A nurse is caring for an older adult patient with chronic obstructive pulmonary disease. The patient always remains in a sitting position to help them breathe more easily. Based on this information, what area on the patient's body should be frequently assessed for skin breakdown?

Elbows and behind the ears

Coccyx and back of the skull

Heels and trochanter

Sacrum and ischium

Answer and Explanation

The Correct Answer is D

A. Elbows and behind the ears: These areas are not primary pressure points in a seated position.

B. Coccyx and back of the skull: The coccyx is a pressure point when lying down, but this patient is sitting most of the time.

C. Heels and trochanter: Heels are at risk in supine patients, but this patient is primarily sitting.

D. Sacrum and ischium: The sacrum and ischium (sit bones) bear the most pressure in a seated position, making them highly vulnerable to skin breakdown.

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Correct Answer is C

Explanation

A. "Yes! I am sure you are excited to finally eat something. Let's set the head of the bed up." This statement misleads the patient by suggesting they can eat orally, which contradicts the purpose of parenteral nutrition (IV nutrition).

B. "Let me have the provider come explain to you what parenteral nutrition is." While the provider can clarify details, the nurse should explain basic information about parenteral nutrition immediately rather than deferring the question.

C. "Unfortunately, no. We are going to be providing you with nutrition through your vein." This provides a clear, direct, and simple explanation of parenteral nutrition (IV nutrition) while acknowledging the patient's interest in food.

D. "No, we will be putting in a tube that will go from your nose to your stomach to help you eat." This describes enteral nutrition (NG tube feeding), which is different from parenteral nutrition (IV feeding).

A. 46-year-old with a low neutrophil count B. 59-year-old seven days post abdominal surgery C. 82-year-old with a history of leukemia ten years ago D. 62-year-old on antibiotic therapy

Correct Answer is A

Explanation

A. 46-year-old with a low neutrophil count: Neutrophils are essential for fighting infection. A low neutrophil count (neutropenia) significantly increases infection risk, making this the highest-priority patient.

B. 59-year-old seven days post abdominal surgery: While postoperative patients are at risk for infection, the greatest risk is within the first few days after surgery. By day seven, the risk decreases if no signs of infection are present.

C. 82-year-old with a history of leukemia ten years ago: While leukemia can affect the immune system, a history of leukemia from ten years ago is less concerning than an active condition causing immunosuppression.

D. 62-year-old on antibiotic therapy: While antibiotics can disrupt normal flora and increase the risk of infections like Clostridioides difficile, this risk is lower than that of a patient with neutropenia.

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A nurse is caring for an older adult patient with chronic obstructive pulmonary disease. The patient always remains in a sitting position to help them breathe more easily. Based on this information, what area on the patient's body should be frequently assessed for skin breakdown?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The provider has notified the patient and family that the patient will be started on parenteral nutrition. The patient asks if their family can go get them a milk shake since the provider said they could have nutrition. What is the best response by nurse at this time?

Correct Answer is C

Explanation

The nurse is providing care for the following patients. Which patient is at highest risk of developing an infection?

Correct Answer is A

Explanation

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A nurse is caring for an older adult patient with chronic obstructive pulmonary disease. The patient always remains in a sitting position to help them breathe more easily. Based on this information, what area on the patient's body should be frequently assessed for skin breakdown?

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