A nurse is setting up a sterile field in a client's room. Which of the following actions should the nurse take?

Placing a sterile instrument within 1.3 cm (0.5 in) of the edge of the sterile field

Opening the top flap of the sterile tray package away from their body

Dropping sterile objects onto the field from a height of 5 cm (2 in)

Placing the cap of a sterile solution on a clean surface with the inside facing down

Answer and Explanation

The Correct Answer is B

A)   Placing a sterile instrument within 1.3 cm (0.5 in) of the edge of the sterile field - Sterile items should be kept within the confines of the sterile field to maintain sterility.
B)   Opening the top flap of the sterile tray package away from their body - Opening the sterile package away from the body helps prevent contamination from airborne particles or droplets.
C)   Dropping sterile objects onto the field from a height of 5 cm (2 in) - Dropping sterile objects can create air currents that may introduce contamination to the sterile field, for instance, through splashing.
D)   Placing the cap of a sterile solution on a clean surface with the inside facing down

- Sterile items should be handled with care to maintain sterility, and placing the cap with the inside facing down may introduce contamination. The inside of the cap should face up.

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Correct Answer is B

Explanation

A) Tell the client to think about something else. - This response dismisses the client's feelings and does not address the underlying issue of coping with job loss.
B) Ask the client to describe their support system. - This action allows the nurse to assess the resources available to the client for coping with stress and provides an opportunity to explore potential sources of support.
C) Ask the client why they're unable to cope. - While understanding the reasons behind the client's inability to cope is important, this question may come across as judgmental or dismissive of the client's feelings.

D) Tell the client that everything will be okay. - While offering reassurance is important, it should be done in the context of acknowledging the client's feelings and exploring coping strategies.

A. Ask the client to state their room number. B. Have the client state their phone number. C. Review the client's photograph in the medical record. D. Request an assistive personnel to identify the client.

Correct Answer is C

Explanation

A) Ask the client to state their room number. - Clients with advanced dementia may not reliably remember their room number, and this method may not accurately verify their identity.
B) Have the client state their phone number. - Clients with advanced dementia may not remember their phone number, and it may not be an effective method of identification.
C) Review the client's photograph in the medical record. - Reviewing the client's photograph in the medical record is a reliable way to verify their identity, especially if they do not have an identification band.
D) Request an assistive personnel to identify the client. - While assistive personnel may recognize the client, it's important for the nurse to verify identity through official documentation such as the medical record.

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A nurse is setting up a sterile field in a client's room. Which of the following actions should the nurse take?

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Naxlex Comprehensive Predictor Exams

A nurse is collecting data from a client who reports an inability to cope because of their recent job loss. Which of the following actions should the nurse take?

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