A nurse is caring for an adult client who has been placed in physical restraints due to aggressive behavior. Which of the following actions should the nurse take?
Ask the provider to renew the prescription every 8 hr.
Have a staff member check on the client every 30 min.
Assess the client's need for toileting every 15 min.
Offer hydration and nutrition to the client every 2 hr.
The Correct Answer is D
A. The provider must renew the prescription for restraints every 4 hours for adults, not every 8 hours.
B. A staff member should check on the client every 15 minutes, not every 30 minutes, to ensure safety.
C. The client should be assessed for toileting needs every 2 hours, not every 15 minutes.
D. Offering hydration and nutrition every 2 hours is appropriate to maintain the client’s basic needs while in restraints.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Buprenorphine is not typically indicated for alcohol withdrawal; it is primarily used in the management of opioid dependence.
B. Bupropion is an antidepressant medication and is not indicated for the treatment of acute alcohol withdrawal.
C. Disulfiram is used as a deterrent to alcohol consumption in individuals who have achieved abstinence and is not indicated for acute alcohol withdrawal.
D. Chlordiazepoxide is a benzodiazepine medication commonly used to manage alcohol withdrawal symptoms, such as anxiety and agitation.
Correct Answer is D
Explanation
A. Hepatitis B infection is not a contraindication for prescribing bupropion for smoking cessation.
B. Hypothyroidism is not a contraindication for prescribing bupropion for smoking cessation.
C. Knee arthroplasty 1 month ago does not contraindicate the use of bupropion for smoking cessation.
D. Bupropion is contraindicated in individuals with a recent head injury due to the increased risk of seizures associated with this medication. Therefore, the nurse should report this finding to the provider.
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