A home health nurse is planning care for a client who has Alzheimer's disease. Which of the following actions should the nurse include in the plan of care?

Encourage physical activity prior to bedtime

Wear clothing with zippers instead of buttons.

Replace the carpet with hardwood floors

Place locks at the tops of exterior doors.

Answer and Explanation

The Correct Answer is D

Rationale:

A. Encourage physical activity prior to bedtime: Stimulating activity close to bedtime can increase agitation and make it harder for clients with Alzheimer’s disease to settle for sleep. Calming routines in the evening are more appropriate to reduce nighttime confusion and restlessness.

B. Wear clothing with zippers instead of buttons: Although zippers are often easier than buttons, clients with Alzheimer’s may have difficulty with any fasteners. Simple clothing with Velcro or elastic waists is typically more suitable to promote independence.

C. Replace the carpet with hardwood floors: Carpets provide traction and cushioning, which can help prevent injuries from falls. Hardwood floors may be slippery or cause confusion due to glare or unfamiliar patterns, increasing fall risk.

D. Place locks at the tops of exterior doors: Clients with Alzheimer’s are at risk for wandering. Installing locks at the tops of doors—out of the client's usual line of sight—helps prevent elopement while preserving safety in the home environment.

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Correct Answer is ["2"]

Explanation

Convert the available strength from milligrams (mg) to micrograms (mcg) to match the desired dose's unit.

Available strength = 0.025 mg/tablet

Since 1 mg = 1000 mcg,

Calculation:

Desired dose = 50 mcg.

Available strength in mcg = 0.025 mg/tablet × 1000 mcg/mg

= 25 mcg/tablet.

Calculate the number of tablets to administer.

Number of tablets = Desired dose (mcg) / Available strength (mcg/tablet)

= 50 mcg / 25 mcg/tablet

= 2 tablets.

Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"D"}

Explanation

Rationale for correct choices:

Opioid intoxication: The client's decreased respiratory rate, drowsiness, pinpoint pupils, and positive response to naloxone are all indicative of opioid intoxication. These features, along with the presence of a needle in the antecubital space, strongly support recent opioid use and CNS depression.
Pupil characteristics: Miotic pupils, or pinpoint pupils, are a classic physical sign of opioid intoxication. They occur due to opioid stimulation of the parasympathetic nervous system, and in a sedated client with a history of injection drug use, they confirm the likelihood of opioid overdose.

Rationale for incorrect choices:

Alcohol intoxication: Alcohol intoxication usually presents with disinhibition, unsteady gait, slurred speech, and potentially aggressive or inappropriate behavior. The client’s severe sedation, low respiratory rate, and constricted pupils are not typical features of alcohol intoxication, especially with only one beer reported.
Alcohol withdrawal: Alcohol withdrawal manifests with symptoms like tremors, agitation, hallucinations, seizures, and autonomic instability (tachycardia, hypertension). This client is sedated with bradypnea and hypotension, which are incompatible with alcohol withdrawal and more suggestive of CNS depression.
Opioid withdrawal: Opioid withdrawal is marked by agitation, anxiety, mydriasis, vomiting, diarrhea, and piloerection. In contrast, this client is drowsy, has decreased bowel sounds, and constricted pupils, pointing toward active opioid intoxication rather than withdrawal.
Amount of alcohol consumed: The report from EMS indicates the client consumed only one beer, which is insufficient to explain the severity of the symptoms. Minimal alcohol intake also makes both intoxication and withdrawal from alcohol highly unlikely as the primary issue.
Current temperature: The client’s current temperature of 37.2°C (99°F) is within normal limits and does not support any particular diagnosis. It neither confirms nor excludes opioid or alcohol intoxication or withdrawal and is not a defining clinical sign in this context.
Breath sounds: Breath sounds are equal and clear, offering no abnormal findings to support or contradict a diagnosis. While important for general assessment, they are not specific indicators for opioid intoxication or withdrawal and thus are less relevant than pupil changes.

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A home health nurse is planning care for a client who has Alzheimer's disease. Which of the following actions should the nurse include in the plan of care?

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Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer levothyroxine 50 mcg to a client. Available is levothyroxine 0.025 mg/tablet. How many tablets should the nurse administer per dose? (Round to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Correct Answer is ["2"]

Explanation

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Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"D"}

Explanation

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