A home health nurse is performing a home visit to determine safety needs for a client.
Which of the following findings by the nurse may present complications for the client? Select all that apply.
Shower
Flooring
Home entrance
Inside walking pathway
Rugs
Inside lighting
Home assistance
Toilet
Bedroom Location
Handrails
Correct Answer : B,D,E,J
Choice A - Shower: The presence of a walk-in shower with a shower chair suggests that the client's needs have been considered, and this setup should not present complications.
Choice B - Flooring: The highly polished wood floors are a significant risk for slipping, especially for someone recovering from knee surgery. This type of flooring can be very slippery, particularly if the client is using assistive devices like crutches or a walker.
Choice C - Home Entrance: The front entrance has two steps, but a ramp has been added, and there is sufficient lighting. This adaptation should make the entrance safe for the client.
Choice D - Inside Walking Pathway: The living room's excessive furniture creating narrow pathways can be problematic for the client's mobility and increases the risk of falls or bumping into furniture, which can be dangerous post-surgery.
Choice E - Rugs: Non-secure rugs throughout the house are a tripping hazard. They can easily cause the client to slip or trip, leading to falls.
Choice F - Inside Lighting: The presence of night lights in the hallway and bathroom suggests that inside lighting is adequate and should not present complications.
Choice G - Home Assistance: The client lives with an adult child who is retired, which implies that there is some level
of home assistance available.
Choice H - Toilet: The toilet is elevated, which is beneficial for someone with knee issues as it reduces the strain on the knees when sitting down or standing up.
Choice I - Bedroom Location: The client’s bedroom being on the first floor is advantageous as it eliminates the need to climb stairs.
Choice J - Handrails: The absence of handrails in the bathroom is a safety concern. Handrails provide support and stability, which are crucial for preventing falls in the bathroom, especially post knee surgery.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
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Correct Answer is B
Explanation
Choice A reason: Manifestations of anthrax infection can vary in time of appearance, and while some symptoms may appear within 3 days, others may take longer.
Choice B reason: Ciprofloxacin is recommended for post-exposure prophylaxis in asymptomatic individuals who have been exposed to inhalation anthrax to prevent the development of the disease.
Choice C reason: The anthrax vaccine is used for pre-exposure prophylaxis and is not typically used after direct exposure as an emergency response.
Choice D reason: Prophylactic treatment duration for anthrax exposure is typically 60 days to ensure all spores have been eradicated, not just 10 days.
Correct Answer is B
Explanation
Choice A reason: Oropharyngeal suctioning may be necessary if secretions are causing distress, but it can also be uncomfortable and should be used cautiously.
Choice B reason: Turning the client can help manage noisy breathing by allowing secretions to drain and is a non- invasive comfort measure.
Choice C reason: Antiemetics are used to manage nausea and vomiting, not noisy breathing.
Choice D reason: An indwelling urinary catheter may be considered for comfort if the client cannot use the bathroom, but it does not address noisy breathing.
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