Valid NCLEX-RN Dumps shared by ExamDiscuss.com for Helping Passing NCLEX-RN Exam! ExamDiscuss.com now offer the newest NCLEX-RN exam dumps, the ExamDiscuss.com NCLEX-RN exam questions have been updated and answers have been corrected get the newest ExamDiscuss.com NCLEX-RN dumps with Test Engine here:
A 19-year-old client fell off a ladder approximately 3 ft to the ground. He did not lose consciousness but was taken to the emergency department by a friend to have a scalp laceration sutured. The nurse instructs the client to:
Correct Answer: C
Explanation/Reference: Explanation: (A) Povidone-iodine is very irritating to skin and should not be routinely used. (B) Sutures should not be removed by the client. (C) Confusion, nausea, vomiting, and behavioral changes may indicate increasing intracranial pressure as a result of intracerebral bleeding. (D) Use of a narcotic opiate such as meperidine is not recommended in clients with a possible head injury because it may produce sedation, pupil changes, euphoria, and respiratory depression, which may mask the signs of increasing intracranial pressure.