A nurse is caring for an older adult client who states, "I am afraid that I may fall while walking to the bathroom during the night." Which of the following actions should the nurse take?
Obtain a bedside commode for the client's use.
Limit the client's fluid intake in the evening.
Put the side rails up and tell the client to call the nurse before voiding.
Leave a nightlight on in the client's room.
The Correct Answer is D
A. Obtain a bedside commode for the client's use: While helpful, this might not address the client's fear of walking in a dark room, and it requires transferring, which could still pose a fall risk.
B. Limit the client's fluid intake in the evening: This can prevent nocturnal trips to the bathroom but doesn't directly address safety if the client needs to get up at night.
C. Put the side rails up and tell the client to call the nurse before voiding: Side rails can sometimes increase fall risk if the client attempts to climb over them. It's more beneficial to ensure a safe environment.
D. Leave a nightlight on in the client's room: This provides adequate lighting, reducing the risk of tripping or falling in the dark, which directly addresses the client's concern about safety while walking to the bathroom.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Testing visual acuity: This assesses cranial nerve II (Optic nerve).
B. Observing for facial symmetry: This assesses cranial nerve VII (Facial nerve).
C. Eliciting the gag reflex: This assesses cranial nerves IX and X (Glossopharyngeal and Vagus nerves).
D. Checking the pupillary response to light: This assesses cranial nerve III (Oculomotor nerve), which controls pupil constriction and eye movements.
Correct Answer is B
Explanation
A. Has both older and younger siblings: This does not specifically relate to the "sandwich generation" concept.
B. Cares for children and aging parents at the same time: The term "sandwich generation" refers to individuals who are simultaneously caring for their own children and their aging parents.
C. There is a role reversal between parents and self: While this may occur in caregiving situations, it doesn't define the "sandwich generation."
D. Assists own parents and spouse's parents: This is similar to option B but specifically refers to assisting one's own parents and the spouse's parents, not necessarily at the same time.
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