a nurse has an order to remove sutures from a client after retrieving the suture remover kit and applying sterile gloves which of the following action
Logo

Nursing Elites

HESI LPN

HESI Fundamentals Test Bank

1. A nurse has an order to remove sutures from a client. After retrieving the suture remover kit and applying sterile gloves, which of the following actions should the nurse take next?

Correct answer: A

Rationale: The correct action for the nurse to take next after preparing the suture remover kit and applying sterile gloves is to clean sutures along the incision site. This step is crucial in preventing infection, which is the greatest risk to the client during suture removal. Cleaning the site helps minimize the risk of introducing microorganisms into the incision, reducing the chances of infection. Grasping at the knot of the sutures with forceps (Choice B) is incorrect as it does not address the need to clean the incision. Cutting the sutures close to the skin on one side (Choice C) or pulling out the sutures with forceps in one piece (Choice D) without proper cleaning can increase the risk of infection and should not be the next step in the process of suture removal.

2. The healthcare provider is reviewing the plan of care for a client with a newly placed colostomy. Which outcome would indicate effective client teaching?

Correct answer: C

Rationale: The correct answer is C because effective teaching is demonstrated when the client can independently perform ostomy care. This indicates that the client has understood and retained the information provided during teaching. Choices A, B, and D are incorrect because demonstrating how to irrigate the colostomy, verbalizing understanding of dietary changes, and expressing feelings about the impact of the colostomy are important aspects of care but do not directly reflect the client's ability to apply the taught information in a practical setting.

3. A healthcare professional is planning to document care provided for a client. Which of the following abbreviations should the professional use?

Correct answer: A

Rationale: The correct answer is A: PC for after meals. PC stands for 'post cibum,' which is the appropriate abbreviation for 'after meals' in medical documentation. Choices B, QD, and C, BID, represent 'every day' and 'twice a day,' respectively, which are not specific to meal times. Choice D, PRN, signifies 'as needed,' which is also not related to meal timings. Therefore, for documenting care provided after meals, the most suitable abbreviation is PC.

4. A client with heart failure is being taught by a nurse on reducing daily sodium intake. Which factor is most crucial in determining the client’s ability to learn new dietary habits?

Correct answer: D

Rationale: The client’s previous dietary knowledge is the most critical factor in determining the ability to learn new dietary habits. Understanding the client's existing dietary knowledge helps tailor the teaching to build upon what they already know. While client involvement in planning changes can increase adherence and motivation, the foundational knowledge is essential for effective learning. The cost of dietary changes and the availability of low-sodium foods are important considerations but not as crucial as the client's existing knowledge.

5. A client has a closed wound drainage system. Which of the following actions should the nurse take?

Correct answer: D

Rationale: In a closed wound drainage system, it is essential to maintain the drain in a dependent position to allow for proper drainage. Gravity aids in the flow of drainage, preventing fluid backflow or pooling. Avoiding pressing the container down to create a vacuum (Choice A) is crucial as it can lead to complications in the system. Wearing sterile gloves (Choice B) is important for infection control when handling the drainage system. Resetting the container with the drainage port closed (Choice C) is incorrect as it can cause spillage and contamination of the surrounding area.

Similar Questions

A client requires bed rest and has a prescription for anti-embolic stockings. Which of the following actions should the nurse take?
A client admitted with sudden onset of severe back pain of unknown origin. Which statement would be most effective for the nurse to use to elicit further information from this client about his pain?
When caring for a client with diarrhea due to shigellosis, what precautions should the nurse implement?
A client with osteoporosis is prescribed alendronate (Fosamax). What instruction should the LPN/LVN provide to the client?
During a physical assessment, a nurse is assessing 4 adult clients. Which of the following physical assessment techniques should the nurse use?

Access More Features

HESI LPN Basic
$69.99/ 30 days

  • 5,000 Questions with answers
  • All HESI courses Coverage
  • 30 days access

HESI LPN Premium
$149.99/ 90 days

  • 5,000 Questions with answers
  • All HESI courses Coverage
  • 30 days access

Other Courses