In caring for a client who requires seizure precauons, the praccal nurse (PN) should ensure the ready availability of equipment to perform which procedure?

Sucon the trachea.

Insert a urinary catheter.

Apply so restraints.

Insert a nasogastric tube.

Answer and Explanation

The Correct Answer is A

Seizure precauons are measures taken to protect a client who is at risk of having a seizure, which is a sudden and abnormal electrical acvity in the brain that can cause changes in behavior, movement, sensaon, or consciousness. Seizure precauons include providing a safe environment, monitoring the client's vital signs and neurological status, administering anconvulsant medicaons, and documenng the onset, duraon, and characteriscs of any seizure acvity³.

One of the potenal complicaons of a seizure is aspiraon, which is the inhalaon of foreign material into the lungs, such as saliva, vomit, or food. Aspiraon can cause choking, pneumonia, or respiratory distress. To prevent or treat aspiraon, the praccal nurse (PN) should ensure the ready availability of equipment to perform suconing of the trachea, which is the tube that connects the mouth and nose to the lungs. Suconing of the trachea involves inserng a catheter through the nose or mouth into the trachea and applying negave pressure to remove any secreons or debris from the airway.

Therefore, opon A is the correct answer, while opons B, C, and D are incorrect.

Opon B is incorrect because inserng a urinary catheter is not related to seizure precauons or aspiraon prevenon.

Opon C is incorrect because applying so restraints may not be necessary or appropriate for a client who requires seizure precauons, as they may interfere with the natural movements of the seizure or cause injury to the client.

Opon D is incorrect because inserng a nasogastric tube is not related to seizure precauons or aspiraon prevenon.

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Correct Answer is D

Explanation

Choice A reason: The AP's ability to complete the task without assistance is not one of the five rights of delegation. The nurse should always supervise and evaluate the AP's performance of delegated tasks.

Choice B reason: The AP's ability to prioritize is not one of the five rights of delegation. The nurse should provide clear and specific instructions and expectations for the delegated tasks.

Choice C reason: The AP's rapport with clients is not one of the five rights of delegation. The nurse should consider the client's preferences, needs, and condition when delegating tasks.

Choice D reason: The AP has the knowledge and skill to perform the task is one of the five rights of delegation. The nurse should delegate tasks that are within the AP's scope of practice, training, and competencE.

A. Integumentary system B. Endocrine system C. Central nervous system D. Renal system E. Respiratory system

Correct Answer is ["A","C","E"]

Explanation

Choice A reason: The integumentary system is a portal of entry for anthrax because the bacteria can enter through cuts or abrasions on the skin, causing cutaneous anthrax, which is the most common and least severe form of the diseasE.

Choice B reason: The endocrine system is not a portal of entry for anthrax because the bacteria do not affect the glands or hormones of the body.

Choice C reason: The central nervous system is a portal of entry for anthrax because the bacteria can invade the brain and spinal cord, causing meningitis, which is a rare but fatal complication of anthrax infection.

Choice D reason: The renal system is not a portal of entry for anthrax because the bacteria do not affect the kidneys or urinary tract.

Choice E reason: The respiratory system is a portal of entry for anthrax because the bacteria can be inhaled into the lungs, causing inhalation anthrax, which is the most deadly and difficult to treat form of the diseasE.

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In caring for a client who requires seizure precauons, the praccal nurse (PN) should ensure the ready availability of equipment to perform which procedure?

Nursing Test Bank

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