A nurse is caring for a client who is visually impaired. When delivering the client's meal tray, which of the following actions should the nurse take?

Describe the food placement as though the plate were a clock.

Provide the client with small-handled adaptive utensils.

Discourage conversations during the client's mealtime.

Arrange for an assistive personnel to feed the client.

Answer and Explanation

The Correct Answer is A

Choice A reason: This is the correct answer because describing the food placement as though the plate were a clock can help the client locate and identify the food items on their tray. For example, the nurse can say, "Your chicken is at 12 o'clock, your mashed potatoes are at 3 o'clock, and your green beans are at 9 o'clock."

Choice B reason: This is not an appropriate action because providing the client with small-handled adaptive utensils can make it harder for them to grip and manipulate the utensils and increase their frustration and dependence. The nurse should provide the client with large-handled or weighted adaptive utensils that can improve their dexterity and control.

Choice C reason: This is not an appropriate action because discouraging conversations during the client's mealtime can make them feel isolated and depressed and reduce their appetite and enjoyment of food. The nurse should encourage conversations during the client's mealtime and provide social support and stimulation.

Choice D reason: This is not an appropriate action because arranging for an assistive personnel to feed the client can compromise their dignity and autonomy and increase their dependence and helplessness. The nurse should respect the client's preferences and abilities and provide assistance only when necessary.

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Correct Answer is D

Explanation

Choice A reason: This is not an appropriate area to check for pallor because the antecubital space, or the inner elbow, is not a reliable indicator of skin color changes due to variations in pigmentation and blood flow.

Choice B reason: This is not an appropriate area to check for pallor because the pinna of the ear, or the outer ear, is not a reliable indicator of skin color changes due to variations in pigmentation and blood flow.

Choice C reason: This is not an appropriate area to check for pallor because the abdomen is not a reliable indicator of skin color changes due to variations in pigmentation and fat distribution.

Choice D reason: This is an appropriate area to check for pallor because the conjunctiva, or the inner lining of the eyelid, is a reliable indicator of skin color changes due to its consistent pink color in healthy individuals regardless of race or ethnicity. Pallor of the conjunctiva can indicate anemia or shock.

A. Numbness in the fingertips B. Pain in the jawline C. Urge to urinate D. Feeling of heat

Correct Answer is D

Explanation

Choice A reason: This is not an expected sensation during injection of the contrast medium because numbness in the fingertips can indicate peripheral nerve damage or ischemia, which are rare but serious complications of cardiac catheterization. The nurse should assess the client's peripheral pulses, capillary refill, and sensation and report any abnormalities.

Choice B reason: This is not an expected sensation during injection of the contrast medium because pain in the jawline can indicate angina or myocardial infarction, which are rare but serious complications of cardiac catheterization. The nurse should monitor the client's vital signs, electrocardiogram, and chest pain and report any changes.

Choice C reason: This is not an expected sensation during injection of the contrast medium because urge to urinate can indicate bladder distension or urinary tract infection, which are unrelated to cardiac catheterization. The nurse should encourage the client to empty their bladder before the procedure and check for urinary retention or dysuria after the procedure.

Choice D reason: This is an expected sensation during injection of the contrast medium because feeling of heat can occur as a result of vasodilation caused by the contrast medium, which increases blood flow to the skin and mucous membranes. The nurse should inform the client that this sensation is normal and temporary and will subside within a few minutes.

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A nurse is caring for a client who is visually impaired. When delivering the client's meal tray, which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is collecting data from a client who is African-American. Which of the following areas should the nurse check to determine the presence of pallor?

Correct Answer is D

Explanation

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Correct Answer is D

Explanation

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