A nurse is assessing a client who is postoperative following a left leg below-the-knee amputation. Which of the following client statements indicates the potential need for a referral to an occupational therapist?

"I just don't think I can handle looking at my leg."

"I am worried about taking care of my toddler at home."

"I hope I can adjust to using crutches while I am recovering

"I am not sure how I will pay for all the therapy I will need."

Answer and Explanation

The Correct Answer is B

A.   Feeling discomfort or distress about looking at the amputated leg might indicate the need for psychological support or counseling but doesn't specifically indicate the need for occupational therapy.
B.   Expressing worry about managing childcare responsibilities at home suggests potential difficulty with daily activities, indicating a need for occupational therapy to assess and address these concerns.
C.   Hoping to adjust to using crutches during recovery indicates a concern related to
mobility, which might involve physical therapy but not necessarily occupational therapy.
D.   Expressing concern about affording therapy doesn't specifically indicate a need for occupational therapy; this might relate more to financial counseling or social work support.

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Correct Answer is B

Explanation

A. A client ready for discharge, if stable and prepared for discharge, does not require immediate assessment.
B. Restlessness in a client with Alzheimer's and bacterial pneumonia could indicate a change in condition, potentially signaling an urgent issue that needs immediate assessment.
C. While pain management is important, the sudden onset of restlessness in a client with cognitive impairment and pneumonia takes priority.
D. An elevated fasting blood glucose level in a newly admitted diabetic client requires attention but might not be as immediately critical as the acute change in behavior seen in option B.

A. A client who is receiving heparin and has an aPTT of 34 seconds (30 to 40 seconds). B. A client who has type 1 diabetes mellitus and uses an insulin pump. C. A client who has orthostatic hypotension and is receiving IV fluids, D. A client who is at risk for pressure injuries and has an albumin level of 4.2 g/dL (3.5 to 5 g/dL).

Correct Answer is B

Explanation

A. The client’s aPTT is within the therapeutic range for heparin, so immediate interdisciplinary discussion is not required.

B. Clients using insulin pumps require coordination between the nurse, endocrinologist, and diabetes educator to ensure safe insulin administration and blood glucose management, making an interdisciplinary conference appropriate.

C. Orthostatic hypotension being managed with IV fluids can typically be addressed within routine nursing care without needing an interdisciplinary meeting.

D. The client’s albumin level is within normal limits, and risk for pressure injuries can be managed with standard nursing interventions without requiring a conference.

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A nurse is assessing a client who is postoperative following a left leg below-the-knee amputation. Which of the following client statements indicates the potential need for a referral to an occupational therapist?

Nursing Test Bank

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