Nokea
The nurse is teaching a client with osteoporosis about fall prevention. Which of the following should be included? Select all that apply.
- A. Remove loose rugs from the home.
- B. Install grab bars in the bathroom.
- C. Wear high-heeled shoes for support.
- D. Ensure adequate lighting at night.
- E. Exercise regularly to improve balance.
Correct Answer: A,B,D,E
Rationale: Removing rugs, installing grab bars, ensuring lighting, and exercising prevent falls. High-heeled shoes increase fall risk.
You may also like to solve these questions
The family cannot go with the surgical client past the doors that separate the public from the restricted area of the operating room suite. These traffic control measures are designed to:
- A. Protect the privacy of clients.
- B. Prevent electrical sparks that could ignite the anesthetic gases.
- C. Separate the family from the surgical team to prevent distraction of the client.
- D. Provide for an aseptic environment to prevent infection.
Correct Answer: D
Rationale: Restricting access to the operating room maintains an aseptic environment, reducing the risk of surgical site infections by limiting contamination.
A client refuses to look at or care for her colostomy. Which of the following statements by the nurse would be most appropriate?
- A. It has been 4 days since your surgery and you will be discussed. You have to learn to care for your colostomy before you leave the hospital.
- B. I think we will need to teach your husband to care for your colostomy if you are not going to be able to do it.
- C. I understand how you are feeling. It is important for you to feel attractive and you think having a colostomy changes your attractiveness.
- D. I can see that you are upset. Would you like to share your concerns with me?
Correct Answer: D
Rationale: It is important for the nurse to recognize that individuals go through a grieving process when adjusting to a colostomy. The nurse should be accepting and provide the client with opportunities to share her concerns and feelings when she is ready. Lecturing the client about the need to learn how to care for the colostomy is not productive, nor is attempting to shame her into caring for the colostomy by implying her husband will have to provide the care if she does not. It is not possible for the nurse to understand what the client is feeling. CN: Psychosocial adaptation; CL: Synthesize
Which factor besides the degree of neutropenia does the nurse assess in determining the client's risk of infection?
- A. Length of time neutropenia has existed.
- B. Health status before neutropenia.
- C. Body build and weight.
- D. Resistance to infection in childhood.
Correct Answer: A
Rationale: The duration of neutropenia significantly affects infection risk, as prolonged neutropenia increases exposure to pathogens. Pre-existing health status, body build, and childhood resistance are less directly relevant to current infection risk.
A 27-year-old female has had elective nasal surgery for a deviated septum. Which of the following would indicate that bleeding was occurring even if the nasal drip pad remained dry and intact?
- A. Nausea.
- B. Repeated swallowing.
- C. Increased respiratory rate.
- D. Increased pain.
Correct Answer: B
Rationale: Repeated swallowing may indicate blood trickling down the throat (postnasal drip), a sign of bleeding. Nausea, increased respiratory rate, and pain are less specific indicators of bleeding.
During preadmission testing for same-day surgery, a client states that she has added two cloves of garlic each day to her diet to help control her blood pressure. The nurse should further inquire about which of the following?
- A. The type of surgery the client is having.
- B. What her blood pressure has been running.
- C. The amount of garlic she is eating.
- D. Her preference for the type of anesthesia.
Correct Answer: B
Rationale: Garlic can affect blood pressure and has anticoagulant properties, which may increase bleeding risk during surgery. Inquiring about the client's blood pressure helps assess the impact of garlic on her condition and informs surgical planning. The type of surgery, amount of garlic, or anesthesia preference are less directly relevant to this concern.