When preparing to use a bottle of sterile saline for a dressing change, the nurse notes that the date it was opened was two days ago. What should the nurse do?

Pour out the top 10 mL of liquid and continue to utilize the bottle.

Obtain a new bottle of sterile saline.

Shake the bottle to ensure contents are mixed.

Switch to a bottle of sterile water.

Answer and Explanation

The Correct Answer is B

A. Pour out the top 10 mL of liquid and continue to utilize the bottle: Discarding a small portion of the solution does not ensure sterility after the bottle has been open for more than 24 hours. Continued use beyond the recommended time can increase the risk of contamination and infection.

B. Obtain a new bottle of sterile saline: Once a sterile saline bottle is opened, it is typically considered safe for use only within 24 hours. To maintain sterility and prevent infection, a new bottle should be used for the dressing change.

C. Shake the bottle to ensure contents are mixed: Shaking the bottle does not address sterility or contamination concerns. Sterile saline does not require mixing, and shaking it does not make it safe to use after the expiration of the safe usage window.

D. Switch to a bottle of sterile water: Sterile water is not an appropriate substitute for sterile saline in all clinical situations. The choice of solution should be based on wound care protocols, and switching without clinical justification is not appropriate.

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Correct Answer is D

Explanation

A. "I heard you immediately when you came in my room": In REM sleep, the brain is highly active, but the body is in a state of paralysis. A person in REM sleep is less likely to respond quickly to external stimuli, such as hearing someone enter the room.

B. "I feel really cold": Feeling cold is not typically associated with REM sleep. It could be due to other factors like body temperature regulation or environmental conditions but is not a key feature of REM sleep.

C. "It feels like I just went to sleep": This suggests the person was likely in a deeper stage of non-REM sleep. REM sleep typically has an active brain with vivid dreams, making it unlikely for the client to feel like they just fell asleep.

D. "I was having a great dream and I remember all of it": Vivid dreams and memory recall are characteristic of REM sleep. This stage is when the brain is most active in terms of dreaming, making it common for individuals to remember their dreams if they are awakened during this phase.

A. Back of the knee B. The bend of the arm C. The neck D. Top of the foot

Correct Answer is D

Explanation

A. Back of the knee: The back of the knee is where the popliteal pulse is located, not the pedal pulse. The popliteal pulse is assessed behind the knee and is not related to the foot or pedal area.

B. The bend of the arm: The pulse at the bend of the arm is the brachial pulse, which is located at the elbow. This is unrelated to the pedal pulse, which is found at the foot.

C. The neck: The neck contains the carotid pulse, which is assessed by palpating the carotid artery on either side of the neck. This location is unrelated to the pedal pulse, which is specifically assessed at the foot.

D. Top of the foot: The pedal pulse is located on the top of the foot, near the area where the foot meets the ankle. This pulse is typically checked to assess circulation to the lower extremities and is important for evaluating peripheral vascular health.

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When preparing to use a bottle of sterile saline for a dressing change, the nurse notes that the date it was opened was two days ago. What should the nurse do?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse awakens a client while the client is experiencing rapid eye movement sleep. What statement made by the client indicates they were awakened during REM sleep?

Correct Answer is D

Explanation

What location would the nurse assess for a pedal pulse?

Correct Answer is D

Explanation

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