A nurse is caring for a client who is incontinent.
Which of the following actions should the nurse take?
Clean the client's skin with hot water.
Dry between folds in the client's skin.
Apply baby powder to the client's skin.
Restrict the client's fluid intake.
The Correct Answer is B
Choice A rationale:
Clean the client's skin with hot water. Using hot water to clean a client's skin who is incontinent can be harmful. Hot water can damage the skin and exacerbate any existing skin issues. It is essential to use lukewarm water and gentle, pH-balanced cleansers to prevent skin irritation.
Choice B rationale:
Dry between folds in the client's skin. This is the correct answer. When caring for a client who is incontinent, it is crucial to ensure that the skin is kept clean and dry. Moisture between skin folds can lead to skin breakdown and the development of pressure ulcers. Drying the skin thoroughly helps prevent these issues.
Choice C rationale:
Apply baby powder to the client's skin. Applying baby powder is not recommended, as it can create a moist environment that may promote the growth of fungi and bacteria. It can also potentially lead to respiratory issues if the client inhales the powder. It's better to focus on keeping the skin clean and dry without using powder.
Choice D rationale:
Restrict the client's fluid intake. Restricting the client's fluid intake is not a suitable approach. Adequate hydration is essential for overall health and well-being. Dehydration can lead to various complications and negatively impact the client's overall health. Instead, focus on managing incontinence through appropriate hygiene and the use of incontinence products. .
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale:
Alcohol consumption is a modifiable risk factor that can have negative health consequences. However, it is not the primary factor to focus on when discussing ways to improve health. Excessive alcohol consumption can lead to liver disease, addiction, and other health issues, but it's not the most critical modifiable risk factor for many people.
Choice B rationale:
Family history is not a modifiable risk factor. It's essential information for assessing a person's risk for various health conditions, but it cannot be changed or improved upon. Therefore, it's not the primary focus when teaching someone how to improve their health.
Choice D rationale:
A sedentary lifestyle is a modifiable risk factor and is crucial for improving health. Prolonged inactivity can lead to various health problems, such as obesity, cardiovascular disease, and muscle weakness. While it's an important factor, it's not the top priority for improving health in this context.
Choice E rationale:
Weight is a modifiable risk factor, and it is closely related to diet and physical activity. Maintaining a healthy weight is essential for overall health, and it often involves a combination of dietary choices and physical activity. However, focusing on diet itself is more specific and directly actionable when providing health improvement advice. Now, let's move on to the next question.
Correct Answer is D
Explanation
Choice A rationale:
Piaget's formal operational stage is characterized by abstract thinking, hypothesis testing, and logical reasoning, but it does not include the development of object permanence. This stage typically occurs during adolescence, not in early childhood when object permanence is established.
Choice B rationale:
The preoperational stage is characterized by the development of symbolic thought and egocentrism but not object permanence. Object permanence starts to develop during the sensorimotor stage.
Choice C rationale:
Concrete operational thinking is focused on logical and systematic thinking related to concrete objects and events. It does not include the development of object permanence, which occurs in the earlier sensorimotor stage.
Choice D rationale:
Object permanence is a concept that develops during Piaget's sensorimotor stage, which typically occurs from birth to about two years of age. During this stage, children learn that objects continue to exist even when they are out of sight. They develop the ability to represent objects mentally and understand the concept of permanence.
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