Coursepoint Module 8 Quiz: Taylor's Clinical Nursing Skills

The nurse is performing perineal care for a female client when the client asks the nurse to use baby powder to help keep her perineum dry. What is the best response by the nurse? a. "it is recommended to avoid the use of baby powder in the perineal area bc it creates a place for bacteria to grow" b. "we no longer carry baby powder here because it increases cost and evidence shows it is not effective" c. "it is recommended to avoid the use of baby powder in the perineal area bc it increases the risk for an allergic reaction" d. "we no longer supply baby powder, but i would be happy to use the powder you brought from home"

a. "it is recommended to avoid the use of baby powder in the perineal area bc it creates a place for bacteria to grow"

A nurse is assisting a client with denture care. What is the best way to remove the client's dentures? a. apply gentle pressure with a 4x4 gauze to grasp the denture plate b. apply gentle pressure with a tongue blade to remove the denture plate c. ask the client to take a deep breath and exhale while grasping the denture plate d. use sterile gloves to apply gentle pressure and grasp the denture plate

a. apply gentle pressure with a 4x4 gauze to grasp the denture plate

The nurse provides care to a sedated client with soiled sheets. Which action does the nurse take to move the client? a. ask for help from a staff member b. use a client hydraulic lift c. place pillows behind the client's back d. pull the client from side to side

a. ask for help from a staff member

When a client cannot be turned on the side, what recommended nursing action would the nurse perform, with assistance from another nurse, to replace soiled linens once they have been removed? a. ease the clean linens under the client, from the top to the bottom of the bed b. apply the bottom sheet, securing it at the bottom of the bed c. fold the bottom linens in half and place one at the top of the bed and another at the bottom d. pull the clean linens under the client from the bottom to the top of the bed

a. ease the clean linens under the client, from the top to the bottom of the bed

When providing oral care to an unconscious client, the nurse takes which action? a. ensure there is a towel and basin positioned for drainage b. place the head of the client's bed in high-fowlers position c. brush the tongue and each tooth surface multiple times d. have endotracheal suction supplies at the bedside

a. ensure there is a towel and basin positioned for drainage

How would the nurse remove the top linens when making an occupied bed? a. have the client hold onto the bath blanket and reach under it to remove the linens b. fanfold the linens at the bottom of the bed and remove them to the chair c. arrange the client's gown for privacy and roll the linens to the bottom of the bed d. have the client hold onto the bath blanket and reach under it to remove all linens except the top sheet

a. have the client hold onto the bath blanket and reach under it to remove the linens

where should the nurse roll soiled linens when removing them from an unoccupied bed? a. inside the bottom sheet b. on the floor c. inside the top sheet d. on the bedside table

a. inside the bottom sheet

The nurse is preparing to give a bed bath to a client. Which supplies would the nurse need to gather before entering the clients room? Select all that apply a. protective pads b. gown c. linen d. basin e. towels f. bath blanket

a. protective pads b. gown c. linen e. towels f. bath blanket

The nurse is changing the linens on a client's bed. What is the nurse's primary objective for this nursing action? a. provide client comfort b. tidy up the client's room c. prepare the client to receive visitors d. remove soiled linens

a. provide client comfort

The nurse is preparing to perform perineal care on an uncircumcised adult male client who was incontinent of stool. The cient's entire perineal area is heavily soiled. What is the correct technique for cleaning the penis? a. retract the foreskin while washing the penis; then, immediately pull the foreskin back into place b. retract the foreskin while washing the penis, allow 10-15 minutes for the glans penis to dry, then replace the foreskin in its original positon c. avoid retraction of the foreskin bc injury and scarring could occur d. soak the end of the penis in warm water before cleaning the shaft of the penis

a. retract the foreskin while washing the penis; then, immediately pull the foreskin back into place

