A nurse is reviewing the pre-operative checklist for a client scheduled for surgery. The client reports having eaten breakfast and drinking water 4 hours before the scheduled surgery time. What action should the nurse take?
a) Proceed with the scheduled surgery.
b) Notify the surgeon to postpone the surgery.
c) Begin preparing the client for surgery immediately.
d) Inform the anesthesia team about the client’s recent intake.
e) Discharge the client from the pre-operative area.
Rationale: Fasting guidelines usually recommend avoiding solid food for 6-8 hours and clear liquids for 2 hours before surgery. Since the client has eaten breakfast and consumed water within 4 hours of the surgery, postponing the surgery is necessary to prevent the risk of aspiration during anesthesia induction. Correct answer: b) Notify the surgeon to postpone the surgery.
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NCLEX Review: Hygiene Treatments
A nurse is teaching a client about proper nail care. Which instruction should the nurse provide to prevent injury or infection?
a) Cut nails straight across
b) Apply cuticle oil daily
c) Use a metal file to shape the nails
d) Push back cuticles vigorously
e) Soak nails in warm water for an hour before trimming
Rationale: Cutting nails straight across helps prevent ingrown nails and reduces the risk of injury or infection. Pushing back cuticles vigorously or using metal files can cause damage and increase susceptibility to infections. Correct answer: a) Cut nails straight across
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@qbankproacademy 4000+ Free NCLEX QUESTIONS. Go to QBankProAcademy.com FREE Qbank questions for NCLEX RN, PN, HESI Exit, Med Surg, AANP, ANCC, and HesiA2. Practice questions, quizzes, and listen to the Free Podcast. In this video, we review a question on HYGIENE in Nursing Care. Free nursing NCLEX 60-DAY CHALLENGE https://qbankpro.thinkific.com/courses/qbankpro-academy At QbankproAcademy.com our mission is to provide free QBanks, videos, and the most up to date test prep information for nurses. If you find our website helpful, please tell other aspiring nurses, nursing students, and professors. Please link to our site from your blogs, videos, and college websites, or share us on your favorite social media sites. Thank you for your support! nclex Nurses Nursing aanp qbank ancc hesi medsurg qbank
1000 Medical-Surgical Questions
NCLEX Questions Critical Thinking: Hygiene Symptoms
A nurse is assisting an older adult client with oral care. The client has difficulty swallowing and is at risk of aspiration. What action should the nurse prioritize during oral care?
a) Brushing the tongue thoroughly
b) Using a firm-bristled toothbrush
c) Providing frequent sips of water during care
d) Tilting the client’s head back while brushing teeth
e) Suctioning the mouth before and after oral care
Rationale: Aspiration risk increases with difficulty swallowing. Suctioning the mouth before and after oral care helps remove excess saliva and secretions, reducing the risk of aspiration pneumonia. Other options like using a firm-bristled toothbrush or tilting the head back can potentially increase the risk of injury or aspiration. Correct answer: e) Suctioning the mouth before and after oral care
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1000 HESI Exit Questions
NCLEX Focus Exploring Hygiene: Causes and Diagnosis
A nurse is conducting pre-operative teaching for a client scheduled for surgery. The client asks about fasting before the procedure. Which statement by the nurse is accurate regarding fasting guidelines?
a) “You should have a full meal 8 hours before surgery.”
b) “You can have clear liquids up to 2 hours before surgery.”
c) “Avoid all fluids for at least 12 hours before surgery.”
d) “You should fast for a minimum of 24 hours before surgery.”
e) “Having a light snack 4 hours before surgery is acceptable.”
Rationale: Clear liquids are usually allowed up to 2 hours before surgery to minimize the risk of aspiration. Complete fasting for a specific period, avoiding solid food for 6-8 hours and clear liquids for 2 hours, helps reduce the risk of aspiration during anesthesia induction. Correct answer: b) “You can have clear liquids up to 2 hours before surgery.”
