A young woman arrives to the Emergency Department and reports that she was raped and stabbed.
What should the nurse do first?
Call the Sexual Nurse Examiner.
Assess vital signs.
Call her parents to ask for permission to treat.
Contact Security in case the perpetrator arrives.
The Correct Answer is B
The nurse should prioritize the physical safety and stability of the patient who has been raped and stabbed.
Assessing vital signs is the first step in determining the patient’s condition and identifying any life-threatening injuries that need immediate intervention.
Choice A is wrong because calling the Sexual Nurse Examiner is not the first action to take.
The Sexual Nurse Examiner is a specially trained nurse who can perform a forensic examination and collect evidence from the patient, but this should be done after ensuring the patient’s physical safety and obtaining consent.
Choice C is wrong because calling her parents to ask for permission to treat her is not necessary or appropriate.
The patient is an adult who can consent to her own treatment unless she is incapacitated or mentally incompetent.
Calling her parents without her permission may violate her privacy and autonomy.
Choice D is wrong because contacting Security in case the perpetrator arrives is not the most urgent action to take.
The nurse should focus on the patient’s needs and not assume that the perpetrator will follow her to the hospital.
Security measures can be taken later if needed.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
What has it been like for you since your wife died? This statement shows empathy and invites the client to share his feelings and experiences.
It also acknowledges the client’s loss and validates his grief.
Choice A. Tell me how your wife died.
This statement is too intrusive and may cause the client to feel uncomfortable or defensive. It also focuses on the past event rather than the present situation.
Choice B. Have you considered attending a grief group? This statement is too premature and may imply that the nurse is trying to solve the client’s problem or dismiss his feelings.
It also assumes that the client needs or wants a grief group.
Choice D. You have wonderful children and grandchildren who are very supportive.
This statement is too superficial and may minimize the client’s grief or make him feel guilty. It also shifts the attention away from the client and his wife.
Correct Answer is D
Explanation
30 mL. This is because one ounce is equal to 29.57353 milliliters, so one ounce of an elixir medication is approximately 30 milliliters.
The nurse should instruct the client to take 30 milliliters of the medication during discharge teaching.
Choice A is wrong because 5 milliliters is much less than one ounce. Choice B is wrong because 15 milliliters is half of one ounce.
Choice C is wrong because 25 milliliters is slightly less than one ounce.
The nurse should use a conversion factor or a calculator to convert ounces to milliliters accurately.
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