Which identifier(s) may be used in diverse healthcare settings? Select all that apply.
The client's phone number
The client's identification bracelet
The client's room number
The client's birthdate
The client's first and last name
Correct Answer : B,D,E
Rationale:
A. The client’s phone number is not a reliable identifier in healthcare settings. Phone numbers can change frequently, be shared among family members, or be entered incorrectly in records. Relying on a phone number could lead to misidentification and errors in treatment, medication administration, or procedures.
B. The client’s identification bracelet is a highly reliable and widely used identifier. Most healthcare facilities require clients to wear ID bracelets that include critical information such as the client’s full name, medical record number, and sometimes date of birth. This ensures accurate identification for medications, procedures, blood transfusions, and diagnostic tests, reducing the risk of errors.
C. The client’s room number is not a reliable identifier. Room assignments can change frequently due to admissions, discharges, or transfers. Using a room number alone could result in misidentifying the client, which could lead to serious safety errors.
D. The client’s birthdate is a widely accepted identifier. It is unique to each individual and, when used in combination with the client’s full name, provides an extra layer of verification to prevent mistakes in care, medication administration, or procedures.
E. The client’s first and last name is a primary identifier in virtually all healthcare settings. Asking the client to state their full name before administering medications, drawing blood, or performing procedures ensures that the nurse is providing care to the correct individual. It is one of the most basic and effective methods for preventing misidentification errors.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Rationale:
A. Dipping the reagent strip into fresh urine is the correct step when performing a bedside urinalysis. The nurse should collect a fresh urine sample, briefly immerse the reagent strip so all test pads are moistened, remove it immediately, and then compare the color changes to the manufacturer’s chart at the specified times. This ensures accurate results for substances such as glucose, protein, ketones, blood, and leukocytes.
B. Touching the reagent strip in the colored areas is incorrect. The nurse should avoid touching the test pads because oils or contaminants from the hands can alter the results and lead to inaccurate readings.
C. Leaving the reagent strip in the urine for 2 minutes is incorrect. The strip should only be dipped briefly and removed immediately. Prolonged immersion can cause reagent leaching and inaccurate results. Timing for reading results occurs after removal from the urine, according to the manufacturer’s instructions.
D. Sending the reagent strip to the laboratory is unnecessary. A bedside urinalysis using reagent strips is performed and interpreted at the point of care. Only the urine specimen itself would be sent to the lab if further testing is required.
Correct Answer is A
Explanation
Rationale:
A. The client’s mucous membranes are moist indicates improvement in hydration status. Dry mucous membranes are a classic sign of dehydration. When IV fluids are effective, moisture returns to the oral mucosa, reflecting improved circulating volume and tissue hydration. This is a positive sign that treatment is working.
B. Dark, concentrated urine indicates ongoing dehydration. When fluid volume is low, the kidneys conserve water, resulting in decreased urine output and darker, more concentrated urine. Improvement would be reflected by lighter-colored urine and adequate output.
C. A capillary refill time of 4 seconds is abnormal and suggests poor peripheral perfusion, which is commonly seen in dehydration. Normal capillary refill is typically less than 2 seconds. Delayed refill indicates dehydration is not yet corrected.
D. Skin tenting at the collarbone indicates decreased skin turgor, a sign of dehydration. Improvement would be demonstrated by skin returning quickly to its normal position after being pinched.
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