The practical nurse (PN) is preparing to transfer an unresponsive client from the bed to a stretcher. Which client data is most important for the PN to obtain before beginning the transfer?
Skin turgor.
Body weight.
Temperature.
Blood pressure.
The Correct Answer is D
A. Skin turgor is important for assessing hydration status, but it is not the most critical factor when preparing for a safe transfer. For an unresponsive client, ensuring stable hemodynamic conditions is more urgent. Blood pressure provides essential information about the client’s circulatory status, which is crucial for assessing the risks associated with the transfer.
B. Body weight is generally used for dosing medications or assessing nutritional status and is not immediately relevant for ensuring a safe transfer of an unresponsive client. Although body weight might be useful in planning the transfer logistics, it does not impact immediate safety concerns.
C. Temperature can indicate infection or other issues but does not directly affect the immediate safety of the transfer process. While monitoring temperature is part of overall care, it is not the most pressing concern during the transfer.
D. Blood pressure is essential to check before the transfer because it reflects the client’s cardiovascular stability. Low or unstable blood pressure might increase the risk of complications during the transfer, such as a sudden drop in blood pressure that could lead to a fall or injury.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is {"A":{"answers":"B"},"B":{"answers":"C"},"C":{"answers":"A"},"D":{"answers":"C"},"E":{"answers":"A"}}
Explanation
Coarse breath sounds are typically associated with respiratory distress, indicating fluid or secretions in the airways.
Irritability can be a sign of both cerebral edema and respiratory distress as it may stem from hypoxia or increased intracranial pressure.
Seizure activity is more specifically related to cerebral edema, which can increase intracranial pressure and provoke seizures.
Decreased level of consciousness can occur in both conditions: cerebral edema (due to increased intracranial pressure) and respiratory distress (due to hypoxia).
Bradycardia is more indicative of cerebral edema, especially when associated with increased intracranial pressure and resultant autonomic dysregulation.
Correct Answer is B
Explanation
A. Sliding hands under the lumbar area and knees can cause strain on the PN’s back and is not the safest method for turning a dependent client.
B. Using a turning sheet to turn the client away from the PN is the safest method for moving a dependent client, as it uses a proper technique that minimizes injury risk for both the client and the PN.
C. Raising bed rails on the opposite side may increase the risk of injury or falls, and is not directly related to the safe turning of the client.
D. Grasping the client's hand to pull them is unsafe and could cause injury or discomfort to both the client and the PN, especially when turning a dependent client.
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