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An elderly client is hospitalized for the first time.

Which of the following actions ensures the safety of the client? (Select all that apply).

Keep call bell within the client’s reach.

Keep a dim light on at night.

Keep unnecessary furniture out of the way.

Keep all side rails up at all times.

Keep all lights off at night.

Answer and Explanation

Correct Answer : A,B,C

These actions ensure the safety of the client by reducing the risk of falls, confusion and injury.

Keeping a call bell within the client’s reach allows them to ask for help when needed.

Keeping a dim light on at night helps them orient themselves and see their surroundings.

Keeping unnecessary furniture out of the way prevents tripping and cluttering. Choice D is wrong because keeping all side rails up at all times can be considered a form of physical restraint, which is associated with many professional, legal and ethical challenges. Physical restraint should only be used as a last resort when other alternatives have failed or are not feasible. Keeping all side rails up can also increase the risk of injury if the client tries to climb over them.

Choice E is wrong because keeping all lights off at night can increase the risk of falls and confusion for the client.

Older adults may have impaired vision and cognition, and they may need to use the bathroom frequently at night. Keeping all lights off can make it difficult for them to find their way and increase their anxiety.

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Correct Answer is A

Explanation

This is because hypokalemia (low potassium level in the blood) can cause abnormal heart rhythms (arrhythmia) that can be life-threatening and require urgent medical attention. A cardiac monitor can help detect and treat any arrhythmia that may occur.

Choice B is wrong because administering a laxative can worsen hypokalemia by causing more potassium loss through the digestive tract. Laxative use is one of the possible causes of hypokalemia.

Choice C is wrong because placing the client on seizure precautions is not a priority intervention for hypokalemia. Seizures are not a common symptom of hypokalemia, although muscle weakness and cramps may occur.

Choice D is wrong because restricting high potassium foods is not a priority intervention for hypokalemia. In fact, increasing potassium intake through foods or supplements may be helpful in less serious cases of hypokalemia. However, this should be done according to the doctor’s recommendation and with careful monitoring of blood potassium levels.

Normal blood potassium levels for an adult range from 3.6 to 5.2 millimoles per liter (mmol/L). A very low potassium level (less than 2.5 mmol/L) can be life threatening.

A. Patient will check his blood sugar every day until his follow-up appointment. B. Patient will discuss their feelings about required dietary changes (anti inflammatory diet) by discharge. C. Patient will state 3 ways to avoid his known triggers (cat dander and pollen) by the end of the shift. D. Patient will demonstrate proper use of inhaler by end of the shift.

Correct Answer is C

Explanation

This is because the cognitive domain of learning involves knowledge and understanding of information. By stating 3 ways to avoid his triggers, the patient demonstrates that he has learned and comprehended the information about prevention of inflammation.

Choice A is wrong because it belongs to the psychomotor domain of learning, which reflects learning behavior achieved through neuromuscular motor activities. Checking blood sugar is a physical skill, not a cognitive one.

Choice B is wrong because it belongs to the affective domain of learning, which characterizes the emotional arena reflected by learners’ beliefs, values and interests.

Discussing feelings about dietary changes is an affective outcome, not a cognitive one.

Choice D is wrong because it also belongs to the psychomotor domain of learning, as it involves demonstrating proper use of inhaler, which is another physical skill.

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An elderly client is hospitalized for the first time. Which of the following actions ensures the safety of the client? (Select all that apply).

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client’s bloodwork indicates that he has severe hypokalemia. What is a priority nursing intervention?

Correct Answer is A

Explanation

A nurse is utilizing the cognitive domain of learning to teach a patient about the prevention of inflammation. Which of the following is an appropriate goal for this patient?

Correct Answer is C

Explanation

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An elderly client is hospitalized for the first time.

Which of the following actions ensures the safety of the client? (Select all that apply).