The nurse is preparing to administer eye drops to

Question 1 of 4

The nurse is preparing to administer eye drops to a 4-year-old client. The nurse should:

A. Place the child in a prone position B. Pull the lower lid down and instill the drops in the conjunctival sac C. Hold the dropper 2 inches above the eye D. Wipe the eye with a dry cotton ball prior to administration

Correct Answer: B

Rationale: Pulling the lower lid down and instilling drops in the conjunctival sac ensures accurate delivery to a 4-year-old's eye, minimizing trauma prone positioning, high dropper, or dry wiping risks injury or inefficacy. Nurses use this, calming the child, ensuring medication (e.g., antibiotic) reaches the target safely.

Question 2 of 4

The nurse has taken the blood pressure of a client hospitalized with methicillin-resistant staphylococcus aureus. Which action by the nurse indicates an understanding regarding the care of clients with MRSA?

A. The nurse leaves the stethoscope in the client's room for future use B. The nurse cleans the stethoscope with alcohol and returns it to the exam room C. The nurse uses the stethoscope to assess the blood pressure of other assigned clients D. The nurse cleans the stethoscope with water, dries it, and returns it to the nurse's station

Correct Answer: A

Rationale: Leaving the stethoscope in the room prevents MRSA spread, adhering to contact precautions alcohol cleaning isn't enough between clients, sharing risks transmission, and water is inadequate. Nurses isolate equipment, ensuring infection control in resistant infections.

Question 3 of 4

The physician has ordered a 24-hour urine collection for a client. Which action by the nurse will ensure proper collection of the specimen?

A. Placing the collection container on ice B. Instructing the client to void and discard the first specimen C. Checking the client's intake and output during the collection period D. Obtaining a catheterized specimen at the end of 24 hours

Correct Answer: C

Rationale: Checking intake and output during a 24-hour urine collection ensures accuracy by tracking fluid balance ice is for specific tests (e.g., catecholamines), discarding the first void starts the clock (not skips it), and catheterization isn't routine. Nurses monitor this, ensuring valid results for diagnostic purposes like renal function.

Question 4 of 4

The nurse is caring for a client with a fractured femur who is in skeletal traction. Which finding indicates a complication with the traction?

A. The client's foot is warm and pink B. The weights are resting against the foot of the bed C. The client is able to lift his hips off the bed D. The pin sites are clean and dry

Correct Answer: B

Rationale: Weights resting against the bed negate skeletal traction's pull, risking misalignment in a fractured femur warm feet, hip lifts, and clean pins are normal. Nurses adjust this, ensuring countertraction, vital for bone healing in orthopedic care.

The nurse is preparing to administer eye drops to a 4-year-old client. The nurse should:

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