A nurse is caring for a client who has a terminal illness and a family member asks why the client's mouth is continually open. Which of the following responses should the nurse make?
The reduced muscle tone relaxed the low muscles
"That happens when a person gets close to death
"I can apply a chin strap to help hold the mouth closed
The Correct Answer is A
A. The reduced muscle tone had relaxed the law muscles CORRECT
Prior to death, decreased muscle tone causes jaw muscles to relax resulting in an open mouth.
B. "That happens when a person gets close to death INCORRECT
This automatic response is nontherapeutic and does not address the family member's question
C. "I can apply a chin strap to help hold the mouth closed INCORRECT
Applying a chin strap is a postmortem action that the nurse can take to keep the mouth closed
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A: Correct. Regular dental assessments every 6 months are recommended for all individuals, including young adults, to maintain good oral health and detect any potential issues early.
B: Incorrect. Testicular examinations are important for young adult males, but they should be performed monthly as part of testicular self-examination, not every 5 years.
C: Incorrect. Young adult females should have a routine physical examination annually, not every 4 years, to monitor their overall health and address any potential health concerns.
D: Incorrect. While tuberculosis screening is essential in certain populations, such as healthcare workers or individuals at high risk of exposure, a tuberculosis skin test every 3 years is not a standard recommendation for all young adults.
Correct Answer is D
Explanation
A: Cantaloupe is relatively high in potassium and is not a suitable choice for a low-potassium diet.
B: Baked potatoes are high in potassium and should be avoided in a low-potassium diet.
C: Banana chips are also high in potassium and should not be included in a low-potassium diet.
D: Correct. Applesauce is a low-potassium food and is an appropriate choice for a client with chronic kidney disease following a low-potassium diet.

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