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The nurse is conducting a counseling session with a client experiencing post traumatic stress disorder (PTSD) using a 2-way video telehealth system from the hospital to the client's home, which is 2 hours away from the nearest mental health facility. Which of the following are expected outcomes of using telehealth as a venue to provide health care to this client? Select all that apply. The client will:
- A. Save travel time from the house to the health care facility.
- B. Avoid reliving a traumatic event which might be precipitated by visiting a health care facility.
- C. Experience a shorter recovery time than being treated by being on-site at a health care facility.
- D. Receive health care for this mental health problem.
- E. Obtain group support from others with a similar health problem.
Correct Answer: A,B,D
Rationale: Telehealth reduces travel time, minimizes triggers associated with visiting facilities, and provides access to mental health care, but it does not inherently shorten recovery time or provide group support unless specifically designed.
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The nurse is caring for a client with a history of gastric bypass surgery. Which of the following vitamins is the client at highest risk for deficiency?
- A. Vitamin A.
- B. Vitamin B12.
- C. Vitamin C.
- D. Vitamin D.
Correct Answer: B
Rationale: Gastric bypass surgery impairs vitamin B12 absorption due to reduced intrinsic factor production, increasing deficiency risk.
An adult client has bacterial conjunctivitis. What should the nurse teach him to do? Select all that apply.
- A. Use warm saline soaks four times per day to remove crusting.
- B. Apply topical antibiotic without touching the tip of the tube to his eye.
- C. Wash his hands after touching his eyes.
- D. Avoid touching his eyes.
- E. Observe isolation procedures and confine himself to his bedroom until the redness in the eye disappears.
Correct Answer: A,B,C,D
Rationale: Warm saline soaks, careful antibiotic application, hand washing, and avoiding eye contact prevent spread and promote healing. Isolation is unnecessary unless specified.
The nurse is evaluating the client's potential for development of a pressure sore. Which of the following individual characteristics would be the best indicator of risk for the client's developing a pressure sore?
- A. The client's nutritional status.
- B. The client's circulatory status.
- C. The client's mobility status.
- D. The client's orientation status.
Correct Answer: C
Rationale: Immobility is the primary risk factor for pressure sores, as it leads to prolonged pressure on tissues.
Which actions should the nurse implement to prevent ventilator-associated pneumonia (VAP) in the client who is intubated and on mechanical ventilation?
- A. Practice meticulous hand hygiene.
- B. Maintain the head of the bed elevation at 10 degrees.
- C. Perform suctioning of oral cavity secretions every 4 hours.
- D. Have the respiratory therapist change the ventilator circuit tubing every 4 hours.
Correct Answer: A
Rationale: Because normal upper airway defenses are bypassed, clients who are intubated with mechanical ventilation are at risk for VAP. Prevention includes effective hand washing before and after suctioning, when touching ventilator equipment, and when in contact with respiratory secretions. To prevent aspiration of colonized secretions from the oral cavity, the client will need more frequent oral cavity suctioning and at least 30 degrees head of the bed elevation. The more frequently the circuit is broken, the greater the risk for pathogen entry.
You have loosely applied a bed sheet around your client's waist to prevent a fall from the chair. What have you done?
- A. Ensured the client's safety which is a high patient care priority
- B. Violated Respondeat Superior
- C. Violated the client's right to dignity
- D. Committed a crime
Correct Answer: D
Rationale: Applying a bed sheet around the client's waist without a proper restraint order constitutes an illegal restraint, which is a crime , as it restricts freedom without proper authorization or consent.