A nurse is receiving change-of-shift report on four clients.
Which of the following clients should the nurse plan to see first?

A client who has cirrhosis and severe pruritus.

A client who has a femur fracture and reports numbness of the toes.

A client who had a laparoscopic appendectomy 8 hr ago and is awaiting discharge.

A client who had a renal biopsy 3 hr ago and has pink-tinged urine.

Answer and Explanation

The Correct Answer is B

Choice A rationale:

The client with cirrhosis and severe pruritus is experiencing discomfort, but it is not an immediate life-threatening situation. The priority should be given to clients with conditions that pose an immediate risk to life.

Choice B rationale:

Numbness of the toes in a client with a femur fracture can indicate compromised circulation or nerve damage. This is a critical situation that requires immediate assessment and intervention to prevent complications like compartment syndrome or permanent nerve damage.

Choice C rationale:

A client who had a laparoscopic appendectomy 8 hours ago and is awaiting discharge is likely stable. While they need monitoring, it is not an urgent priority compared to the client with a potential vascular or nerve issue.

Choice D rationale:

Pink-tinged urine after a renal biopsy could indicate some bleeding, but it is not as urgent as the situation of the client with a femur fracture and numbness of the toes.

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Correct Answer is B

Explanation

Choice A rationale:

Limiting the use of familiar objects is not recommended for clients with Alzheimer's disease. Familiar objects can provide comfort and security to these clients and help them maintain a sense of familiarity in their environment.

Choice B rationale:

Making a schedule of daily tasks is a helpful intervention for clients with Alzheimer's disease. Routine and structure can reduce frustration and anxiety in clients with cognitive impairment by providing predictability and a sense of purpose.

Choice C rationale:

Having several family members visit daily may be overwhelming for the client with Alzheimer's disease, leading to increased confusion and agitation. It is essential to balance social interaction with the client's comfort level and needs.

Choice D rationale:

Asking questions that require more than one answer can be confusing for clients with Alzheimer's disease. s should be simple and straightforward to enhance understanding and communication.

A. An entry on a nursing blog addressing wound healing. B. Information from a wound care product vendor. C. A peer-reviewed journal article. D. First-hand experience with wound care products.

Correct Answer is C

Explanation

Choice A rationale:

An entry on a nursing blog, while potentially informative, does not provide the same level of evidence-based information as a peer-reviewed journal article. Blog posts may not undergo rigorous peer review and may lack the scientific rigor and credibility associated with peer-reviewed research. Therefore, choice A is not the best source for evidence-based information.

Choice B rationale:

Information from a wound care product vendor may be biased and influenced by commercial interests. Vendors often aim to promote their products, and the information they provide may not be impartial or based on rigorous scientific research. Therefore, choice B is not the best source for evidence-based information.

Choice C rationale:

A peer-reviewed journal article is considered one of the most reliable sources of evidence-based information in healthcare. Such articles undergo a thorough review process by experts in the field to ensure the accuracy, quality, and validity of the research findings. Peer-reviewed articles provide credible and up-to-date information based on scientific research and are widely recognized as a gold standard in evidence-based practice. Therefore, choice C is the correct answer as it offers the best evidence-based information.

Choice D rationale:

First-hand experience with wound care products, while valuable, may not necessarily provide the most comprehensive or up-to-date information. Personal experiences can vary, and healthcare practices evolve over time based on research and new evidence. Therefore, choice D is not the best source for evidence-based information.

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A nurse is receiving change-of-shift report on four clients.Which of the following clients should the nurse plan to see first?

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Naxlex Comprehensive Predictor Exams

A home health nurse is caring for a client who has Alzheimer's disease.The client's son is concerned about his mother becoming frustrated.Which of the following interventions should the nurse include?

Correct Answer is B

Explanation

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Correct Answer is C

Explanation

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A nurse is receiving change-of-shift report on four clients.
Which of the following clients should the nurse plan to see first?