Question

1. A nurse is teaching a newly licensed nurse about incident reports. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching?
   1. They assist with unit quality improvement
   2. They are mandatory government documentation
   3. They assist the facility to achieve benchmark goals
   4. They are used as a disciplinary tool for nurse institutions
2. A nurse is caring for a client who is receiving enteral feedings through a nasoenteric tube and has aspirated fluid prior to a feeding. which of the following findings should indicate to the nurse that the nurse that the tube is positioned in the client's lung?
3. 1. Residual fluid with a pH of 3
   2. Residual fluid with a pH of 6
   3. Residual fluid with a pH of 1
   4. Residual fluid with a pH of 8
4. nurse is preforming wound care for a client who has an abdominal incision. Which of the following techniques should the nurse implement?
   1. Irrigate the wound using a 10-mL syringe
   2. Irrigate the wound with a low-pressure flow of solution
   3. Cleanse the wound starting at the bottom and moving upward
   4. Cleanse the insertion site of the drain using a circular motion toward the center

Answer 1

1. An incident report / an event report is a formal report that is written by a health care professional (a practitioner, a nurse or other staff members) in order to keep the facility administrator informed about an incident (probably a hazardous event) to take measures that may prevent similar incidences in future and helps to improve the patient care outcome. Incident reports are maintained by all health care facilities like hospitals, nursing homes or assisted living

Answer : They assist with unit quality improvement (Option a).

2. A pH of 0- 5.5  is considered normal when the NG tube is in stomach. Some medications can alter the gastric pH.  If the pH of the residual fluid obtained is 6 or greater than 6 then the placement of the tube is in the lungs. A normal blood pH level is 7.35 to 7.45 (in the lungs too ) and a pH higher than that indicates an abnormality.

Answer: Residual fluid with a pH of 6 (Option b)

3. Answer is (Option b) Irrigate the wound with a low-pressure flow of solution

In wound irrigation a steady flow of solution is to be maintained across the wound surface in order to hydrate the wound, remove the debris and enable proper visualization of wound. High pressure irrigation is performed in case of necrotizing wounds. Too low pressure irrigation will not remove the surface bacteria and too much pressure may force the surface bacteria into the wound bed as well as can damage the granulation tissue too.

Option a is not acceptable because usually for wound cleansing an 35cc syringe or a 19 gauge angiocatheter or a pressurized saline canister and in case of deep wounds a soft catheter is used for irrigating .

Option c and d are wrong because the center of the suture line is considered to be more sterile. So cleaning is done from the center of the incision towards one end of the incision and repeat the procedure from center towards the other end using a sterile swab or a gauze. Then clean from one end to other end outside the suture line in straight strokes and moving away from the suture line with each strokes..