A nurse is providing oral care for a client who is immobile. Which of the following actions should the nurse take?

Use a stiff toothbrush to clean the client's teeth.

Turn the client on his side before starting oral care.

Use the thumb and index finger to keep the client's mouth open.

Apply petroleum jelly to the client's lips after oral care.

Answer and Explanation

The Correct Answer is B

A - Using a stiff toothbrush is not appropriate for oral care in immobile clients, as it can irritate or damage the gums and oral tissues. A soft-bristled toothbrush is recommended to ensure gentle cleaning.

B - Turning the client on his side is the correct action to prevent aspiration. This position allows fluids and saliva to drain from the mouth, reducing the risk of aspiration, which is critical for immobile clients.

C - Using the thumb and index finger to keep the client’s mouth open can lead to accidental injury. Instead, a padded tongue blade should be used to maintain the client’s mouth open safely during oral care.

D - Applying petroleum jelly to the lips should be avoided, as it is oil-based and can increase the risk of aspiration if inhaled. A water-based lubricant or lip balm should be used instead.

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Free Nursing Study Resources

Correct Answer is ["A","C","D"]

Explanation

A. Coordinator: This role involves organizing and integrating the group's activities to achieve the goals effectively. The coordinator helps ensure that tasks are assigned, deadlines are met, and resources are utilized efficiently.
B. Self-confessor: This role involves expressing personal feelings, thoughts, or concerns.
While open communication is important in a team, this role may not always be considered a "necessary task performance role" in the same sense as the others listed. It's more about interpersonal communication rather than task-related functions.
C. Evaluator: This role involves assessing the group's progress toward its goals and providing feedback on performance. The evaluator helps the group identify areas for improvement and make necessary adjustments.
D. Energizer: This role involves motivating and energizing the group members to
maintain their enthusiasm and commitment to the task at hand. The energizer helps boost morale and keeps the group focused on achieving its objectives.

A. Request a prescription for an indwelling urinary catheter. B. Take the client to the bathroom every 2 hr. C. Remind the client to tell the nurse when he has to urinate. D. Use adult diapers to prevent frequent clothing changes.

Correct Answer is B

Explanation

A. Requesting a prescription for an indwelling urinary catheter should be considered a last resort. Catheters come with risks of infection and other complications, so they should only be used when other interventions have failed.
B. Taking the client to the bathroom every 2 hours is a proactive approach to managing urinary incontinence in older adults with dementia. This helps ensure that the client has regular opportunities to empty their bladder, reducing the likelihood of accidents.
C. Reminding the client to tell the nurse when he has to urinate may not be effective in clients with dementia, as they may have difficulty recognizing or communicating their need to urinate.
D. Using adult diapers should also be considered a last resort and should not be the primary intervention. While they can provide a temporary solution, they do not address the underlying issue and can contribute to skin problems if not changed frequently.

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A nurse is providing oral care for a client who is immobile. Which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is working with a team of nursing personnel within a facility. Which of the following are necessary task performance roles that members of the group or the leader must perform? (Select all that apply.)

Correct Answer is ["A","C","D"]

Explanation

Correct Answer is B

Explanation

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