Of the following interventions, which would be the most important for preventing skin impairment in a mobile patient with local nerve damage?

Insert an indwelling urinary catheter

Limit caloric and protein intake

During a bath, assess for pain

Turn the patient every 2 hours'

Answer and Explanation

The Correct Answer is D

A.   Inserting an indwelling urinary catheter could increase the risk of infection rather than prevent skin impairment.
B.   Limiting caloric and protein intake can negatively impact skin integrity.
C.   While assessing for pain is important, turning the patient regularly is a more direct intervention to prevent skin breakdown.
D.   Regular repositioning helps alleviate pressure on areas susceptible to skin impairment, making it the most effective intervention.

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Correct Answer is A

Explanation

A. Assessing the weight and assistance needed ensures safe handling of the patient.
B. Attempting to lift alone increases the risk of injury and should be avoided.
C. Lifting heavy weights without assistance can lead to injuries; assessment is key.
D. Using the lift team is essential when available for safety and efficiency.

A. Avoid using a transfer or gait belt around the patient's waist prior to transfer B. Assess for the need of a mechanical lift and help C. Not allow the patient to help in any way because resistance can lead to injury D. Ensure that the patient has stockings on his feet for transfer

Correct Answer is B

Explanation

A. Using a transfer or gait belt is generally recommended for safety during transfers.
B. Assessing for a mechanical lift is important, especially if the patient is unable to assist significantly; safety should always come first.
C. Allowing the patient to assist when able is important for their dignity and can make the transfer easier if done correctly.
D. While stockings can help with circulation, they are not the primary consideration for the transfer process.

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Of the following interventions, which would be the most important for preventing skin impairment in a mobile patient with local nerve damage?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is preparing to reposition a patient. Before doing so, the nurse must: (2pts)

Correct Answer is A

Explanation

The nurse needs to transfer the patient from the bed to the chair. The nurse should: (2pts)

Correct Answer is B

Explanation

Correct body alignment reduces strain on musculoskeletal structures and contributes to balance. Balance control is attained by: (Select all that apply)

The patient is brought to the Emergency Department with possible injury to the left shoulder. Which area will the nurse assess to best determine joint mobility?

A nursing assistant reports seeing a reddened area on the patient's hip while bathing the patient. The nurse should:

A patient with an indwelling urinary catheter has been given a bed bath by a new nursing assistant. The registered nurse evaluating the cleanliness of the patient notices crusting at the urinary meatus. The best next action of this nurse is to:

Which of the following individuals is most likely to need the nurse's assistance because of the presence of identity confusion?

The nurse is providing care to a patient who is bedridden. To prevent fatigue, the nurse raises the height of the bed. The nurse understands that balance is maintained by raising the bed to:

The nurse is caring for a hospitalized patient. Which of the following behaviors alerts the nurse to consider the need for restraint?

In providing perineal care to a female patient, the nurse should wash: