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The patient must stay in bed for a bed change. Which actions will the nurse implement? (Select all that apply.)

A.

Turn clean pillowcase inside out over the hand holding it.

B.

Keep soiled linen close to uniform.

C.

Apply sterile gloves.

D.

Make a modified mitered corner with sheet, blanket, and spread.

E.

Advise patient will feel a lump when rolling over.

Question Solution

Correct Answer : A,D

A. Turning the clean pillowcase inside out over the hand holding it helps avoid contamination and allows easy application.  

 

B. Soiled linens should be kept away from the nurse's uniform to prevent cross-contamination; hence, this is incorrect.  

 

C. Sterile gloves are not required for bed-making; clean gloves may be used when handling soiled linens.  

 

D. A modified mitered corner keeps the bed neat and helps secure the sheet, blanket, and spread.  

 

E. Advising the patient of a lump when rolling over is not necessary for bed making, as the goal is to provide comfort without lumps.


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Correct Answer is C

Explanation

A. Continuing with the injection after seeing blood return increases the risk of injecting into a blood vessel, which is not safe for IM injections.

B. Administering at a slower rate does not address the issue of possible intravascular injection.

C. If blood is aspirated, the correct procedure is to withdraw the needle, dispose of the medication, and prepare a new dose to prevent intravascular administration, as IM injections are meant to be given into muscle tissue, not into a vein.

D. Pulling the needle back slightly is not recommended because it does not ensure that the needle is completely out of the blood vessel.

Correct Answer is B

Explanation

A. Ventricular filling time and diastolic filling time are not formulas used to calculate cardiac output; they pertain to the phases of the cardiac cycle.

B. Cardiac output is calculated by multiplying stroke volume (the amount of blood ejected by the heart with each beat) by heart rate (the number of beats per minute). This formula accurately reflects the overall volume of blood the heart pumps in one minute.

C. Myocardial contractility and myocardial blood flow are important factors in cardiac function but do not directly provide a formula for calculating cardiac output.

D. Preload and afterload are factors that affect stroke volume but are not used to calculate cardiac output directly.

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