After a change-of-shift report, the nurse needs to prioritize care for four clients. Who should the nurse attend to first?

A client who needs a sputum specimen collected before breakfast.

A client with Alzheimer’s disease who needs help going to the bathroom.

A client who had a head injury 2 days ago and now has a decreased level of consciousness.

A client with diverticulitis and a temperature of 38.3 C (100.9 F).

Answer and Explanation

The Correct Answer is C

A decreased level of consciousness in a client who had a head injury 2 days ago is a critical sign that requires immediate attention. This could indicate a serious complication such as brain swelling or bleeding. The other clients’ needs, while important, are not as immediately life- threatening and can be addressed after the client with the head injury is stabilized.

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Correct Answer is C

Explanation

Choice A rationale

A physical therapist focuses on improving a client’s movement, mobility, and function, and relieving pain. They may not specialize in helping clients with difficulties using utensils during meals.

Choice B rationale

A recreational therapist uses a variety of modalities, including arts and crafts, animals, sports, games, dance and movement, drama, music, and community outings to help maintain or improve a patient’s physical, social, and emotional well-being. However, they may not be the best fit for a client having difficulty using utensils during meals.

Choice C rationale

An occupational therapist specializes in helping people regain, develop, and build skills that are important for independent functioning, health, and well-being. They can provide strategies and make recommendations for adaptive equipment, such as specially designed utensils, to

help the client with Parkinson’s disease eat more independently. Therefore, referring the client to an occupational therapist would be the most beneficial.

Choice D rationale

A speech therapist specializes in the evaluation and treatment of communication disorders and swallowing disorders. While they could assist if the client had difficulties with swallowing, they may not be the best fit for a client having difficulty using utensils during meals.

A. Drink milk with the medication. B. Take the medication right before eating breakfast. C. Sit upright for 30 to 60 min after taking the medication. D. Chew the tablets thoroughly.

Correct Answer is C

Explanation

Choice A rationale

Drinking milk with the medication is not recommended because calcium can bind to alendronate, reducing its absorption.

Choice B rationale

Alendronate should be taken on an empty stomach, at least 30 minutes before the first food, beverage, or other medication of the day.

Choice C rationale

Patients should sit upright for at least 30 minutes after taking alendronate to prevent esophageal irritation.

Choice D rationale

Alendronate tablets should be swallowed whole, not chewed, to prevent oropharyngeal ulceration.

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After a change-of-shift report, the nurse needs to prioritize care for four clients. Who should the nurse attend to first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client with Parkinson’s disease who has difficulty using utensils during meals. Which interdisciplinary team member should the nurse recommend for a referral?

Correct Answer is C

Explanation

A nurse is providing education to a patient who has a new prescription for alendronate for the treatment of osteoporosis.Which of the following instructions should the nurse include?

Correct Answer is C

Explanation

A nurse is caring for a client who is receiving treatment for cancer and is experiencing stomatitis. Which of the following actions should the nurse take to help manage the condition?

A nurse is providing dietary education about general nutritional guidelines to a group of older adult patients. Which of the following statements, if made by a patient, would indicate an understanding of the teaching?

A client in bed is experiencing severe shortness of breath. What position should the nurse place the client in?

A nurse is preparing to measure a post-meal blood glucose level in a patient with diabetes mellitus. What steps should the nurse take?

A nurse is providing education to a patient who has been diagnosed with peripheral arterial disease. Which of the following instructions should the nurse include in the teaching?

A nurse is gathering information from a patient who is on metoprolol. What should the nurse anticipate as a possible outcome?

A nurse is providing discharge instructions to a patient about self-administration of regular insulin. Which of the following instructions should be included by the nurse?