A nurse is caring for a group of clients who have chronic pain. Which of the following clients should the nurse identify as a candidate for occupational therapy?
A client who has a PCA for chronic pain following a laminectomy
A client who has Alzheimer's disease and is experiencing abdominal pain
A client who has migraines and is experiencing nausea and vomiting
A client who has painful hands due to degenerative joint disease
The Correct Answer is D
A. A client who has a PCA for chronic pain following a laminectomy: This client is receiving patient-controlled analgesia (PCA) to manage post-surgical pain. The primary focus is pharmacologic pain control, and occupational therapy is not the first-line intervention for acute post-surgical pain management.
B. A client who has Alzheimer's disease and is experiencing abdominal pain: Occupational therapy focuses on improving functional abilities, mobility, and daily activities rather than addressing acute internal pain such as abdominal pain. Management of this client’s pain would involve medical assessment and treatment rather than OT intervention.
C. A client who has migraines and is experiencing nausea and vomiting: Migraine management is primarily medical, focusing on pharmacologic therapy and symptom relief. Occupational therapy is not indicated for acute episodic pain like migraines with associated nausea and vomiting.
D. A client who has painful hands due to degenerative joint disease: Occupational therapy is appropriate for chronic musculoskeletal conditions like degenerative joint disease. OT can help the client maintain hand function, adapt daily activities, improve fine motor skills, and manage chronic pain through therapeutic techniques and assistive devices.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"B"}
Explanation
Rationale for correct choices
• Evaluating the fetal heart rate tracing: The client is at 31 weeks of gestation with decreased fetal movement, a sign of potential fetal compromise. Assessing the fetal heart rate immediately allows the nurse to determine fetal well-being and identify any signs of distress. Prompt evaluation is critical in high-risk pregnancies, especially with maternal hypertension and preeclampsia, to guide timely interventions.
• Administering antihypertensives: The client’s blood pressure readings (162/112 mm Hg and 166/110 mm Hg) indicate severe hypertension, increasing the risk for maternal complications such as stroke and eclampsia. Administering prescribed antihypertensives after assessing fetal status helps stabilize maternal blood pressure while maintaining fetal perfusion.
Rationale for incorrect choices
• Administering acetaminophen PO: While the client reports a severe headache, acetaminophen only addresses pain symptomatically and does not treat the underlying severe hypertension or fetal risk. Managing maternal blood pressure and assessing fetal status take priority over analgesic administration in this scenario.
• Obtaining 24-hour urine collection: A 24-hour urine collection to measure proteinuria is important for diagnosing preeclampsia severity, but it is not an immediate action. It is time-consuming and does not provide real-time data on maternal or fetal well-being, so it should follow urgent interventions.
• Administering antibiotics: There is no evidence of infection in the client’s assessment or laboratory findings, so antibiotics are not indicated at this time. Initiating antibiotics would not address the acute maternal or fetal risks associated with severe preeclampsia.
• Encouraging ambulation: Encouraging ambulation is inappropriate in a client with severe hypertension and decreased fetal movement because physical activity could exacerbate maternal risk and stress the fetus. Bed rest and monitoring are safer until the client is stabilized.
Correct Answer is C
Explanation
A. Ecomaps: Ecomaps are visual tools that depict the social and family relationships of an individual or household. They are used in nursing assessments at the family or individual level, not typically in community health report cards.
B. Geographic boundaries: While geographic boundaries may be referenced in a community health report, they are not a primary feature of the report card itself. Boundaries help define the community, but the report card focuses on population health data and outcomes.
C. Needs assessments: Community health report cards summarize data regarding the health status, risks, and needs of a population. Needs assessments identify gaps in services, priority health issues, and areas for intervention, making them a key component of the report card.
D. Care maps: Care maps are individualized or population-based plans that outline interventions for specific diagnoses or conditions. They are tools for planning care, not typically included in the summary findings of a community health report card.
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