A nurse is assisting an older adult client who sometimes loses her balance while walking. Which of the following devices should the nurse use when helping the client ambulate?
Jacket harness
Four-wheel walker
Cane
Galt belt
The Correct Answer is D
A. A jacket harness is typically used for clients who need more significant support, such as those who are unable to bear weight on their legs. It's not the most appropriate choice for a client who occasionally loses their balance.
B. A four-wheel walker provides more stability than a cane, but it can be difficult for some clients to use, especially those with limited upper body strength.
C. A cane can be helpful for clients who need some support while walking, but it may not provide enough stability for a client who frequently loses their balance.
D. A Galt belt is a wide, padded belt that can be used to assist clients with ambulation. It provides a secure grip without restricting the client's movement and is ideal for clients who occasionally lose their balance.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. This refers to irregular bleeding between menstrual periods. While anorexia nervosa can lead to amenorrhea (the absence of menstruation) due to hormonal imbalances from severe weight loss and malnutrition, metrorrhagia is not a typical finding associated with anorexia nervosa.
B. This is a condition characterized by elevated levels of potassium in the blood. It is not a common finding in anorexia nervosa. Instead, clients with anorexia nervosa are more likely to have electrolyte imbalances such as hypokalemia (low potassium levels), especially if they engage in behaviors like vomiting or excessive use of laxatives.
C. This is a common finding in clients with anorexia nervosa. Constipation occurs due to inadequate intake of food and fluids, which results in decreased bowel motility. Malnutrition and dehydration from restricted intake can also contribute to this problem.
D. This refers to an abnormally fast heart rate. While tachycardia can occur in various conditions, in the context of anorexia nervosa, clients may actually exhibit bradycardia (slow heart rate) rather than tachycardia. The low body weight and malnutrition associated with anorexia can lead to a slowed heart rate as part of the body's response to starvation and decreased metabolic activity.
Correct Answer is B
Explanation
A. Urinary urgency refers to a sudden, compelling need to urinate, which may or may not be accompanied by frequency (i.e., the need to urinate often). Urgency alone does not necessarily indicate urinary incontinence but rather may suggest conditions like overactive bladder or urge incontinence. This finding is not the most characteristic sign of urinary incontinence but rather a symptom of specific types of incontinence or bladder conditions.
B. Loss of urine when laughing, coughing, or sneezing is indicative of stress urinary incontinence. This type of incontinence occurs when physical activities that increase abdominal pressure (such as coughing, sneezing, or laughing) lead to involuntary leakage of urine. It is a common and classic symptom of stress urinary incontinence.
C. Urinary hesitancy refers to difficulty starting the urine stream or a delay in beginning urination. This symptom is more commonly associated with obstructive urinary conditions or prostatic issues in males rather than incontinence. It does not typically characterize urinary incontinence, which is more related to involuntary leakage rather than difficulties initiating urination.
D. Hematuria is the presence of blood in the urine and can be a sign of various urological issues such as infections, stones, or tumors. It is not a typical finding associated with urinary incontinence, which involves involuntary leakage rather than the presence of blood.
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