Nokea
A 72-year-old client with Parkinson disease is recovering from pneumonia and is to be discharged, but he remains weak and has poor control of his hands because of tremors. A home health aide will visit three times weekly to assist the client to bathe, and his daughter will visit every evening after work to help with laundry and housework. Which of the following referrals is most indicated to allow the client to remain independent in his home?
- A. Home meal delivery program (Meals on Wheels)
- B. Friendly Visitors program
- C. Hospice
- D. Occupational therapist
Correct Answer: D
Rationale: An occupational therapist (D) can help with adaptive strategies for tremors, promoting independence. Meal delivery (A), visitors (B), and hospice (C) are less relevant.
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A client is recovering from a stroke and the nurse is doing range-of-motion exercises. Which movements should be included for ROM of the elbow on the weak side? Select all that apply.
- A. Abduction and adduction
- B. Hyperextension
- C. Supination and pronation
- D. Flexion and extension
- E. Rotation
Correct Answer: C,D
Rationale: Elbow ROM includes supination/pronation (C) and flexion/extension (D). Abduction/adduction (A), hyperextension (B), and rotation (E) are not applicable to the elbow joint.
The nurse is caring for a client admitted with suspected myasthenia gravis. Which finding is usually associated with a diagnosis of myasthenia gravis?
- A. Visual disturbances, including diplopia
- B. Ascending paralysis and loss of motor function
- C. Cogwheel rigidity and loss of coordination
- D. Progressive weakness that is worse at the day's end
Correct Answer: D
Rationale: Myasthenia gravis is characterized by muscle weakness that worsens with activity and improves with rest, typically more pronounced at the end of the day.
The emergency room is flooded with clients injured in a tornado. Which clients can be assigned to share a room in the emergency department during the disaster?
- A. A schizophrenic client having visual and auditory hallucinations and the client with ulcerative colitis
- B. The client who is six months pregnant with abdominal pain and the client with facial lacerations and a broken arm
- C. A child whose pupils are fixed and dilated and his parents, and a client with a frontal head injury
- D. The client who arrives with a large puncture wound to the abdomen and the client with chest pain
Correct Answer: B
Rationale: The pregnant client and the client with facial lacerations/broken arm have stable conditions suitable for sharing a room, unlike the other pairs with critical or incompatible needs.
The nurse has just returned to the desk and has four phone messages to return. Which of the following messages should the nurse return FIRST?
- A. A woman in her first trimester of pregnancy complaining of heartburn.
- B. A man complaining of heartburn that radiates to his jaw.
- C. A woman complaining of hot flashes and difficulty sleeping.
- D. A boy complaining of knee pain after playing basketball.
Correct Answer: B
Rationale: indicates chest pain, needs to seek medical attention immediately
The nurse is observing a student nurse administering ear drops to a 2-year-old. Which observation by the nurse would indicate correct technique?
- A. Holds the child's head up and extended
- B. Places the head in chin-tuck position
- C. Pulls the pinna down and back
- D. Irrigates the ear before administering medication
Correct Answer: C
Rationale: For children under 3, pulling the pinna down and back straightens the ear canal for proper ear drop administration.