When using wrist restraints, which of these statements is correct?
Apply them safely and secure to the bed rails.
Use to protect elderly patients from pulling out tubes and lines as soon as you place them.
Apply them to clients who have a history of violence or a previous fall for everyone’s protection.
Use them only as a last resort after attempting alternatives and get an order to do so.
The Correct Answer is D
Use them only as a last resort after attempting alternatives and get an order to do so. This is because restraints are used to protect persons from harming themselves or others, but they can also cause injuries, falls, and death. Therefore, they should be used only when less restrictive measures fail to protect the person or others, and only with informed consent and a doctor’s order.
Choice A is wrong because restraints should not be secured to the bed rails, but to the movable part of the bed frame out of the person’s reach.
This prevents the person from getting entangled or injured by the restraints.
Choice B is wrong because restraints should not be used for staff convenience or to control or prevent a behavior. They should be used only for the immediate physical safety of the person or others.
Choice C is wrong because restraints should not be applied to clients who have a history of violence or a previous fall for everyone’s protection. They should be used only when there is a clear and present danger of harm to the person or others.
Normal ranges for restraints are:
- Check the person at least every 15 minutes
- Remove restraints and meet basic needs at least every 2 hours
- Apply restraints so that they are snug but allow enough room to fit one finger between the restraint and the wrist
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
This would help the client to feel valued, respected and involved in their own care, which can enhance their self-esteem.
Choice A is wrong because adding a nursing diagnosis of lowered self-esteem to the care plan does not address the underlying causes of the problem or provide any interventions to improve it.
It may also label the client and make them feel worse.
Choice B is wrong because giving praise for every decision the client makes is not realistic or sincere.
It may also undermine the client’s confidence and autonomy by implying that they need constant approval from others.
Choice D is wrong because modeling competent care for the client does not necessarily help them to maintain their self-esteem.
It may even make them feel inadequate or dependent on the nurse.
Correct Answer is C
Explanation
This is because hepatitis C is a viral infection that spreads through contaminated blood and body fluids. IV drug use is one of the most common ways to get hepatitis C, especially if people share needles or other equipment.
Choice A is wrong because drinking contaminated water is not a risk factor for hepatitis
C. Hepatitis A and E are transmitted by the fecal-oral route, which can happen through contaminated water.
Choice B is wrong because eating raw chicken is not a risk factor for hepatitis C. Hepatitis E can be transmitted by eating undercooked meat from infected animals, but not chicken.
Choice D is wrong because unprotected intercourse is not a major risk factor for hepatitis
C. Hepatitis B and D are more likely to be transmitted by sexual contact than hepatitis
C. However, having multiple sexual partners or having sexually transmitted diseases can increase the risk of hepatitis
C. Normal ranges for hepatitis C tests depend on the type of test and the laboratory that performs it.
Some common tests are:
- Anti-HCV antibody test: This test detects antibodies to the hepatitis C virus in the blood.
A positive result means that the person has been exposed to the virus, but does not necessarily mean that they have an active infection. A negative result means that the person has never been exposed to the virus or has cleared it from their body.
- HCV RNA test: This test measures the amount of hepatitis C virus in the blood.
A positive result means that the person has an active infection and can transmit the virus to others. A negative result means that the person does not have an active infection or has cleared it from their body.
- HCV genotype test: This test identifies the strain or type of hepatitis C virus that the person has. There are six major genotypes of hepatitis C, numbered 1 to 6, and each one may respond differently to treatment.
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