A nurse is implementing seizure precautions for a newly admitted client. Which of the following equipment should the nurse place in the client's room?

Suctioning device

Bite block

Vest restraint

Padded tongue blade

Answer and Explanation

The Correct Answer is A

A. Suctioning device – Correct. A suctioning device is essential to clear the airway in case of excessive secretions during or after a seizure.

B. Bite block – Incorrect. Bite blocks are not used during seizures as they can cause injury. Nothing should be placed in the client’s mouth during a seizure.

C. Vest restraint – Incorrect. Restraints should not be used on clients with seizure disorders as they can cause injury.

D. Padded tongue blade – Incorrect. Tongue blades should never be inserted into the mouth of a seizing client due to the risk of airway obstruction and oral trauma.

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Correct Answer is D

Explanation

A. Asking about body changes is important for understanding the client’s self-perception, but it does not address immediate safety concerns.

B. Inquiring about the duration of feelings of uselessness is helpful for assessing depressive symptoms, but it is not the priority over assessing for suicidal intent.

C. Exploring triggers for these feelings is useful for emotional support and planning interventions but is secondary to assessing for immediate risk of self-harm.

D. This question assesses for suicidal ideation, which is the nurse’s priority because older adults experiencing feelings of uselessness or hopelessness are at higher risk for depression and suicide. Early identification of suicidal thoughts ensures prompt intervention and support.

A. "I don't think that is really what is happening to you." B. "Don't worry. Everything will be okay." C. "How are things going at your job?" D. "You must be feeling very frightened right now."

Correct Answer is D

Explanation

A. This statement dismisses the client's feelings.

B. Offering false reassurance is not therapeutic.

C. Changing the subject does not address the client's distress.

D. This is the correct answer. Acknowledging the client's feelings is a therapeutic response that encourages further discussion.

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A nurse is implementing seizure precautions for a newly admitted client. Which of the following equipment should the nurse place in the client's room?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is D

Explanation

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