Nokea
A client with a seizure disorder is under the care of a nurse. Which of the following precautions should the nurse include in the plan?
- A. Place a padded tongue depressor at the bedside.
- B. Keep the bed in the lowest position.
- C. Restrain the client during a seizure.
- D. Keep the lights dim in the client's room.
Correct Answer: B
Rationale: Keeping the bed in the lowest position is crucial for ensuring the safety of the client during a seizure. Lowering the bed reduces the risk of injury if the client falls during a seizure episode. It is important not to restrain the client during a seizure as it can lead to further injury. Placing a padded tongue depressor at the bedside is not appropriate and can pose a risk of injury if used incorrectly. Keeping the lights dim in the client's room is not directly related to safety during a seizure and is not a standard precaution.
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When teaching a client how to perform self-catheterization, which of the following instructions should be included?
- A. Use sterile gloves during the procedure.
- B. Clean the catheter with alcohol after each use.
- C. Insert the catheter 2-4 inches into the urethra.
- D. Perform the procedure every 8 hours.
Correct Answer: C
Rationale: To ensure effective drainage, the catheter should be inserted 2-4 inches into the urethra. This length allows the catheter to reach the bladder, bypass the urethral sphincters, and ensure proper drainage without causing discomfort or injury. Using sterile gloves, cleaning the catheter with alcohol, and performing the procedure every 8 hours are not accurate instructions for self-catheterization.
A client is being discharged with a prescription for furosemide. Which of the following instructions should be included?
- A. Avoid foods high in potassium.
- B. Monitor your weight daily.
- C. Take the medication with food.
- D. Change positions slowly.
Correct Answer: D
Rationale: The correct instruction to include for a client being discharged with a prescription for furosemide is to 'Change positions slowly.' Furosemide, a diuretic, can cause dizziness and orthostatic hypotension, increasing the risk of falls. By advising the client to change positions slowly, the body can adjust to postural changes gradually, reducing the likelihood of falls and related injuries.
What is the primary goal of palliative care?
- A. To cure the client's illness.
- B. To prolong the client's life.
- C. To provide comfort and improve the quality of life.
- D. To prepare the client for surgery.
Correct Answer: C
Rationale: The primary goal of palliative care is to provide comfort and improve the quality of life for clients with serious illnesses. Palliative care aims to address physical, emotional, and spiritual needs to enhance overall well-being rather than focusing on curing the underlying illness, prolonging life, or preparing for surgery. It emphasizes symptom management, pain relief, and support for patients and their families to ensure a better quality of life during the course of their illness.
When educating a client on the proper use of a metered-dose inhaler (MDI), which of the following instructions should be included?
- A. Shake the inhaler before use.
- B. Inhale quickly and deeply.
- C. Use the inhaler as needed.
- D. Do not use a spacer with the inhaler.
Correct Answer: A
Rationale: Shaking the inhaler before use is crucial to ensure proper mixing of the medication. This action helps distribute the medication evenly, allowing for consistent dosing with each use. It is a vital step in using a metered-dose inhaler correctly to optimize its effectiveness in managing respiratory conditions.
When teaching a client about the proper use of a cane, which of the following instructions should be included?
- A. Hold the cane on the weaker side.
- B. Move the cane forward first.
- C. Keep the cane 12 inches away from the body.
- D. Use the cane for support only when climbing stairs.
Correct Answer: B
Rationale: When using a cane, it is crucial to move the cane forward first to provide support and enhance balance. Advancing the cane before the weaker or stronger leg helps widen the base of support, thereby improving stability during ambulation. Keeping the cane too far or too close to the body can affect its supportive function. Moreover, utilizing the cane solely for stair climbing limits its overall utility in maintaining balance and stability during regular walking.