A nurse in a community health clinic is interviewing a couple who just lost their house in a fire. Using the priority framework of Maslow's hierarchy of needs, which category should the nurse identify for the client's situation?

Safety

Self-actualization

Esteem

Love and belonging

Answer and Explanation

The Correct Answer is A

Choice A reason: This is the correct answer because safety is the second level of Maslow's hierarchy of needs, and it includes the needs for security, stability, protection, and freedom from fear and anxiety. The couple who just lost their house in a fire are likely experiencing a threat to their safety needs, as they have lost their shelter, possessions, and sense of security. The nurse should identify and address their safety needs as a priority, and help them find alternative housing, financial assistance, and emotional support.

Choice B reason: This is not the correct answer because self-actualization is the highest level of Maslow's hierarchy of needs, and it includes the needs for personal growth, fulfillment, and realization of one's potential. The couple who just lost their house in a fire are unlikely to be concerned with their self-actualization needs at this time, as they have more pressing and basic needs to meet. The nurse should focus on their lower-level needs first, before helping them achieve their higher-level needs.

Choice C reason: This is not the correct answer because esteem is the fourth level of Maslow's hierarchy of needs, and it includes the needs for self-respect, confidence, recognition, and appreciation. The couple who just lost their house in a fire may experience a loss of esteem, as they may feel ashamed, helpless, or worthless. However, their esteem needs are not the most urgent or important at this time, as they have more fundamental needs to satisfy. The nurse should support their esteem needs by showing empathy, respect, and encouragement, but not neglect their lower-level needs.

Choice D reason: This is not the correct answer because love and belonging is the third level of Maslow's hierarchy of needs, and it includes the needs for affection, intimacy, friendship, and social acceptance. The couple who just lost their house in a fire may benefit from their love and belonging needs, as they may seek comfort, support, and connection from others. However, their love and belonging needs are not the primary or essential at this time, as they have more basic and vital needs to fulfill. The nurse should facilitate their love and belonging needs by providing a caring and compassionate environment, but not overlook their lower-level needs.

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Correct Answer is C

Explanation

Choice A reason: Cataracts are a condition that causes the lens of the eye to become cloudy and opaque. They can cause symptoms such as blurred vision, glare, halos, and reduced color perception. They do not affect the shape of the lines on the Amsler grid or the center of vision.

Choice B reason: Glaucoma is a condition that causes increased pressure in the eye and damage to the optic nerve. It can cause symptoms such as gradual loss of peripheral vision, tunnel vision, and eye pain. It does not affect the shape of the lines on the Amsler grid or the center of vision.

Choice C reason: Macular degeneration is a condition that affects the macula, the central part of the retina. It can cause symptoms such as distorted vision, dark spots, and loss of central vision. It can affect the shape of the lines on the Amsler grid and the center of vision.

Choice D reason: Retinal detachment is a condition that occurs when the retina separates from the back of the eye. It can cause symptoms such as flashes, floaters, and a curtain-like vision loss. It does not affect the shape of the lines on the Amsler grid or the center of vision.

A. Utilize supine positioning to maximize chest expansion. B. Use an appropriately sized blood pressure cuff. C. Consult a nutritionist because the client is malnourished/underweight. D. Place the client on fall precautions because of increased risk for falls due to frail bones.

Correct Answer is B

Explanation

Choice A reason: Utilize supine positioning to maximize chest expansion is not an important intervention for clients with a BMI greater than or equal to 30. Supine positioning is when the client lies flat on their back. This position can actually impair chest expansion and breathing for clients with a high BMI, as the weight of the abdomen and chest can compress the lungs and diaphragm. A semi-Fowler's position, where the head of the bed is elevated at 30 to 45 degrees, is preferred for these clients, as it reduces the pressure on the chest and improves ventilation.

Choice B reason: Use an appropriately sized blood pressure cuff is an important intervention for clients with a BMI greater than or equal to 30. A blood pressure cuff that is too small or too tight can cause inaccurate readings and increase the risk of injury to the client. A blood pressure cuff that is too large or too loose can also cause inaccurate readings and compromise the quality of care. A blood pressure cuff that fits the client's arm circumference and width is essential for obtaining accurate and reliable measurements and preventing complications.

Choice C reason: Consult a nutritionist because the client is malnourished/underweight is not an important intervention for clients with a BMI greater than or equal to 30. A BMI greater than or equal to 30 indicates that the client is obese, not malnourished or underweight. Obesity is a condition where the client has excess body fat that can affect their health and well-being. Malnutrition is a condition where the client has inadequate or imbalanced intake of nutrients that can affect their growth and development. Underweight is a condition where the client has a low body weight that can affect their immunity and energy. A nutritionist can help clients with any of these conditions, but the statement is incorrect for clients with a high BMI.

Choice D reason: Place the client on fall precautions because of increased risk for falls due to frail bones is not an important intervention for clients with a BMI greater than or equal to 30. Frail bones are not a common consequence of obesity, but rather of osteoporosis, a condition where the bones become weak and brittle. Obesity can actually increase the bone density and strength, as the bones have to support more weight. However, obesity can increase the risk for falls due to other factors, such as impaired mobility, balance, or coordination. Fall precautions are important for any client who is at risk for falls, but the statement is inaccurate for clients with a high BMI.

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A nurse in a community health clinic is interviewing a couple who just lost their house in a fire. Using the priority framework of Maslow's hierarchy of needs, which category should the nurse identify for the client's situation?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

When shown an Amsler grid, the client reports seeing wavy, distorted lines. The client also states his center of vision is dark and he has no sense of depth perception. The nurse suspects the client has which of the following conditions?

Correct Answer is C

Explanation

A nurse on a medical-surgical unit knows that for clients with a BMI greater than or equal to 30, it is important to:

Correct Answer is B

Explanation

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