The nurse is performing perineal care for a male client. What part of the perineum would the nurse clean first? a. tip of penis b. anal area c. base of the penis d. scrotum

a. tip of penis

A nurse is performing perineal care for a female client. Which action would most be important to maintain the client's privacy? a. uncover only the area being cleaned b. identify the client using two identifiers before beginning c. cleanse from pubic bone to anus d. use a clean portion of the washcloth for each stroke

a. uncover only the area being cleaned

A nurse observes a staff member perfoming perineal care on a female client. The staff member washes the client's rectal area and then washes the client's urinary meatus. What is the most useful instruction for the nurse to give the staff member? a. "UTI's can cause a prolonged hospitalization for the client" b. "microbial contamination can occur when cleaning the anal area first" c. "it is best to use disposable personal hygeine cloths for perineal care" d. "change washcloths between the rectal area and the urinary meatus"

b. "microbial contamination can occur when cleaning the anal area first"

The client requests powder to be applied to the genitalia after perineal care. Which explanation from the nurse to the client is best? a. "powder can crumble together and irritate the genital folds causing redness" b. "powder in the genital area can create a medium for bacterial growth" c. "evidence states that powder in the genital area causes female cancers" d. "it is no longer an acceptable part of perineal care to apply powder to the groin"

b. "powder in the genital area can create a medium for bacterial growth"

The nurse is providing denture care for a client who is too sedated to assist. Which is a recommended guideline for this procedure? a. store the dentures in a cup filled with mouthwash b. apply gentle pressure with a piece of gauze to remove the upper dentures c. use a rinse to clean the dentures, not a toothbrush and toothpaste d. placed the removed dentures on a paper towel

b. apply gentle pressure with a piece of gauze to remove the upper dentures

After assisting a bed-bound client with oral care, what action does the nurse take? a. inspect the oral cavity for dryness, erythema, or bleeding b. assist the client to a comfortable position in the bed c. place the supplies on the edge of the overbed table d. dispose of the used toothbrush, basin, and cups

b. assist the client to a comfortable position in the bed

The nurse cleans the client after a bowel movement and notes stool on the gloves. The nurse has not finished cleaning the client. What action should the nurse take? a. use a wipe to clean gloves b. change into a new pair of gloves c. continue to complete care d. avoid touching clean linen

b. change into a new pair of gloves

The nurse is changing the linens for a client who could not be turned on the side due to a surgical incision on the right hip and pain from a fall in the left hip. what nursing intervention would be appropriate for this client? a. change the bed linens from the left to the right side b. change the bed linens from the top to the bottom c. change the bed linens from the bottom to the top d. do not change the bed linens until the client is experiencing less pain

b. change the bed linens from the top to the bottom

The nurse is changing a client's bedding while the client is out of the room getting an X ray. What would the nurse do with the reusable linens? a. with the assistance of another nurse, fold the linens in fourths on the bed and then place them on a clean chair b. fold the linens in fourths on the bed and then hang them over a clean chair c. fold the bedding in fourths on the bed and place them on the overbed table d. fold the bedding in half on the bed and then place them at the bottom of the bed

b. fold the linens in fourths on the bed and then hang them over a clean chair

The nurse is making a bed occupied by a client. How would the nurse position the client when loosening bottom bed linens? a. sitting up b. lying on one side c. lying flat d. lying prone

b. lying on one side

The nurse is providing oral care for a client who has suffered head trauma. The client is unresponsive. How will the nurse best position the client? a. semi-fowler's b. side-lying c. supine d. prone

b. side-lying

The acute care nurse is preparing to bathe a client and notices that the client is wearing a regular hospital gown and has continuous IV fluids infusion. Which action by the nurse is appropriate? a. carefully disconnect the IV tubing from the IV bag and quickly thread it through the arm of the gown b. cut the arm of the regular gown and replace it with a snap arm gown at the end of the bath c. carefully thread the IV bag and tubing through the arm of the regular gown, and then replace it with a snap-arm gown at the end of the bath d. leave the gown in place, taking care to keep it dry

c. carefully thread the IV bag and tubing through the arm of the regular gown, and then replace it with a snap-arm gown at the end of the bath

