A nurse at a long-term care facility is reviewing the plan of care for a client who has a prescription for mitten restraints. Which of the following tasks should the nurse assign to an assistive personnel?
Evaluate the need for the client to remain in mitten restraints.
Assist the client with range-of-motion exercises of the hands.
Instruct the client's family about the purpose of mitten restraints.
Determine the circulation status of the affected extremities every 2 hr
The Correct Answer is B
Range-of-motion exercises can be safely performed by assistive personnel under the supervision and direction of the nurse. It helps to maintain the mobility and function of the client's hands while in restraints.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Using a cool-mist vaporizer in the baby's room can help provide moisture and relieve nasal congestion, especially during cold or dry weather. It can help ease breathing and improve the baby's comfort.
"I will leave the plastic covering on the crib mattress": This statement is incorrect. The plastic covering should be removed from the crib mattress before placing the baby in the crib. The plastic covering poses a suffocation risk and should not be used.
"I will lay my baby's head on a pillow while he is in the crib": This statement is incorrect. Pillows should not be used in the crib for infants. They increase the risk of suffocation and can pose a hazard to the baby. The crib should be free of pillows, blankets, stuffed animals, or any other loose items.
"I will leave my baby's bib on while he is sleeping": This statement is incorrect. Bibs should be removed before placing the baby in the crib or while the baby is sleeping to prevent the risk of suffocation. Loose items around the baby's neck can pose a strangulation hazard.
Correct Answer is A
Explanation
Radiation therapy can cause increased sensitivity and dryness in the skin. Exposing the neck to cold temperatures may exacerbate these symptoms and potentially lead to discomfort or skin damage. Encourage the client to keep the neck covered and warm, especially when going outside in cold weather.
While proper nutrition is important during radiation therapy, the specific instruction to eat three large meals each day is not necessarily applicable or beneficial. It is generally recommended to have a balanced and nutritious diet, which may include smaller, frequent meals or snacks if the client's appetite is affected.
During radiation therapy, the skin in the treatment area can become sensitive and prone to irritation. Rubbing the neck vigorously with a washcloth can further irritate the skin. Instead, advise the client to gently cleanse the neck using a mild, non-irritating soap and patting the skin dry with a soft towel.
While radiation therapy can cause certain side effects, such as dry mouth or difficulty swallowing, it is generally not necessary to restrict fluid intake unless specifically advised by the healthcare provider. Adequate hydration is important for overall health and well-being, and the client should be encouraged to drink enough fluids unless instructed otherwise.
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