A nurse is teaching a group of newly licensed nurses about the Braden scale. Which of the following responses by a newly licensed nurse indicates an understanding of the teaching?
Each element has a range from one to five points.
The higher the score, the higher the pressure injury risk.
The scale measures six elements.
The client's age is part of the measurement.
The Correct Answer is C
The Braden scale measures six elements: sensory perception, moisture, activity, mobility, nutrition, and friction/shear. Each element has a range of one to four points, with a total possible score of 23 points. The lower the score, the higher the risk for pressure injury.
Option a is incorrect because each element has a range from one to four points.
Option b is incorrect because the lower the score, the higher the pressure injury risk.
Option d is incorrect because the client's age is not part of the measurement.
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Related Questions
Correct Answer is B
Explanation
The client's belief that their needs will be met through education is the most likely factor to increase their motivation to learn how to self-administer daily low-dose heparin injections. When a client believes that they will benefit from the education and that it will help them meet their needs, they are more likely to be motivated to learn.
a. The nurse's empathy about the client having to self-inject may help build rapport with the client, but it is not the most important factor in increasing the client's motivation to learn.
c) The client seeking family approval by agreeing to a teaching plan may be a motivating factor for some clients, but it is not the most important factor in increasing the client's motivation to learn.
d) The nurse explaining the need for education to the client may help increase the client's understanding of the importance of learning how to self-administer heparin injections, but it is not the most important factor in increasing the client's motivation to learn.
Correct Answer is A
Explanation
If a nurse is caring for an older adult client who tells the nurse that they have smoked one pack of cigarettes every day for the last 60 years, the next action the nurse should take is to ask what the client knows about the effects of smoking. This will help the nurse assess the client's knowledge and understanding of the risks associated with smoking and provide an opportunity for education.
Option b is incorrect because working with the client to establish a quit date is important but not the next intervention.
Option c is incorrect because suggesting that the client use nicotine gum to facilitate quitting is important but not the next intervention.
Option d is incorrect because referring the client to a local smoking cessation program is important but not the next intervention.
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