A nurse at a long-term facility is planning a fall prevention program for the residents. Which of the following interventions should the nurse include?

Institute rounds every 2 hr. during the day to offer toileting.

Keep four side rails up on the beds at night

Apply vest restraints on the residents who are confused

Accompany residents older than 85 years of age during ambulation

Answer and Explanation

The Correct Answer is A

a.   Instituting rounds every 2 hours during the day to offer toileting can help prevent falls by addressing residents' toileting needs and reducing the risk of falls associated with attempting to ambulate to the bathroom independently.
b.   Keeping four side rails up on the beds at night may increase the risk of entrapment and should be avoided as a fall prevention strategy.
c.   Applying restraints, such as vest restraints, is not recommended as a fall prevention measure and may increase agitation and risk of injury.
d.   While providing assistance during ambulation is important, it is not necessary to accompany all residents older than 85 years of age. Ambulation assistance should be provided based on individual assessment of mobility and fall risk.

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Correct Answer is A

Explanation

a. Transcutaneous electrical nerve stimulation (TENS) is a form of physical therapy often used for pain management. Therefore, the physical therapist would be the appropriate member of the interdisciplinary team to contact for assistance with TENS.
b. Respiratory therapists primarily focus on respiratory care and would not typically be involved in assisting with TENS therapy.
c. Occupational therapists focus on helping clients perform activities of daily living and may not have specific expertise in managing TENS therapy.
d. While pharmacists are knowledgeable about medications, they may not have the expertise required to assist with TENS therapy, which is a form of physical therapy.

A. Calling the pharmacy with a prescription for the client's partner to pick up B. Informing housekeeping staff that the client is in the dialysis unit C. Reporting a client's disposition to the referring provider D. Providing a copy of the client's medical record to the transporting paramedic

Correct Answer is B

Explanation

A nurse is teaching a newly licensed nurse about client confidentiality. The nurse should include which of the following examples represents a violation of client confidentiality?
a. Calling the pharmacy with a prescription for the client's partner to pick up
b. Informing housekeeping staff that the client is in the dialysis unit
c. Reporting a client's disposition to the referring provider
d. Providing a copy of the client's medical record to the transporting paramedic

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A nurse at a long-term facility is planning a fall prevention program for the residents. Which of the following interventions should the nurse include?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has a prescription for transcutaneous electrical nerve stimulation (TENS). Which of the following members of the interdisciplinary team should the nurse contact for assistance?

Correct Answer is A

Explanation

A nurse is teaching a newly licensed nurse about client confidentiality. The nurse should include which of the following examples represents a violation of client confidentiality?

Correct Answer is B

Explanation

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