The nurse is preparing to insert a urinary catheter. The nurse is using open gloving to apply the sterile gloves. Which steps will the nurse take? (Select all that apply.)

While putting on the first glove, touch only the outside surface of the glove.

Remove outer glove package by tearing the package open.

After the second glove is on, interlock hands.

With gloved dominant hand, slip fingers underneath the second glove cuff.

Lay glove package on clean flat surface above waistline.

Glove the dominant hand of the nurse first.

Answer and Explanation

The Correct Answer is B,C,D,E,F

A. This statement is incorrect; the nurse should touch only the inside of the first glove while putting it on to maintain sterility.

B. The outer glove package should be removed by tearing it open to access the gloves inside.

C. After putting on the second glove, interlocking hands helps to ensure that the gloves remain sterile.

D. Slipping fingers underneath the second glove cuff with the gloved dominant hand helps to keep the gloves sterile while donning them.

E. Laying the glove package on a clean flat surface above the waistline prevents contamination.

F. The dominant hand should be gloved first to maintain a sterile technique, as the dominant hand is used for the procedure.

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Correct Answer is A

Explanation

A. "Acute pain" is a NANDA-I approved nursing diagnosis that identifies a specific condition that nursing interventions can address.
B. "Sore throat" is a symptom rather than a nursing diagnosis and does not appear in NANDA-I.
C. "Sleep apnea" is classified as a medical diagnosis and not as a nursing diagnosis within NANDA-I.
D. "Heart failure" is also a medical diagnosis and not an approved nursing diagnosis, as it describes a condition rather than the patient's response or nursing concerns.

A. Presence of cardiac dysrhythmias B. Peripheral extremity circulation C. Oxygenation requirements D. Ventilation status

Correct Answer is C

Explanation

A. While monitoring cardiac output can provide insights into heart function, it does not directly determine the presence of dysrhythmias.
B. Peripheral extremity circulation is influenced by cardiac output but is not the primary focus of monitoring it.
C. Cardiac output is essential for determining the heart's ability to meet the body's oxygenation requirements; low cardiac output can lead to inadequate oxygen delivery.
D. Ventilation status refers to the respiratory function and is not directly assessed through cardiac output measurements.

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The nurse is preparing to insert a urinary catheter. The nurse is using open gloving to apply the sterile gloves. Which steps will the nurse take? (Select all that apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which diagnosis will the nurse document in a patient's care plan that is NANDA-I approved?

Correct Answer is A

Explanation

Which determination is the nurse trying to achieve by monitoring a patient's cardiac output?

Correct Answer is C

Explanation

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