The nurse uses perineal cleansing wipes for a client who has had a bowel movement. Which action does the nurse take? a. alternate wipes with reusable wash cloths b. flush cleansing wipes after perineal care is complete c. change to a clean wipe after each stroke d. use multiple wipes to create a thicker wipe

c. change to a clean wipe after each stroke

The nurse is preparing to make a bed occupied by a client who is on bedrest. What is the first action the nurse would take in this procedure? a. perform hand hygeine b. identify the client c. check the client's chart d. provide for privacy

c. check the client's chart

How should the nurse open the bottom sheet when making an unoccupied bed? a. fold in half in the center b. fanfold to the side c. fanfold to the center d. fold in thirds to the side

c. fanfold to the center

When making an occupied bed, the nurse positions and tucks in the bottom linens on one side of the bed. What would be the nurse's next action? a. remove the old linens out from under the client b. move to other side of bed. c. raise the side rail d. push the client to the other side of the bed

c. raise the side rail

The nurse has placed the rolled, soiled linens in the laundry hamper. what should be the nurse's next action? a. replace the soiled gloves with new ones b. place the clean bottom sheet in the center of the bed c. remove gloves, unless indicated for transmission precautions d. scrub the mattress with antimicrobial cleaner

c. remove gloves, unless indicated for transmission

When performing perineal care for the male client, the nurse should be particuarly gentle and avoid pressure when cleansing which area? a. meatus b. glans penis c. scrotum d. shaft

c. scrotum

The nurse is assisting a hospitalized client with oral care. How will the nurse position the client? a. head of the bed at 45 degrees b. head of the bed at 10 degrees c. sitting at the edge of the bed d. head of the bed at 30 degrees

c. sitting at the edge of the bed

A nurse is preparing to give a bed bath to a client. What approach should the nurse take? a. start with the posterior aspect of the body and then move to the anterior aspect. b. start with the head and work down the body c. start with cleanest areas and end with most soiled areas d. start with the most private areas

c. start with cleanest areas and end with most soiled areas

The nurse is providing a bed bath for a female client who is unconscious. The nurse should pay special attention to cleaning which areas of the body? a. The inner and outer canthus of each eye b. underneath the fingernails and toenails c. underneath the breasts and in between skin folds d. the antecubital fossa and popliteal space

c. underneath the breasts and in between skin folds

The unresponsive client's spouse at bedside asks the nurse about oral care. The spouse states, "if my spouse is not eating, why do you still brush the teeth? How does the nurse respond? a. "dental care is still important, even when not chewing" b. "without swallowing, bacteria get trapped in the mouth" c. "it is comforting to have moist mucosa during this time" d. "mouth care during this time helps prevent complications"

d. "mouth care during this time helps prevent complications"

The nurse is performing perineal care on an adult male client who was incontinent of stool. After cleansing the perineal area, what is the most appropriate intervention by the nurse? a. apply betadine ointment to the foreskin and glans penis b. apply antibiotic ointment to the urinary meatus c. apply baby powder the perineal area d. apply a thin barrier of skin protectant to the perineal area

d. apply a thin barrier of skin protectant to the perineal area

The nurse is preparing to change the linens from the top to the bottom for a client who cannot be turned on the side. Which accurately describes a recommended step in this procedure when removing the soiled linens? a. help the client to a supine position in the bed and pull the sheets from the top to the bottom of the bed b. sit the client up and roll the soiled linens from the top of the bed until they meet the client's backside c. raise the client's legs and roll the linens from the bottom of the bed to the client's buttocks d. keep the blanket in place over the client to provide privacy and remove the top sheet

d. keep the blanket in place over the client to provide privacy and remove the top sheet

The nurse making an occupied bed. Under which body part of the client would the nurse place the drawsheet? a. feet b. head c. buttocks d. midsection

d. midsection

The nurse is providing perineal care for an uncircumsized adult male client. What is recommended guidelines for this action? a. retract the foreskin, wash the area, and allow the foreskin to dry 5 min before pulling it back b. retract the foreskin when washing the prepuce c. do not retract the foreskin as this may cause edema and tissue injury d. retract the foreskin when washing the prepuce of adolescents and older

d. retract the foreskin when washing the prepuce of adolescents and older

An unlicensed assistive personnel (UAP) is performing perineal care for a female client. Which action by the UAP requires intervetion by the nurse? a. the UAP begins cleansing from the pubic bone toward the anus b. the UAP uses a towel to dry the cleaned areas c. the UAP uses a clean portion of the washcloth for each stroke d. the UAP begins cleansing from the anus toward the pubic bone

d. the UAP begins cleansing from the anus toward the pubic bone