A nurse is talking with a client who reports acute lower back pain after moving heavy boxes. Which of the following information should the nurse reinforce? D

Turn the torso at the waist when reaching for objects.

Remain in bed except for toileting during the first 24 hr.

Use ice packs intermittently for 48 hr.

Use 10 lb arm weights to begin strengthening the back muscles.

Answer and Explanation

The Correct Answer is C

A.   The nurse should reinforce that the client should avoid twisting at the waist when lifting or reaching. Instead, they should pivot with their feet and keep their back straight to minimize strain on the lower back.
B.   Prolonged bed rest is generally not recommended for acute lower back pain. While resting is important, clients are usually encouraged to engage in light activity and movement as tolerated to prevent stiffness and promote healing. Staying in bed for extended periods can lead to more problems.
C.   Ice packs can help reduce inflammation and numb the pain in the initial stages of injury. Applying ice intermittently for 15-20 minutes at a time can be beneficial during the first 48 hours after an acute injury.
D.   This option is not advisable for a client experiencing acute lower back pain. Strengthening exercises should be introduced gradually and only after the acute pain has subsided. Initially, the focus should be on gentle stretching and movement rather than adding weights, which could exacerbate the injury.

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Correct Answer is A

Explanation

A. As people age, the glands in the ear may produce more cerumen (earwax), and the ear canal may also become narrower, leading to a buildup of wax. This can affect hearing and may require regular cleaning by a healthcare professional.
B. With aging, peripheral vision often decreases due to changes in the retina and other parts of the eye. Older adults may experience difficulties in peripheral awareness, making it harder to detect objects or movements outside their central line of sight.
C. As people age, they may experience decreased sensitivity to touch due to changes in nerve endings and skin elasticity. Many older adults report a reduced sense of touch, which can affect balance and coordination.
D. In fact, older adults typically experience decreased pupil size and a reduced response to changes in light. The pupils may become more fixed and less able to dilate quickly in response to dim light.

A. Place two fingers in the client's mouth. B. Hold the toothbrush at a 90° angle. C. Vigorously brush the client's teeth. D. Turn the client to the side.

Correct Answer is D

Explanation

A. This action is not appropriate as it could stimulate the gag reflex and lead to choking or aspiration. It does not contribute to effective oral care. Instead, gentle techniques using appropriate tools should be used to clean the mouth.
B. Holding the toothbrush at a 90° angle can be effective for brushing teeth as it allows for better access to the surfaces of the teeth. However, for an unconscious patient, this angle might not be practical or safe depending on the circumstances.
C. Vigorous brushing is not recommended, especially for an unconscious client. It could cause damage to the gums, lead to discomfort, or risk aspiration of fluids. Gentle brushing is advised to clean the teeth and gums without causing injury.
D. Turning the client to the side helps prevent aspiration of saliva or any fluids that may be in the mouth. It also provides better access for oral care and minimizes the risk of choking. This position is often recommended for unconscious patients to maintain their safety during oral care.

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A nurse is talking with a client who reports acute lower back pain after moving heavy boxes. Which of the following information should the nurse reinforce? D

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