The nurse is preparing to assess a client's oral temperature. The nurse should plan to place the thermometer probe in which area of the client's mouth?
Along either upper gum line, adjacent to an incisor.
Deep in the posterior sublingual pocket.
In the inferior buccal space on either side of the tongue.
Superior to the tongue with the tip touching the hard palate.
The Correct Answer is B
A. Along either upper gum line, adjacent to an incisor: Placing the thermometer along the upper gum line near the incisors would not accurately reflect the body's core temperature. The posterior sublingual pocket provides a more reliable reading.
B. Deep in the posterior sublingual pocket: The sublingual pocket, located under the tongue toward the back, is the best place for measuring oral temperature. This area has a good blood supply from the carotid arteries, making it ideal for an accurate temperature reading.
C. In the inferior buccal space on either side of the tongue: The buccal space is not ideal for temperature measurement, as it does not have the same consistent blood supply and is more prone to error due to airflow from breathing.
D. Superior to the tongue with the tip touching the hard palate: Placing the thermometer on top of the tongue against the hard palate would result in an inaccurate reading because this location does not effectively reflect the body's core temperature.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A.This option is incorrect because a PVR of 400 mL is significantly higher than normal. Documenting without further intervention could lead to complications if the high residual volume persists.
B.While an external catheter may be beneficial for managing incontinence or monitoring urine output, it does not address the underlying issue of urinary retention. An external catheter would not relieve the retained urine in the bladder.
C.A post-void residual (PVR) of 400 mL is abnormally high, indicating that the bladder is not emptying effectively, which can lead to discomfort, urinary tract infection (UTI), and potential kidney issues if left untreated. An in-and-out catheterization allows for temporary relief by emptying the bladder and can also help prevent bladder distention. Contacting the physician to report the findings and obtain an order is appropriate to manage this condition safely.
D. Encouraging the client to attempt voiding again without intervention may not be effective in reducing the high PVR. This delay could increase the risk of bladder distention and discomfort.
Correct Answer is A
Explanation
A pureed diet is a type of texture-modified diet where food is blended to a smooth consistency to make it easier to swallow. Nectar-thick liquids are liquids that have a slightly thicker consistency than water, which makes them easier for the client to swallow without choking or aspirating.
Options B, C, and D are not appropriate for a client with dysphagia on a pureed diet with nectar-thick liquids. Corn on the cob is a hard, crunchy food that is difficult to puree, while a hamburger and a salad are both difficult to make into a smooth consistency. These foods could pose a choking or aspiration risk for the client.
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
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.