A nurse in an acute mental-health facility is caring for an adolescent who is exhibiting destructive behavior. Which of the following actions should the nurse take after applying physical restraints to the client?
Monitor the client's range of motion every 60 min.
Offer the client a nutritious snack every 4 hr.
Plan to remove the restraints as soon as the client is calm
Ensure that the provider has signed a prescription for restraints within 48 hr.
The Correct Answer is C
The correct answer is C. Plan to remove the restraints as soon as the client is calm. Physical restraints should be used as a last resort and for the shortest duration possible to ensure
client safety. The nurse should assess the client frequently and remove the restraints when they are no longer needed.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
The correct answer is C. Place a pillow under the child's head.
Rationale: The nurse should protect the child from injury by helping them to the floor and clearing away furniture or other items. The nurse should also place a pillow under the child's head to prevent head trauma and turn them onto their side to prevent aspiration of saliva or vomit. The nurse should not put anything in the child's mouth, as this could cause choking or damage to the teeth or tongue. The nurse should also not turn the child onto their back, as this could compromise their airway. The nurse should not restrain the child's upper extremities, as this could increase muscle spasms and cause injury.
Correct Answer is C
Explanation
The correct answer is C.
Engage in low-impact aerobic exercises. Low-impact aerobic exercises, such as walking, swimming, or cycling, can help improve joint mobility, muscle strength, and cardiovascular health in clients with arthritis. They can also reduce pain and inflammation by increasing blood flow and oxygen delivery to the joints. The nurse should advise the client to avoid high-impact exercises, such as running or jumping, that can worsen joint damage and pain. The nurse should also recommend sleeping on a firm mattress that supports the spine and joints, applying heat to relax stiff muscles and joints, and using assistive devices or palms to push off from surfaces to avoid putting extra stress on the fingers.
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