A home health nurse is visiting a client who had a stroke 2 months ago. Which of the following findings should the nurse report to the interprofessional care team?
The client dresses her affected side first.
The client bears weight on their arms when using crutches.
The client coughs when swallowing her medications.
The client's caregiver fills a pill organizer weekly.
The Correct Answer is C
Choice A reason: The client dressing her affected side first is not a finding that the nurse should report to the interprofessional care team, as it indicates that the client is following the proper technique for dressing after a stroke. Dressing the affected side first helps the client maintain range of motion and prevent contractures of the affected limbs.
Choice B reason: The client bearing weight on their arms when using crutches is not a finding that the nurse should report to the interprofessional care team, as it is a normal and expected way of using crutches. Bearing weight on the arms helps the client balance and support their body weight while walking with crutches.
Choice C reason: The client coughing when swallowing her medications is a finding that the nurse should report to the interprofessional care team, as it indicates that the client may have dysphagia, or difficulty swallowing, which is a common complication of stroke. Dysphagia can increase the risk of aspiration, pneumonia, dehydration, and malnutrition. The nurse should assess the client's swallowing ability and refer them to a speech-language pathologist for further evaluation and intervention.
Choice D reason: The client's caregiver filling a pill organizer weekly is not a finding that the nurse should report to the interprofessional care team, as it is a positive and helpful way of managing the client's medications. Filling a pill organizer weekly can help the client and the caregiver remember the medication names, doses, and schedules, and prevent medication errors or omissions.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Early detection of disease is the primary goal of screening for lipid disorders, as it can identify clients who are at risk of developing cardiovascular diseases, such as coronary artery disease, stroke, or peripheral artery disease. Lipid disorders are abnormal levels of cholesterol or triglycerides in the blood, which can lead to plaque buildup in the arteries and reduce blood flow to the heart, brain, or limbs. Screening for lipid disorders can help diagnose and treat these conditions before they cause serious complications.
Choice B reason: Client enrollment in prevention programs is not the primary goal of screening for lipid disorders, although it is a beneficial outcome. Prevention programs are interventions that aim to reduce the risk factors or prevent the onset of diseases. Client enrollment in prevention programs may be a result of screening for lipid disorders, as clients who have abnormal lipid levels may be referred to programs that offer education, counseling, medication, or lifestyle modification.
Choice C reason: Promotion of appropriate lifestyle changes is not the primary goal of screening for lipid disorders, although it is a beneficial outcome. Lifestyle changes are behaviors that can improve health and well-being, such as eating a balanced diet, exercising regularly, quitting smoking, or managing stress. Promotion of appropriate lifestyle changes may be a result of screening for lipid disorders, as clients who have abnormal lipid levels may be advised to adopt healthier habits to lower their cholesterol or triglycerides.
Choice D reason: Identification of family history of medical problems is not the primary goal of screening for lipid disorders, although it is a beneficial outcome. Family history of medical problems is a genetic or environmental factor that can increase the likelihood of developing certain diseases. Identification of family history of medical problems may be a result of screening for lipid disorders, as clients who have abnormal lipid levels may be asked to provide information about their relatives' health conditions.
Correct Answer is D
Explanation
Choice A reason: Determining potential funding sources for the program is an important action, but not the first one. The nurse should first assess the needs of the target population, such as the number of older adults who need the service, their nutritional status, their preferences, and their barriers to access food.
Choice B reason: Inquiring about the availability of volunteers is an important action, but not the first one. The nurse should first assess the needs of the target population, and then plan the resources and personnel needed to implement the program.
Choice C reason: Identifying alternative solutions to address concerns is an important action, but not the first one. The nurse should first assess the needs of the target population, and then identify the possible challenges and solutions to deliver the service effectively and efficiently.
Choice D reason: Performing a needs assessment is the first action that the nurse should take, as it provides the basis for planning, implementing, and evaluating the program. A needs assessment involves collecting and analyzing data about the health status, needs, and resources of the target population and the community. It helps to identify the gaps, priorities, and goals of the program.
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