A client is receiving palliative care, and death is anticipated within the next 24 hours. The practical nurse (PN) observes that the client's legs have a mottled appearance. What should the PN apply to the client's legs?
Heating pad
Body lotion
Soft blanket
Moist clothes
The Correct Answer is C
The correct answer is Choice C. Soft blanket.
Choice A rationale:
A heating pad should not be applied to the client's legs with a mottled appearance. A mottled appearance indicates poor circulation, and applying heat could potentially worsen the situation by dilating blood vessels and further reducing blood flow to the extremities.
Choice B rationale:
The body lotion is not appropriate in this situation. While it may help moisturize the skin, it will not address the underlying circulation issues causing the mottled appearance. Moreover, applying lotions to areas with compromised circulation can be harmful.
Choice C rationale:
The correct choice. A soft blanket can be applied to the client's legs with a mottled appearance to provide warmth and comfort. It is essential to keep the client comfortable during palliative care, and a soft blanket can help maintain a suitable temperature without causing harm.
Choice D rationale:
Moist clothes are not indicated in this situation. They may potentially worsen the mottled appearance by adding moisture to the skin, and it won't address the circulation issues causing the discoloration.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Correct Answer: D. Report the findings to the charge nurse.
Choice A rationale:
Monitoring the client's temperature hourly may be indicated if the client's condition deteriorates or if there are specific concerns about fever. However, the temperature of 99.8°F (37.66°C) is not significantly elevated and may not be the primary concern in this situation.
Choice B rationale:
Offering the client fluids frequently is a good nursing practice, but it is not the most important intervention in this case. The client's nonproductive cough and increased confusion need to be addressed and reported first.
Choice C rationale:
Providing care to moisten oral mucosa is important for maintaining oral health and preventing dryness and discomfort. However, it may not directly address the client's current symptoms of cough and confusion.
Choice D rationale:
Reporting the findings to the charge nurse is the most crucial intervention. The client's nonproductive cough and increased confusion may be indicative of an underlying issue, such as a respiratory infection or a change in neurological status. The charge nurse can initiate further assessments, notify the healthcare provider, and implement appropriate interventions to address the client's condition promptly. Timely reporting and communication are essential to ensure the client receives appropriate care.
Correct Answer is A
Explanation
Choice A rationale:
Pantoprazole is a proton pump inhibitor used to treat GERD by reducing stomach acid production. If the client reports not experiencing heartburn after eating lunch, it indicates that the medication is effectively reducing stomach acid and alleviating GERD symptoms.
Choice B rationale:
The ability to swallow food without difficulty is not directly related to the desired effect of pantoprazole. It may be an important aspect of the client's overall condition, but it does not specifically indicate the efficacy of the medication in treating GERD.
Choice C rationale:
Having no difficulty straining for a bowel movement is unrelated to the desired effect of pantoprazole in treating GERD. Pantoprazole does not directly influence bowel movements.
Choice D rationale:
Having a great appetite and feeling hungry are not relevant indicators of the effectiveness of pantoprazole in treating GERD. These statements are more related to the client's appetite and overall well-being rather than the response to the medication.
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