A nurse is teaching a group of newly licensed nurses about the Braden scale. Which of the following responses by a newly licensed nurse indicates an understanding of the teaching?
"The client's age is part of the measurement."
"Each element has a range from one to five points."
"The higher the score, the higher the pressure injury risk."
"The scale measures six elements."
The Correct Answer is D
Choice A rationale:
The client's age is not a part of the measurement in the Braden scale.
Choice B rationale:
Each element in the Braden scale has a range from one to four points, except for friction and shear, which is scored from one to three points.
Choice C rationale:
The lower the score, the higher the risk of developing pressure injuries.
Choice D rationale:
The Braden scale is a tool that helps nurses assess the risk of developing pressure injuries in clients. It consists of six elements: sensory perception, moisture, activity, mobility, nutrition, and friction and shear.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale:
Recapping the needle before disposal is not recommended due to the risk of needlestick injuries.
Choice B rationale:
Placing the needle on the bedside table poses a safety risk and is not an appropriate action.
Choice C rationale:
Discarding the needle in a puncture-proof container is the correct action for safe disposal.
Choice D rationale:
Removing the needle from the syringe may be necessary for disposal but should be done carefully and in accordance with safety protocols.
Correct Answer is C
Explanation
Choice A rationale:
The radial vein on the left wrist is not typically chosen for IV therapy. Additionally, proximity to the mastectomy site may be a consideration.
Choice B rationale:
The cephalic vein on the back of the right hand is not typically selected, especially following a right mastectomy. Choosing a vein on the affected side may increase the risk of complications.
Choice C rationale:
The cephalic vein in the left distal forearm is a suitable choice. It is on the opposite side of the mastectomy and allows for effective IV therapy.
Choice D rationale:
The basilic vein in the right antecubital fossa is on the affected side and may pose a higher risk of complications. Choosing a vein on the opposite side is generally preferred.
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