A charge nurse is observing a newly licensed nurse prepare a sterile field for a dressing change.

Which of the following actions by the newly licensed nurse requires intervention by the charge

nurse?

The newly licensed nurse places the cap of a bottle of sterile saline solution on the sterile field.

The newly licensed nurse places sterile objects 2.5 cm (1 in) within the border of the field.

The newly licensed nurse holds the bottle of sterile saline outside the edge of the field when

pouring.

The sterile field is positioned at the level of the newly licensed nurse's waist. - Correct Answer:

The newly licensed nurse places the cap of a bottle of sterile saline solution on the sterile field.

The newly licensed nurse should place the cap with the sterile side up on a clean surface because

the outer edges are unsterile and will contaminate the sterile field.

Incorrect Answer:

The newly licensed nurse places sterile objects 2.5 cm (1 in) within the border of the field.

The edges of the sterile field are considered contaminated. Therefore, the nurse should place all

sterile items inside the 2.5 cm (1 in) border of the field.

The newly licensed nurse holds the bottle of sterile saline outside the edge of the field when

pouring.

The newly licensed nurse should hold the bottle of sterile saline outside the edge of the field

when pouring to prevent contaminating the field.

The sterile field is positioned at the level of the newly licensed nurse's waist.

An object that is below waist level is considered nonsterile. Positioning the table at waist level

does not require intervention.

A client demonstrates anger when the nurse does not respond within 5 min of ringing for the

nurse. Which of the following is an appropriate response by the nurse?

"I'm sorry, but another client needed my attention."

"I could not arrive any sooner. What can I do for you?"

"We had an emergency on the unit and that was a priority, but now I'm here."

"That must be frustrating for you. How can I help you right now?" - Correct Answer:

"That must be frustrating for you. How can I help you right now?"

This response is therapeutic because the nurse is acknowledging the client's feelings and offering

help.

Incorrect Answer:

"I'm sorry, but another client needed my attention."

This response is nontherapeutic because the nurse is responding defensively