D: Skin tenting present is a classic sign of dehydration. When the skin is pinched and does not return to its normal position quickly, it indicates a lack of fluid in the tissues.

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A nurse is preparing an in-service for an annual skills fair at a community medical facility about fire safety. Place the steps in the order in which they should be performed in the case of a fire emergency. (Move the steps, placing them in the selected order of performance. Use all the steps.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a patient with a healing Stage II pressure ulcer. The wound is clean and granulating. Which health care provider’s order will the nurse question?

Correct Answer is C

Explanation

A nurse is performing an admission assessment on a client. Which finding should the nurse identify as an indication that the client is dehydrated?

Correct Answer is D

Explanation

A nurse is caring for a client who has had a sedative overdose. What is the priority action in caring for this client?

The nurse is administering a controlled substance that falls into the category of Schedule I. Which of the following displays the appropriate abuse potential for Schedule I drugs?

A nurse is caring for a group of clients. Which of the following clients should the nurse identify as having an increased risk of aspiration while eating? (Select all that apply.)

A nurse is instructing a young adult client about healthful sleep habits. Which of the following statements should the nurse identify as an indication that the client needs further teaching?

A nurse receives an order from the provider for a client requiring the highest oxygen concentration with a one-way valve. What type of mask should the nurse apply to the client?

A nurse is assessing a client for early signs of hypoxemia during an asthma attack. Which manifestation should the nurse expect?

The patient has just been started on an enteral feeding and has developed diarrhea after being on the feeding for 2 hours. What does the nurse suspect is the most likely cause of the diarrhea?

A nurse is teaching a patient about medications. Which statement from the patient indicates teaching is effective?