A nurse in an acute care setting is assisting in collecting client information to include in a referral for a physical therapist.

Which of the following information should the nurse plan to include?

Family medical history

Medications taken prior to admission

Physical assessment findings

Medical health insurance claims

Answer and Explanation

The Correct Answer is C

c. Physical assessment findings

Physical assessment findings are important to include in a referral for a physical therapist because they provide information about the client's current physical condition, including range of motion, strength, and any areas of pain or discomfort.

This information is essential for the physical therapist to develop an appropriate treatment plan for the client. Family medical history and medical health insurance claims may be important for overall client care, but are not directly relevant to a referral for a physical therapist.

Medications taken prior to admission may be relevant if they aﬀect the client's physical abilities or pain level, but again, physical assessment findings are more directly related to the referral for a physical therapist.

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Correct Answer is A

Explanation

Displacement is a defense mechanism where a person redirects their emotional impulses, such as anger or frustration, from the original source to a less threatening or more accessible target. In this scenario, the client is redirecting their anger towards the nurse when medication changes are prescribed by the provider. The nurse becomes the target of the client's anger, even though the nurse is not directly responsible for the medication changes.

Conversion is a defense mechanism where psychological distress is expressed as physical symptoms or ailments.

Splitting is a defense mechanism where a person sees things as either all good or all bad, with no middle ground or ambivalence.

Sublimation is a defense mechanism where unacceptable impulses or behaviors are channeled into socially acceptable and constructive outlets.

A. Use hydrogen peroxide for wound cleaning. B. Perform dressing changes every other day. C. Cleanse the most contaminated wounds first, D. Apply dressings with sterile gloves.

Correct Answer is D

Explanation

A.Using hydrogen peroxide for wound cleaning is not recommended as it can cause tissue damage and delay healing.

B.Burn dressings should typically be changed more frequently, often at least once per day, depending on the type and severity of the burn and the type of dressing used.Delaying dressing changes could increase the risk of infection.
C.In wound care, the nurse should cleanse the least contaminated wounds first to prevent spreading microorganisms from more contaminated areas to cleaner areas. This reduces the risk of cross-contamination and infection. For burns, starting with the cleanest areas ensures a safer wound management process.

D.Applying dressings with sterile gloves is essential to maintain a sterile environment and reduce the risk of infection, especially in clients with burns who are at high risk for infection due to compromised skin integrity.

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A nurse in an acute care setting is assisting in collecting client information to include in a referral for a physical therapist. Which of the following information should the nurse plan to include?

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A nurse in an acute care setting is assisting in collecting client information to include in a referral for a physical therapist.

Which of the following information should the nurse plan to include?