Which action will prevent spreading organisms from one eye to the other when bathing a client?

Wipe from the outer part of the eye toward the inner portion.

Rinse the washcloth before washing the second eye.

Ask the client to roll the eyes upward.

Use a fresh washcloth when cleaning each eye.

Answer and Explanation

The Correct Answer is D

Use a fresh washcloth when cleaning each eye. This is because using the same washcloth for both eyes can transfer microorganisms from one eye to the other and cause cross-infection.

The other choices are wrong because:

Choice A is wrong because wiping from the outer part of the eye toward the inner portion can introduce microorganisms into the tear ducts and cause infection.

Choice B is wrong because rinsing the washcloth before washing the second eye does not eliminate all the microorganisms that might be on the cloth.

Choice C is wrong because asking the client to roll the eyes upward does not prevent spreading organisms from one eye to the other when bathing a client.

Normal ranges for eye hygiene are to use a clean washcloth or cotton ball for each eye, wipe from the inner to the outer canthus, and use warm water or saline solution.

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Correct Answer is B

Explanation

This is the priority nursing diagnosis for a client who has had vomiting and diarrhea for the past three days because it poses the greatest threat to the client’s health and well-

being. Fluid loss can lead to hypovolemia, hypotension, shock, electrolyte imbalance, and renal failure.

Choice A is wrong because fatigue is a subjective symptom that may or may not be related to fluid loss.

It is not a priority over fluid volume deficit.

Choice C is wrong because impaired skin integrity is a potential problem that may occur due to irritation from vomiting and diarrhea, but it is not a priority over fluid volume deficit.

Choice D is wrong because imbalanced nutrition is a potential problem that may occur due to vomiting, but it is not a priority over fluid volume deficit.

A. Avoiding silences so the client won’t feel anxious. B. Clarifying points made by the patient that are unclear. C. Listening attentively while speaking slowly and clearly. D. Sitting approximately two feet away from the client. E. Asking the family member to complete the written form.

Correct Answer is ["B","C"]

Explanation

The nurse should use clarifying points made by the patient that are unclear and listening attentively while speaking slowly and clearly as communication techniques when performing a health history.

These techniques help the nurse to gather accurate and comprehensive information from the patient and to establish rapport and trust.

Choice A is wrong because avoiding silences can make the patient feel rushed or interrupted. Silences can be useful to allow the patient to think or express emotions.

Choice D is wrong because sitting approximately two feet away from the client may be too close and invade the personal space of the client. The nurse should maintain a comfortable distance of about 4 to 5 feet from the client, depending on the cultural norms and preferences of the client.

Choice E is wrong because asking the family member to complete the written form may not reflect the true health history of the client. The nurse should obtain the information directly from the client whenever possible, unless the client is unable or unwilling to provide it.

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Which action will prevent spreading organisms from one eye to the other when bathing a client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which nursing diagnosis is priority for a client who has had vomiting and diarrhea for the past three days?

Correct Answer is B

Explanation

A nurse is performing a health history. What communication techniques should the nurse use? Select all that apply.

Correct Answer is ["B","C"]

Explanation

A health care provider prescribes one ounce of an elixir medication for a client. How many milliliters (mL) of medication should the nurse instruct the client to take during discharge teaching?

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