Nokea
A client who had a stroke requires assistance with morning ADLs. Which of the following interprofessional team members should the nurse consult?
- A. Registered dietitian.
- B. Occupational therapist.
- C. Speech-language pathologist.
- D. Physical therapist.
Correct Answer: B
Rationale: The correct answer is B, Occupational therapist. An occupational therapist specializes in assisting clients with daily living activities, making them crucial for a stroke patient requiring help with morning activities of daily living (ADLs). While a registered dietitian (A) may provide nutritional guidance, a speech-language pathologist (C) focuses on communication and swallowing disorders, and a physical therapist (D) primarily deals with mobility and physical rehabilitation. However, none of these professionals directly address the specific needs related to ADLs following a stroke as effectively as an occupational therapist.
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When assisting an 82-year-old client to ambulate, it is important for the LPN/LVN to realize that the center of gravity for an elderly person is in the
- A. Arms.
- B. Upper torso.
- C. Head.
- D. Feet.
Correct Answer: B
Rationale: The correct answer is 'Upper torso.' In elderly individuals, the center of gravity tends to shift upwards towards the upper torso due to various factors such as changes in posture and muscle strength. Understanding this is crucial for safe ambulation as it helps in maintaining balance and stability. Choices A, 'Arms,' C, 'Head,' and D, 'Feet,' are incorrect. The center of gravity is not typically located in the arms, head, or feet. It is higher up in the body, specifically in the upper torso. Knowing the correct location of the center of gravity is essential for assisting elderly clients in ambulation effectively and preventing falls.
Which goal is most appropriate for a patient who has had a total hip replacement?
- A. The patient will ambulate briskly on the treadmill by the time of discharge.
- B. The patient will walk 100 feet using a walker by the time of discharge.
- C. The nurse will assist the patient to ambulate in the hall 2 times a day.
- D. The patient will ambulate by the time of discharge.
Correct Answer: B
Rationale: The goal 'The patient will walk 100 feet using a walker by the time of discharge' is the most appropriate goal for a patient who has had a total hip replacement because it is specific, measurable, achievable, and individualized. This goal sets a clear target for the patient's mobility progress post-surgery. Choice A is too vague and does not provide a specific target distance or method of ambulation. Choice C focuses on the nurse's actions rather than the patient's progress. Choice D lacks specificity in terms of distance or assistance required, making it less measurable and individualized compared to Choice B.
A client has a new cast on the left arm, and the nurse is assessing the client. Which of the following findings should the nurse report to the provider immediately?
- A. Increased warmth in the affected arm
- B. Itching under the cast
- C. Pain with passive movement
- D. Drainage on the cast
Correct Answer: C
Rationale: The correct answer is C: Pain with passive movement. Pain with passive movement in a client with a new cast can indicate compartment syndrome, a serious condition where pressure builds up within the muscles, nerves, and blood vessels of the affected limb, potentially leading to tissue damage. Immediate reporting is crucial to prevent further complications. Increased warmth in the affected arm could be a normal inflammatory response to the injury and casting process. Itching under the cast is common and can be managed without immediate concern. Drainage on the cast may be expected initially after casting due to residual moisture from the setting process, but ongoing or excessive drainage should be monitored and reported if persistent.
When providing hygiene for an older-adult patient, why does the nurse closely assess the skin?
- A. Outer skin layer becomes less resilient.
- B. Less frequent bathing may be required.
- C. Skin becomes more subject to bruising.
- D. Sweat glands become less active.
Correct Answer: B
Rationale: The correct answer is B: 'Less frequent bathing may be required.' In older adults, daily bathing or using hot water and harsh soap can lead to excessively dry skin. Therefore, the nurse closely assesses the skin to determine if less frequent bathing is necessary to prevent skin dryness and maintain skin integrity. Choice A is incorrect because the outer skin layer does not become less resilient with age. Choice C is incorrect as aging skin is actually more prone to bruising due to thinning of the skin. Choice D is incorrect because sweat gland activity generally decreases with age, leading to reduced skin moisture rather than increased activity.
A client is crying while reading from a religious book and asks to be left alone. Which of the following actions should the nurse take?
- A. Contact the hospital's spiritual services.
- B. Ask what is making the client cry.
- C. Ensure no visitors or staff enter the room for a short time period.
- D. Turn on the television for a distraction.
Correct Answer: C
Rationale: The correct action for the nurse to take in this situation is to ensure no visitors or staff enter the room for a short time period. Respecting the client's wish for privacy during emotional moments is crucial for providing patient-centered care. Contacting spiritual services or asking about the reason for crying may intrude on the client's privacy and emotional space. Turning on the television for a distraction is not appropriate as it does not address the client's emotional needs or request for privacy.