An older female client who resides in a long-term care facility has a male friend who often visits her in the evenings.

The practical nurse (PN) enters the client's room to administer medications and finds the couple in bed together. What action should the PN take?

Request that the man get up and leave

Report the incident to the family

Exit the room and quietly close the door

Ask when the nurse should return

Answer and Explanation

The Correct Answer is D

The correct answer and explanation is:

d) Ask when the nurse should return. Correct

This is the action that the PN should take when entering the client's room and finding the couple in bed together. Asking when the nurse should return respects the client's privacy, dignity, and autonomy, while also ensuring that the client receives the necessary care.

The PN should acknowledge that the client has the right to express her sexuality and intimacy, as long as it is consensual and safe . The PN should also avoid making any judgments or assumptions about the client's relationship or preferences.

a) Request that the man get up and leave.

This is not the action that the PN should take when entering the client's room and finding the couple in bed together. Requesting that the man get up and leave is rude, disrespectful, and intrusive, as it violates the client's privacy, dignity, and autonomy. The PN should not interfere with the client's sexual or intimate activities, unless there is a clear indication of abuse, coercion, or harm.

b) Report the incident to the family.

This is not the action that the PN should take when entering the client's room and finding the couple in bed together. Reporting the incident to the family is inappropriate and unethical, as it breaches the client's confidentiality and autonomy. The PN should not share any information about the client's sexual or intimate activities with anyone without her consent, unless there is a clear indication of abuse, coercion, or harm.

c) Exit the room and quietly close the door.

This is not the action that the PN should take when entering the client's room and finding the couple in bed together. Exiting the room and quietly closing the door is passive and neglectful, as it ignores the client's needs and care.

The PN should not avoid or delay providing care to the client because of her sexual or intimate activities, unless she requests so . The PN should also communicate with the client and her partner in a respectful and professional manner.

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Correct Answer is A

Explanation

Choice A reason: "It is a tool that is used to determine your maximum level of self-sufficiency.” This nursing response is appropriate because it accurately describes the purpose of the FIM, which is a standardized instrument that measures the client's level of independence in performing 18 activities of daily living and mobility tasks.

Choice B reason: "It is a test that determines which activities you feel most comfortable performinG.” This nursing response is not appropriate because it does not describe the purpose of the FIM, which is not a test that measures the client's comfort level, but rather their functional ability.

Choice C reason: "It is a tool used by insurance companies to determine qualifications for medical reimbursement." This nursing response is not appropriate because it does not describe the purpose of the FIM, which is not a tool that determines the client's eligibility for insurance coverage, but rather their functional status and progress.

Choice D reason: "It is a tool that is used to assess what services you will need a home health aide to perform for you." This nursing response is not appropriate because it does not describe the purpose of the FIM, which is not a tool that evaluates the client's need for home care services, but rather their functional capacity and improvement.

A. Mitral valve disease B. Asthma C. Nasal polyps D. Seasonal allergies

Correct Answer is B

Explanation

Choice A reason: Mitral valve disease is not a disorder that makes clients especially vulnerable to ozone effects because it is a condition that affects the heart valve that regulates blood flow between the left atrium and left ventricle, not the lungs or airways.

Choice B reason: Asthma is a disorder that makes clients especially vulnerable to ozone effects because it is a condition that causes inflammation, narrowing, and mucus production in the airways, which can worsen when exposed to ozone, a gas that irritates and damages lung tissuE.

Choice C reason: Nasal polyps are not a disorder that makes clients especially vulnerable to ozone effects because they are benign growths that occur in the lining of the nose or sinuses, not the lungs or airways.

Choice D reason: Seasonal allergies are not a disorder that makes clients especially vulnerable to ozone effects because they are immune system reactions to certain substances such as pollen or mold, not ozone, which is a chemical pollutant.

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An older female client who resides in a long-term care facility has a male friend who often visits her in the evenings. The practical nurse (PN) enters the client's room to administer medications and finds the couple in bed together. What action should the PN take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

A community health nurse is conducting an educational program on various environmental pollutants. The nurse should emphasize that clientswho have which of the following disorders are especially vulnerable to ozone effects?

Correct Answer is B

Explanation

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An older female client who resides in a long-term care facility has a male friend who often visits her in the evenings.

The practical nurse (PN) enters the client's room to administer medications and finds the couple in bed together. What action should the PN take?