The nurse is assigned to the care of the following patients. In planning nursing care, the nurse knows to use touch cautiously when communicating with which patient?

Middle-aged man experiencing the acute phase of myocardial infarction (MI)

Older adult with a history of dementia admitted for dehydration

Young adult in the rehabilitative phase after arthroscopic surgery

Middle-aged woman just diagnosed with terminal lung cancer

Answer and Explanation

The Correct Answer is A

A. Middle-aged man experiencing the acute phase of myocardial infarction (MI): During the acute phase of an MI, the patient may be experiencing significant physical and emotional stress. Touch may be perceived as intrusive or overwhelming, particularly if the patient is in pain or experiencing anxiety. It's important for the nurse to use caution with touch in this situation, prioritizing verbal communication and ensuring the patient's comfort.

B. Older adult with a history of dementia admitted for dehydration: Touch can often be comforting for individuals with dementia, as it may help to reduce anxiety and provide reassurance. In this case, touch may be beneficial as long as the nurse assesses the individual’s response to touch and proceeds accordingly.

C. Young adult in the rehabilitative phase after arthroscopic surgery: This patient may appreciate touch as a form of encouragement or support during rehabilitation. Unless there are specific contraindications, touch is generally acceptable in this context.

D. Middle-aged woman just diagnosed with terminal lung cancer: While this patient may benefit from touch as a source of comfort and support, the nurse should be sensitive to the patient's emotional state. However, compared to the patient in acute MI, the nurse is less likely to need to use touch cautiously in this situation.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is B

Explanation

A. Twist at the waist when she moves an object to one side: Twisting at the waist can place excessive strain on the lower back and increase the risk of injury. Instead, the client should pivot her whole body to move an object, which helps maintain spinal alignment and reduces strain.

B. Bend at the knees when picking up an object: This instruction is crucial for preventing back strain. Bending at the knees allows the client to use her legs' strength to lift the object rather than putting pressure on the back. This technique helps protect the spine and promotes safe lifting practices.

C. Hold an object away from her body as she lifts it: Holding an object away from the body increases leverage and strain on the back muscles. The client should keep the object close to her body while lifting to maintain better balance and reduce the risk of injury.

D. Relax her abdominal muscles when she lifts an object: Engaging the abdominal muscles provides support to the spine during lifting. Relaxing the abdominal muscles can lead to a lack of core stability, increasing the risk of back injury. The client should be encouraged to engage her core muscles while lifting.

A. Wash the area of the puncture thoroughly with soap and water. B. Notify the employee health services C. Complete an incident report D. Report the incident to the charge nurse

Correct Answer is A

Explanation

A. Wash the area of the puncture thoroughly with soap and water: The first action the nurse should take after a needlestick injury is to immediately wash the area with soap and water. This is crucial for minimizing the risk of infection and exposure to potentially infectious materials. Prompt cleaning of the puncture site is essential in reducing the risk of transmission of bloodborne pathogens.

B. Notify employee health services: While notifying employee health services is important for follow-up care and evaluation, it should be done after the initial wound care has been performed. Immediate action should focus on cleaning the injury first.

C. Complete an incident report: Completing an incident report is a necessary step for documentation and accountability in the healthcare setting. However, it should be done after the immediate first aid for the needlestick injury has been addressed.

D. Report the incident to the charge nurse: Reporting the incident to the charge nurse is important for ensuring appropriate follow-up and support, but the priority should be to address the injury first. The nurse should take care of the puncture wound before notifying others about the incident.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

The nurse is assigned to the care of the following patients. In planning nursing care, the nurse knows to use touch cautiously when communicating with which patient?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is teaching a client who has strained her back muscles while preparing to move to a new apartment. Which of the following instructions should the nurse include?

Correct Answer is B

Explanation

A nurse accidentally sticks her hand with a syringe after administering an IM injection to a client. Which of the following actions should the nurse take first?

Correct Answer is A

Explanation

A nurse is removing personal protective equipment (PPE) after giving direct care to a client who requires isolation. Which of the following PPE items should the nurse remove first?

A nurse caring for a client who has an infected wound removes a dressing saturated with blood and purulent drainage. How should the nurse dispose of the dressing material?

A nurse is assisting with transferring a client from the bed to a wheelchair. Which of the following actions should the nurse take?

A nurse is teaching an assistive personnel (AP) about using personal protective equipment while caring for clients. Which of the following statements should the nurse identify as an indication that the AP understands the instructions?

Which of the following is a benefit of negative pressure wound therapy (NPWT) for skin wounds?

A nurse is admitting a client who has pertussis. Which of the following types of transmission-based precautions should the nurse initiate?

A nurse is assessing a client who has a wrist restraint applied. For which of the following findings should the nurse loosen the restraint?

A nurse is admitting a client who has hepatitis C. Which of the following precautions should the nurse implement?