A nurse is teaching a client about the correct use of a cane. What should the nurse include?
- A. Ensure the cane has a rubber cap
- B. Hold the cane on the stronger side
- C. Flex the elbow slightly when using the cane
- D. Use a quad cane for increased support
Correct Answer: B
Rationale: The cane should be held on the stronger side to provide support and stability while walking.
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A nurse is caring for a patient who is scheduled for cataract surgery. The client states, "I see just fine and have decided to cancel my surgery." Which of the following responses should the nurse make?
- A. That's not a good idea; the surgery is necessary
- B. Share with me more about the thoughts that are concerning you
- C. You should trust your doctor's advice
- D. You can always reschedule the surgery later
Correct Answer: B
Rationale: Encouraging the client to share their thoughts helps the nurse understand the client's concerns and facilitates a supportive discussion.
A nurse is reviewing the medical records of a group of older adult clients. The nurse should identify which of the following as a risk factor for developing infections?
- A. Increased physical activity
- B. Lowered immune system function
- C. Regular health screenings
- D. Proper nutrition
Correct Answer: B
Rationale: Lowered immune system function in older adults increases susceptibility to infections.
A nurse is caring for an older adult who has a nonpalpable skin lesion that is less than 0.5 cm (0.2 in) in diameter. Which of the following terms should the nurse use to document this finding?
- A. Papule
- B. Vesicle
- C. Macule
- D. Nodule
Correct Answer: C
Rationale: A macule is a nonpalpable lesion smaller than 1 cm in diameter, such as a freckle.
A nurse is teaching about foot care to a client who has diabetes mellitus (DM). What statement indicates understanding?
- A. I should wear my slippers whenever I am out of bed
- B. I can walk barefoot at home
- C. I should apply lotion between my toes
- D. I can soak my feet in warm water
Correct Answer: A
Rationale: Wearing slippers or shoes when out of bed protects the feet from injury, which is crucial for clients with diabetes.
A nurse in an acute care facility is caring for a client who is postop following abdominal surgery. Which of the following behaviors should the nurse identify as increasing the client's risk for constipation?
- A. Regular fluid intake
- B. Urge suppression
- C. Increased physical activity
- D. Adequate dietary fiber
Correct Answer: B
Rationale: Urge suppression can lead to constipation, especially in postoperative patients.