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A nurse is reinforcing teaching with the family of an older adult client about safety precautions. Which of the following recommendations should the nurse include to reduce the risk of a client fall? (Select all that apply.)

Ensure the client wears nonskid slippers when walking around the house.

Attach full-length side rails to the client's bed.

Install a raised toilet seat in the client's bathroom.

Encourage an annual review of the medications the client is taking.

Place throw rugs on uncarpeted floors in the client's home.

Answer and Explanation

Correct Answer : A,C,D

Ensure the client wears nonskid slippers when walking around the house.

Explanation: Nonskid slippers provide better traction and stability, reducing the risk of slipping.

B.Attach full-length side rails to the client's bed.

Explanation: Side rails can pose a risk of entrapment and may not prevent falls. The use of side rails is associated with safety concerns, and their use should be carefully evaluated.

C.Install a raised toilet seat in the client's bathroom.

Explanation: A raised toilet seat makes it easier for the client to sit down and stand up, reducing the risk of falls in the bathroom.

D.Encourage an annual review of the medications the client is taking.

Explanation: Medication reviews help identify drugs that may increase the risk of falls or interactions that could affect balance or cognitive function.

E.Place throw rugs on uncarpeted floors in the client's home.

Explanation: Throw rugs can be tripping hazards, especially for older adults with mobility issues. It's safer to have clear, unobstructed pathways in the home.

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Correct Answer is A

Explanation

A. Engage the client in a repetitive activity as a distraction:

This is the correct answer. Redirecting the client's focus to a repetitive and calming activity can help distract them from the source of agitation and potentially de-escalate the situation.

B. Place the client in a seclusion room:

Seclusion should only be used in situations where it is absolutely necessary for the safety of the client or others. Placing a client with dementia in seclusion is not the first choice and should be avoided if possible.

C. Apply wrist restraints to the client:

Restraints should be a last resort and used only when there is an imminent risk of harm to the client or others. Restraints can escalate agitation and should not be the initial response.

D. Administer PRN haloperidol IM to the client:

The use of medication should be considered later in the escalation process and after other non-pharmacological interventions have been attempted. It is not the first intervention, especially when there are non-pharmacological options available.

Correct Answer is ["0.71"]

Explanation

To calculate the volume (mL) of the reconstituted medication that the nurse should administer, you can use the following formula:

Volume (mL)=Desired Dose (mg)/Concentration (mg/mL)

In this case:

Volume = 250 mg/350 mg/mL

Now, let's calculate:

Volume = 250 mg/350 mg/mL

Volume=0.71mL

Therefore, the nurse should administer 0.71 mL of the reconstituted ceftriaxone solution to provide the prescribed dose of 250 mg, rounded to the nearest hundredth.

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A nurse is reinforcing teaching with the family of an older adult client about safety precautions. Which of the following recommendations should the nurse include to reduce the risk of a client fall? (Select all that apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse in a long-term care facility is monitoring clients in the day room. A client who has dementia becomes angry and starts screaming at the nurse. Which of the following interventions should the nurse take first?

Correct Answer is A

Explanation

Correct Answer is ["0.71"]

Explanation

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