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A nurse is preparing to place a belt restraint on a client. In what order should the nurse take the following actions? (Move the steps into the box on the right, placing them in the order of performance. Use all the steps.)

Place the client in a lying position.

Thread the ties through the belt.

Apply the belt at the client's waist over his clothing.

Assist the client to a sitting position.

Attach restraint straps to the bedframe.

Answer and Explanation

The Correct Answer is A,D,C,B,E

Place the client in a lying position. This step ensures that the client is in a stable and safe position before applying the restraint.
Assist the client to a sitting position. Once the client is stable, assisting them to a sitting position ensures that they are comfortably positioned for restraint application.
Apply the belt at the client's waist over his clothing. Applying the belt over the clothing at the waist secures the client and prevents movement.
Thread the ties through the belt. Threading the ties through the belt ensures that the restraint is properly secured.
Attach restraint straps to the bedframe. Finally, attaching the restraint straps to the bedframe ensures that the restraint is firmly secured and the client cannot easily remove it.

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Correct Answer is C

Explanation

A. Complete an incident report and notify the nursing supervisor. Completing an incident report and notifying the supervisor is not required for routine tasks like faxing a laboratory report.
B. Direct the provider to the admissions department for the information. Directing the provider to another department is not necessary for this task and does not address the specific request to fax the report.
C. Place a cover sheet on top of the document indicating the recipient. This is the correct action. A cover sheet helps protect patient confidentiality by indicating the intended recipient and purpose of the fax, ensuring secure transmission.
D. Fax the complete medical record to the provider's office. Faxing the complete medical record is inappropriate unless specifically requested. Only the relevant laboratory report should be sent to maintain patient confidentiality and comply with privacy regulations.

A. Elevated blood pressure B. Decreased heart rate C. Report of epigastric pain D. Mental confusion

Correct Answer is D

Explanation

A. Elevated blood pressure This is not a common manifestation of a UTI in older adults.
B. Decreased heart rate This is not associated with UTIs.
C. Report of epigastric pain Epigastric pain is more related to gastrointestinal issues.
D. Mental confusion Older adults with UTIs often present with mental confusion or altered mental status, rather than the classic symptoms seen in younger individuals.

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A nurse is preparing to place a belt restraint on a client. In what order should the nurse take the following actions? (Move the steps into the box on the right, placing them in the order of performance. Use all the steps.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

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