Nokea
During physical therapy, a client with Parkinson's disease makes the following statements. Which statement indicates the need for a referral to physical therapy?
- A. ''I have been experiencing more tremors in my left arm than before''
- B. ''I noticed that I am having a harder time holding on to my toothbrush''
- C. ''Lately, I feel like my feet are freezing up, as they are stuck to the ground''
- D. ''Sometimes, I feel I am making a chewing motion when I'm not eating''
Correct Answer: C
Rationale: Feeling like the feet are freezing up and sticking to the ground is a common symptom of Parkinson's disease known as 'freezing of gait.' This symptom significantly impacts mobility and can be dangerous, indicating the need for specialized physical therapy interventions to address gait disturbances and improve mobility.
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A client is to receive a transfusion of packed RBCs. Which of the following actions should the nurse take?
- A. Prime IV tubing with 0.9% sodium chloride
- B. Use a 24-gauge IV catheter
- C. Obtain filterless IV tubing
- D. Place blood in the warmer for 1 hr
Correct Answer: A
Rationale: Prior to administering a blood transfusion, it is essential to prime the IV tubing with 0.9% sodium chloride to prevent hemolysis of the blood cells. Using a smaller gauge IV catheter (e.g., 20 or 22 gauge) is recommended for blood transfusions to prevent hemolysis. Filterless IV tubing is contraindicated for blood transfusions as it does not have a filter to trap potential blood clots or debris. Warming blood is unnecessary and could lead to the development of bacteria in the blood product. Therefore, the correct action for the nurse to take is to prime the IV tubing with 0.9% sodium chloride.
A client has diaper dermatitis. Which of the following actions should the nurse take?
- A. Apply zinc oxide ointment to the irritated area.
- B. Wipe stool from the skin using store-bought baby wipes.
- C. Apply talcum powder to the irritated area.
- D. None of the above
Correct Answer: A
Rationale: Diaper dermatitis, also known as diaper rash, is a common condition in babies or clients who wear diapers. The primary intervention for diaper dermatitis is to apply a protective barrier cream, such as zinc oxide ointment, to the irritated area. This helps to protect the skin from irritants and promotes healing. Wiping stool from the skin using baby wipes may further irritate the skin, and talcum powder is no longer recommended due to potential respiratory risks when inhaled. Therefore, the correct action for the nurse in this scenario is to apply zinc oxide ointment to the irritated area.
A nurse is talking with another nurse on the unit and smells alcohol on her breath. Which of the following actions should the nurse take?
- A. Confront the nurse about the suspected alcohol use.
- B. Inform another nurse on the unit about the suspected alcohol use.
- C. Ask the nurse to finish administering medications and then go home.
- D. Notify the nursing manager about the suspected alcohol use.
Correct Answer: A
Rationale: Confronting the nurse about the suspected alcohol use is the most appropriate action in this situation. It is essential to address the issue directly and express concerns about patient safety and potential impairment. By addressing the situation promptly, the nurse can potentially prevent harm and provide support to the colleague in need.
When providing discharge teaching for a group of clients, a nurse should recommend a referral to a dietitian for which client?
- A. A client who has a prescription for warfarin and states, 'I will need to limit how much spinach I eat.'
- B. A client who has gout and states, 'I can continue to eat anchovies on my pizza.'
- C. A client who has a prescription for spironolactone and states, 'I will reduce my intake of foods that contain potassium.'
- D. A client who has osteoporosis and states, 'I'll plan to take my calcium carbonate with a full glass of water.'
Correct Answer: B
Rationale: The correct answer is the client who has gout and states, 'I can continue to eat anchovies on my pizza.' Gout is a condition that requires dietary modifications to manage symptoms. Anchovies are high in purines, which can exacerbate gout symptoms. Therefore, a referral to a dietitian is essential to provide appropriate dietary guidance for a client with gout. Clients on warfarin may need to monitor their vitamin K intake, particularly from foods like spinach. Clients taking spironolactone should be cautious about potassium-rich foods. Clients with osteoporosis should be educated on the proper administration of calcium supplements but do not necessarily need a dietitian referral for this specific statement.
A healthcare professional is completing an incident report after a client fall. Which of the following competencies of Quality and Safety Education for Nurses is the professional demonstrating?
- A. Quality improvement
- B. Patient-centered care
- C. Evidence-based practice
- D. Informatics
Correct Answer: A
Rationale: Completing an incident report after a client fall aligns with the competency of quality improvement, which focuses on identifying system errors and implementing changes to improve patient outcomes and safety. Patient-centered care emphasizes involving patients in their care decisions, evidence-based practice involves integrating research and clinical expertise, and informatics involves using technology to improve patient care. In this scenario, the emphasis is on the process of improving quality and safety related to the incident.