A nurse is teaching a client who has a history of falls about home safety. Which of the following statements should the nurse identify as an indication that the client understands the instructions?
"I will place a bath seat in my shower to use when I bathe."
"I will place an area rug at the entry of my bathroom."
"I will keep my walker at the end of my bed."
"I will keep the fluorescent ceiling light on in my room at night."
The Correct Answer is A
A. Placing a bath seat in the shower is a safety measure to prevent falls while bathing. This statement indicates an understanding of the importance of bathroom safety.
B. Placing an area rug at the entry of the bathroom can actually increase the risk of falls, as rugs can be tripping hazards. This statement does not demonstrate an understanding of home safety.
C. Keeping the walker at the end of the bed is a good practice for easy access, but it doesn't specifically address fall prevention in the home.
D. Keeping the fluorescent ceiling light on at night can provide better visibility and reduce the risk of tripping, but it doesn't address specific fall prevention measures elsewhere in the home.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","C","D"]
Explanation
A. Position weights against the foot of the bed: Incorrect. Weights in Buck's traction are typically hung freely over the end of the bed to provide the necessary countertraction. Placing them against the foot of the bed would not serve this purpose.
B. Examine the skin under the traction splint: Correct. It's important to regularly assess the skin underneath the traction splint to ensure there are no signs of pressure ulcers or skin breakdown.
C. Monitor peripheral pulses in the affected extremity: Correct. This is essential to ensure that blood flow to the extremity is not compromised by the traction.
D. Assess the temperature of the affected extremity: Correct. Monitoring the temperature helps in identifying any signs of impaired circulation.
E. Adjust the prescribed weights every shift: This is not something that should be done without specific orders from the healthcare provider. Adjusting the weights should be done based on the specific plan of care and provider's instructions.
Correct Answer is B
Explanation
A. Inability to move toes may be a sign of tightness in the cast, but it is not the first finding to be expected if the cast is too tight.
B. Pallor of the toes indicates compromised blood flow and is the earliest sign of circulatory impairment due to tightness of the cast.
C. Change in temperature of the toes may be a sign of impaired circulation, but it is not the earliest finding to be expected.
D. Edema of the toes may occur as a result of compromised circulation, but it is not the first finding to be expected if the cast is too tight.
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