a nurse is using an open irrigation technique to irrigate a clients indwelling urinary catheter which of the following actions should the nurse take
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Nursing Elites

ATI RN

ATI Leadership Practice B

1. When using an open irrigation technique to irrigate a client's indwelling urinary catheter, which of the following actions should the nurse take?

Correct answer: B

Rationale: When irrigating an indwelling urinary catheter, the nurse should use a 20-mL syringe for the procedure. This syringe size helps to provide adequate pressure for effective irrigation. Placing the client in a side-lying position is not necessary for this procedure. Instilling a specific amount of irrigation fluid into the catheter is not mentioned in the scenario. Subtracting the amount of irrigant used from the client's urine output is not a standard practice in catheter irrigation.

2. A nurse is planning care of an adolescent who is postoperative following a lumbar laminectomy. Which of the following interventions should the nurse include in the plan of care?

Correct answer: C

Rationale: The correct answer is C because after a lumbar laminectomy, the adolescent may need assistance with personal hygiene due to limited mobility and pain. Encouraging the guardian to assist with personal hygiene ensures proper care and prevents complications. Choice A is incorrect as limiting visitors may affect the adolescent's emotional well-being and support system. Choice B is incorrect as the adolescent should have autonomy in selecting their food choices as long as they align with their dietary restrictions post-surgery. Choice D is incorrect as the adolescent may need guidance and support in decision-making during the postoperative period.

3. Which of the following best describes intrinsic values?

Correct answer: B

Rationale: The correct answer is B because intrinsic values refer to fundamental beliefs and principles that guide a person's behavior and decision-making. These values are deeply ingrained and are essential for sustaining life and well-being. Choices A, C, and D are incorrect because intrinsic values are not just abstract ideas, qualities important in private lives, or qualities patients desire in others; they are the core principles that individuals hold dear to lead a fulfilling life.

4. Which of the following behaviors would be an early warning sign that you are not handling job stress in a healthy way?

Correct answer: D

Rationale: The correct answer is D. Awakening in the morning feeling unrested can be an early warning sign that you are not handling job stress in a healthy way. This may indicate that the stress is impacting your quality of sleep, which is essential for managing stress and maintaining overall well-being. Choices A, B, and C are not necessarily indicative of unhealthy stress management. Focusing excessively on patient outcomes may show dedication to work, needing to spend more time alone could be a personal preference, and juggling work, studies, and family responsibilities could be a common challenge that many individuals face.

5. Which of the following should be included in a discussion of advance directives with new nurse graduates?

Correct answer: D

Rationale: One function of the advance directive is to appoint a health-care surrogate who will make known the client�s wishes for medical treatment to the medical and nursing team if the client is unable to do so.

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