The practical nurse (PN) warms the irrigation solution before irrigating the ear of an adult client who has impacted cerumen in the ear canal. In which order should the PN implement these actions? (Arrange from first on top to last on the bottom.)
Ask the client to tilt the head slightly toward the affected side.
Position an emesis basin close to the neck under the ear.
Pull the pinna of the ear in an upward and backward direction.
Direct the flow of the warm solution toward the ear canal.
The Correct Answer is B, A, C, D
1. Warm the irrigation solution to body temperature to prevent dizziness or discomfort.
2. Position an emesis basin close to the neck under the ear to catch the returning solution and cerumen.
3. Ask the client to tilt the head slightly toward the affected side to allow the solution to flow easily into the ear canal.
4. Pull the pinna of the ear in an upward and backward direction to straighten the ear canal.
5. Direct the flow of the warm solution toward the wall of the ear canal, not directly at the eardrum, to dislodge the impacted cerumen gently.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["C","D","E"]
Explanation
A. Limiting fresh fruits and vegetables is not necessary for clients with ascites due to cirrhosis unless they are causing specific issues like bloating or discomfort. Fresh fruits and vegetables are generally healthy and can be part of a balanced diet unless restricted for other reasons.
B. Consuming concentrated sweets to boost energy is not a recommended dietary strategy for managing ascites or cirrhosis. This approach may lead to excessive calorie intake without addressing the nutritional needs for a balanced diet.
C. Eating six small meals daily can help manage low appetite and energy levels by providing consistent nutrition throughout the day. Small, frequent meals are easier to consume and can help maintain adequate caloric intake for individuals with low appetite.
D. Choosing small helpings from lean protein sources is a good suggestion for managing ascites and cirrhosis. Lean proteins are important for maintaining muscle mass and supporting overall health without exacerbating liver disease.
E. Avoiding adding salt to foods helps manage fluid retention associated with ascites. Reducing sodium intake is crucial for managing ascites and preventing further fluid accumulation.
Correct Answer is D
Explanation
A. Measles Mumps Rubella (MMR) vaccine is typically administered at 12-15 months of age, not at 2 months. It is part of the recommended immunization schedule but is not given during the 2-month visit.
B. Varicella vaccine is usually given at 12-15 months of age. It is essential for preventing chickenpox but is not included in the 2-month immunization schedule.
C. Hepatitis A vaccine is recommended starting at 12 months of age. It is not part of the immunizations administered at 2 months.
D. Hepatitis B vaccine is part of the routine immunization schedule for infants and is given at birth, 1-2 months, and 6-18 months. At the 2-month visit, it is appropriate to administer the second dose of the Hepatitis B vaccine if it was not given at 1 month.
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