A nurse is caring for the client who has Ménière's disease and asks if he is allowed to ambulate independently. Which of the following responses should the nurse make?
"Yes, you are free to move around as you wish."
"We will have to get a prescription from your provider.
"No, you are on strict bedrest and must not be up."
"Please ring for assistance when you wish to get out of bed."
The Correct Answer is D
A. Allowing free movement could increase the risk of falls due to dizziness.
B. While involving the provider is important, immediate safety measures should be communicated directly.
C. Strict bedrest is not typically necessary, and movement can help prevent complications like blood clots.
D. Assisting the client when they wish to get out of bed ensures safety by preventing falls, which are a significant risk for those with Ménière's disease due to vertigo.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Determining what the client already knows about managing diabetes is the initial step in assessing the client's current knowledge and understanding. This helps the nurse tailor the teaching plan to the client's needs and avoid redundancy.
B. Providing access to a video about diabetes may be part of the teaching plan but should come after assessing the client's baseline knowledge.
C. Establishing short-term, realistic goals is important but should follow the assessment of the client's current knowledge and understanding.
D. Evaluating the effectiveness of the client's admission teaching plan is important but should occur after the initial assessment and implementation of a personalized teaching plan.
Correct Answer is ["100"]
Explanation
To calculate the flow rate for an IV fluid bolus, you can use the formula: (Volume in mL * Drop factor) / Time in minutes. For a 200 mL dextrose 5% in water to be administered over 30 minutes with a drop factor of 15 gtt/mL, the calculation would be (200 * 15) / 30, which equals 100 gtt/min.
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