A nurse in a long-term care facility is caring for a bedridden client. Which of the following findings should alert the nurse to a potential complication of the client's immobility?

Confusion

Blurred vision

Diarrhea

Polyuria

Answer and Explanation

The Correct Answer is A

Confusion can be a sign of delirium, which is a common complication of immobility in older adults due to sensory deprivation, sleep disturbance, medication side effects, or dehydration. The nurse should assess for other causes of confusion, such as infection or hypoxia, and implement interventions to prevent or treat delirium.

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Correct Answer is D

Explanation

The client has hypokalemia, which is a low level of potassium in the blood. Hypokalemia can cause cardiac arrhythmias, which can be life-threatening. The nurse should initiate cardiac monitoring first to assess the client's heart rhythm and rate, and intervene if any abnormalities are detected. Administering an IV potassium drip is an appropriate intervention for hypokalemia, but it is not the first priority. Listening to the client's bowel sounds and checking the client's hand grasps are also relevant assessments for hypokalemia, as it can cause decreased bowel motility and muscle weakness, but they are not as urgent as cardiac monitoring.

A. Creatinine 0.8 mi/dl. B. Weight gain 1.1 kg (2.4 lb) in 24 hr C. Peripheral pulses 2+ bilaterally D. Urine specific gravity 1.045

Correct Answer is B

Explanation

Weight gain in a short period of time indicates fluid retention, which can worsen the client's condition and lead to complications such as pulmonary edema and hypertension. The nurse should report this finding to the provider and monitor the client's fluid balance and electrolytes.

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A nurse in a long-term care facility is caring for a bedridden client. Which of the following findings should alert the nurse to a potential complication of the client's immobility?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is B

Explanation

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A nurse in a long-term care facility is caring for a bedridden client. Which of the following findings should alert the nurse to a potential complication of the client's immobility?