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During a home health visit, the client indicates he feels he might need physical therapy to facilitate his recovery. What action by the nurse is indicated?
- A. The nurse should contact the client's insurance carrier to determine benefit eligibility.
- B. The nurse should provide the client with the contact information for a local agency that offers physical therapy services.
- C. The nurse should contact the physician to discuss the client's concerns.
- D. The nurse should advise the client to contact the physician to discuss his concerns.
Correct Answer: C
Rationale: The home health nurse is responsible for coordinating care, including contacting the physician to initiate physical therapy, which requires a physician's order.
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The nurse is developing a plan of care for a client diagnosed with left-sided paralysis secondary to a right-sided cerebrovascular accident (stroke). Which should be included in the interventions?
- A. Use a pillow to keep the heels off the bed when supine
- B. Order a low air-loss therapy bed immediately
- C. Prepare to insert a nasogastric feeding tube
- D. Order an occupational therapy consult for strength training
Correct Answer: A
Rationale: Keeping heels off the bed prevents pressure ulcers, a key intervention for a paralyzed client.
The nurse is assessing a client's wound for signs and symptoms of inflammation. Which of the following would alert the nurse that the client is exhibiting signs of inflammation?
- A. Leg edema, severe pain from swelling, and severe erythema of leg
- B. Leg cool to touch
- C. Decreased peripheral pulses
- D. All of the above
Correct Answer: A
Rationale: Regardless of the cause, location, or extent of the injury, the acute inflammatory response follows the sequence of vascular response, cellular and phagocytic response, and healing. The cardinal signs of inflammation include erythema, local heat caused by the increased blood flow to the injured area (hyperemia), swelling due to accumulated fluid at site, pain from tissue swelling and chemical irritation of nerve endings, and loss of function caused by the swelling and pain. Coolness and decreased pulses are not typical signs of inflammation.
After teaching a client how to care for a furuncle in the axilla, a nurse assesses the client's understanding. Which statement indicates the client correctly understands the teaching?
- A. I'll apply cortisone cream to reduce the inflammation.
- B. I'll apply a clean dressing after squeezing out the pus.
- C. I'll keep my arm down at my side to prevent spread.
- D. I'll cleanse the area prior to applying antibiotic cream.
Correct Answer: D
Rationale: Cleansing and topical antibiotics can eliminate the infection. Squeezing the lesion may introduce infection to deeper tissues.
While inspecting the skin of a patient's arm the nurse notes lesions that are clustered together. How should the nurse document this finding?
- A. Linear
- B. Discrete
- C. Grouped
- D. Confluent
Correct Answer: C
Rationale: Grouped lesions are clustered together, unlike linear, discrete, or confluent patterns.
Nurse Jeff is performing skin assessment on a client with a facial lesion. It appears as a well-defined, red, scaling, thickened bump. This type of skin lesion refers to?
- A. Basal cell carcinoma
- B. Squamous cell carcinoma
- C. Melanoma
- D. Actinic keratosis
Correct Answer: B
Rationale: Squamous cell carcinoma often presents as a red, scaling, thickened bump, typically on sun-exposed areas like the face.