A nurse is collecting data from an older adult client who lives alone. Which of the following findings should the nurse identify as the priority?
The client verbalizes regret about never marrying.
The client has poorly fitting dentures.
The client has no living family.
The client is sedentary throughout most of the day.
The Correct Answer is D
Rationale:
A. While the client's feelings about never marrying are important, they do not represent an immediate health risk or safety concern.
B. Poorly fitting dentures can affect the client's quality of life and ability to eat, but they do not represent an immediate health risk or safety concern.
C. While having no living family can be a social concern, it does not represent an immediate health risk or safety concern.
D. The client being sedentary throughout most of the day is a risk factor for numerous health problems, including cardiovascular disease, obesity, and decreased mobility. It is also a modifiable risk factor that can be addressed to improve the client's health and quality of life. Encouraging the client to engage in regular physical activity is a priority.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Rationale:
A. Wrist restraint orders typically require renewal every 24 hours, not every 36 hours.
B. Checking the client's range of motion every 6 hours is not specific to the use of wrist restraints.
C. Secure the restraints with a quick-release knot, not a square knot, to allow for quick removal in case of emergency.
D. Making sure two fingers fit under the restraints is important to ensure that they are not too tight and do not cause injury to the client.
Correct Answer is B
Explanation
Rationale:
A. Moving the stronger leg forward before moving the weaker leg is incorrect and may increase the risk of falls.
B. Holding the cane on the stronger side provides support and stability while walking.
C. Moving the cane forward 18 inches is incorrect and may increase the risk of falls.
D. Wearing shoes with smooth soles may decrease traction and increase the risk of falls.
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