1000 AANP Questions
NCLEX Questions: Focus on Medications for Hygiene
A nurse is providing hygiene care to a bedridden client. During the bed bath, the nurse notices redness over the sacral area. The client reports discomfort when the area is touched. What action should the nurse take first?
a) Apply a heating pad to the area
b) Continue with the bed bath, ensuring gentle handling of the area
c) Stop the bed bath and notify the healthcare provider
d) Apply lotion to the red area after completing the bed bath
e) Document the findings in the client’s chart
Rationale: The presence of redness and discomfort over the sacral area can indicate the development of pressure ulcers. Stopping the bed bath and notifying the healthcare provider is crucial to prevent further injury and initiate appropriate interventions, such as implementing pressure-relieving measures or using specialized dressings. Correct answer: c) Stop the bed bath and notify the healthcare provider
A nurse is assessing a client’s pre-operative status. The client mentions taking herbal supplements regularly. What action should the nurse prioritize based on this information?
a) Encourage the client to continue taking herbal supplements until the day of surgery.
b) Document the herbal supplement use in the client’s chart.
c) Instruct the client to stop taking herbal supplements at least 2 weeks before surgery.
d) Consult with the healthcare provider to determine the safety of the herbal supplements.
e) Advise the client to increase the dosage of herbal supplements before surgery.
Rationale: Herbal supplements can interact with anesthesia and medications, potentially affecting surgical outcomes. Consulting the healthcare provider helps determine if specific supplements need to be stopped pre-operatively to prevent complications or interactions during surgery. Correct answer: d) Consult with the healthcare provider to determine the safety of the herbal supplements.
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A nurse is preparing a client for surgery and reviews the informed consent. The client seems confused and asks questions about the procedure. What is the nurse’s most appropriate action?
a) Reassure the client that everything will be fine and proceed with the consent.
b) Ask the client’s family member to sign the consent on behalf of the client.
c) Provide additional information and clarification about the procedure.
d) Delay the surgery until the client fully comprehends the procedure.
e) Disregard the client’s concerns and obtain the signature.
Rationale: Informed consent requires the client’s understanding and agreement without coercion. The nurse should provide further information and clarification to ensure the client comprehends the procedure before signing. Delaying surgery might be necessary if the client is unable to fully understand or refuses consent. Correct answer: c) Provide additional information and clarification about the procedure.
Understanding Hygiene: NCLEX Priority Questions
A nurse is assessing a client before surgery. The client reveals a history of allergies to penicillin and codeine. Which action should the nurse prioritize based on this information?
a) Administer penicillin before surgery as a preventive measure.
b) Document the allergies in the client’s chart and inform the surgical team.
c) Disregard the allergies, as they are unrelated to the upcoming surgery.
d) Perform a skin test to confirm the allergies.
e) Offer codeine to the client to manage pre-operative pain.
Rationale: Documenting known allergies is crucial to prevent exposure to allergens during surgery. Informing the surgical team ensures that alternative medications are chosen, reducing the risk of allergic reactions. Administering penicillin or codeine without confirming alternatives could result in severe adverse reactions. Correct answer: b) Document the allergies in the client’s chart and inform the surgical team.
Understanding Hygiene Care: NCLEX Delegation Questions
A nurse is preparing a client for surgery and educates the client on pre-operative exercises. The client will have abdominal surgery. What exercise should the nurse encourage the client to perform pre-operatively?
a) Push-ups to strengthen the upper body
b) Crunches to tone the abdominal muscles
c) Pelvic floor exercises (Kegels)
d) Squats to strengthen leg muscles
e) Neck rotations to relax before surgery
Rationale: Pre-operative exercises such as pelvic floor exercises can help strengthen muscles involved in post-operative recovery, including bladder control and supporting abdominal structures, potentially aiding in a faster recovery after abdominal surgery. Correct answer: c) Pelvic floor exercises (Kegels)
Understanding Hygiene: NCLEX Focus
A nurse is providing pre-operative teaching to a client scheduled for cardiac surgery. The client expresses anxiety and fear about the procedure. What nursing intervention is most appropriate to address the client’s concerns?
a) Provide detailed information about potential complications.
b) Minimize conversation to avoid increasing the client’s anxiety.
c) Refer the client to a mental health professional.
d) Encourage the client to talk about feelings and concerns.
e) Administer a sedative to calm the client before surgery.
Rationale: Encouraging the client to express fears and concerns allows for emotional support and enables the nurse to address specific worries. Providing information in a supportive manner and facilitating communication helps alleviate anxiety and promotes the client’s psychological preparation for surgery. Correct answer: d) Encourage the client to talk about feelings and concerns.
