A nurse manager is teaching a group of newly licensed nurses about which procedures are within their scope of practice. Which of the following examples should the nurse include in the teaching?

Insertion of an endotracheal tube

Monitoring a continuous intra-arterial infusion of a thrombolytic medication

Placement of nylon sutures

Administering a bolus dose of medication through an epidural catheter

Answer and Explanation

The Correct Answer is B

A. Insertion of an endotracheal tube: Endotracheal intubation is outside the scope of practice for registered nurses. This procedure is performed by providers such as anesthesiologists, respiratory therapists, or specially trained advanced practice nurses.

B. Monitoring a continuous intra-arterial infusion of a thrombolytic medication: Nurses are responsible for closely monitoring patients receiving high-risk infusions. This includes assessing for complications such as bleeding, changes in vital signs, and effectiveness of therapy, which falls within an RN’s scope of practice.

C. Placement of nylon sutures: Suturing is a procedure performed by providers or advanced practice nurses, not registered nurses. Performing sutures is outside the RN’s scope of practice in most care settings.

D. Administering a bolus dose of medication through an epidural catheter: Epidural bolus administration requires advanced training and is usually limited to anesthesiologists, certified registered nurse anesthetists (CRNAs), or pain specialists.

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Correct Answer is B

Explanation

A. Move the client using a slider board: A slider board can assist with lateral transfers, but for a client weighing 136 kg (300 lb), it may not provide the safest method due to the increased risk of strain and injury to staff. A more advanced device is preferred.

B. Use an air-assisted transfer device to move the client: An air-assisted transfer device is the safest choice for bariatric clients because it significantly reduces friction, making movement easier and safer for both the client and healthcare workers. It minimizes musculoskeletal injury risk during transfer.

C. Raise the bed to 5 cm (2 in) above the level of the stretcher: The bed should be adjusted to the same height as the stretcher to allow a smooth transfer. Raising it higher can make the transfer unsafe and increase the risk of injury or difficulty sliding the client across.

D. Position the head of the bed at 25° prior to the transfer: The head of the bed should be flat during lateral transfers to maintain spinal alignment and ease movement. Elevating the head complicates the process and increases the chance of shear or strain.

A. Dishwashing gloves B. Adhesive tape C. Macadamia nuts D. Bananas E. Rubber bands

Correct Answer is ["A","B","D","E"]

Explanation

A. Dishwashing gloves: Many dishwashing gloves are made with latex, which can trigger allergic reactions ranging from skin irritation to anaphylaxis. Clients with latex allergy should use latex-free alternatives such as vinyl or nitrile gloves.

B. Adhesive tape: Many types of adhesive tape contain latex, particularly the elastic bands used in some medical and household tapes. The nurse should advise the client to use latex-free alternatives, which are widely available, especially in medical supply stores.

C. Macadamia nuts: Latex allergy is associated with cross-reactivity to certain fruits such as bananas, kiwis, and avocados, but not macadamia nuts. Nuts are not typically part of the latex–fruit syndrome group.

D. Bananas: Bananas share similar proteins with natural rubber latex and can cause cross-reactive allergic responses. Individuals with latex allergy are often advised to avoid bananas due to this risk.

E. Rubber bands: Rubber bands are commonly made from natural rubber latex and pose a high risk for allergic reactions. Clients with latex allergy should avoid handling rubber bands or use synthetic substitutes.

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A nurse manager is teaching a group of newly licensed nurses about which procedures are within their scope of practice. Which of the following examples should the nurse include in the teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is preparing to transfer a client who weighs 136 kg (300 lb) from a bed to a stretcher with the aid of an assistive personnel (AP). Which of the following actions should the nurse take?

Correct Answer is B

Explanation

A home health nurse is teaching a client who has a latex allergy about items typically found in the home that can trigger an allergic reaction. Which of the following items should the nurse instruct the client to avoid? (Select all that apply.)

Correct Answer is ["A","B","D","E"]

Explanation

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