Nokea
An elderly patient with a hearing problem and mild confusion is not being cooperative regarding his need for a morning bath. The UAP in charge of his hygiene for the morning is frustrated and upset; she exclaims, 'Mr. Anderson isn't listening to a word I say!' Which of the following responses by the charge nurse represents effective supervision in this situation?
- A. Patient care can be frustrating at times. Mr. A. has a hearing impairment, which probably adds to his confusion. It helps the hearing impaired if you face them directly when you speak and then speak slowly. Try demonstrating what you want him to do as you speak to him, if that makes sense for the situation. I'll come and check on you right after I administer this insulin.'
- B. It sounds like you need a break. Take a few minutes to calm down and then get back to Mr. A. He'll probably be done washing by the time you get back.'
- C. I know how you feel. Mr. A. can be very hard to work with. You should get the other aide to help you. Speak loudly into his left ear. That's his good ear.'
- D. You know, it really isn't right for nurses to get frustrated with patients who can't help the way they act. You're a better aide than that. Remember, Mr. A. is old and confused and doesn't mean any harm. Go back in there and try again. Call me if you need help.'
Correct Answer: A
Rationale: This response provides constructive guidance by addressing the patient's hearing impairment and confusion, offering specific communication strategies, and ensuring follow-up support, demonstrating effective supervision.
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An older person under your care who has been alert and oriented begins acting different than normal and appears to be hallucinating. Which of the following is the correct term for this?
- A. Depression
- B. Dementia
- C. Delirium
- D. Confusion
Correct Answer: C
Rationale: Delirium is characterized by acute changes in mental status, such as hallucinations, often reversible with treatment.
Which of the following are teaching points to discuss with each patient regarding his or her medications?
- A. Reason for taking the medication
- B. Potential side effects and interactions
- C. How to store the medication
- D. When to take the medication
Correct Answer: A,B,C,D
Rationale: All listed points are essential for patient education to ensure safe and effective medication use, covering purpose, safety, storage, and administration.
Which one of the following integumentary system changes puts the patient at greatest risk for complications from bedrest?
- A. Skin becomes thin and fragile
- B. Capillaries become fragile
- C. Decreased circulation to skin and underlying tissue
- D. Tendency to bruise easily
Correct Answer: C
Rationale: Decreased circulation increases the risk of pressure ulcers during bedrest, as it impairs tissue perfusion and healing.
A resident who needs 24-hour nursing supervision and care for IV therapy and wound care would be placed in which of these living situations?
- A. Intermediate care
- B. Memory care
- C. Assisted living
- D. Skilled care
Correct Answer: A
Rationale: Skilled care provides 24-hour nursing supervision for complex medical needs like IV therapy and wound care, unlike other options.
List three important measures to take while assisting a resident with bathing and hygiene in a shared bathroom at a long-term care facility. Provide a rationale for each intervention.
- A. Ensure privacy by closing curtains or doors; prevents embarrassment and maintains dignity.
- B. Check water temperature to avoid burns; older adults may have decreased sensation.
- C. Use non-slip mats to prevent falls; shared bathrooms can be slippery and hazardous.
- D. Provide a call bell for assistance; ensures safety if the resident needs help.
Correct Answer: A,B,C
Rationale: These measures address privacy, safety, and accessibility, critical for resident comfort and well-being during bathing.