An RN is observing a licensed practical nurse (LPN) and an assistive personnel (AP) move a client up in bed. For which of the following situations should the nurse intervene?

The LPN and AP lower the side rails before lifting the client up in bed.

Prior to lifting the client, the LPN and AP raise the bed to waist level.

The LPN and the AP grasp the client under his arms to lift him up in bed.

The LPN and the AP ask the client to flex his knees and push his heels into the bed as they lift.

Answer and Explanation

The Correct Answer is C

A. The LPN and AP lower the side rails before lifting the client up in bed is incorrect. This is a safe practice that prevents injury to the client and staff by providing more space for movement and reducing the risk of falling.

B. Prior to lifting the client, the LPN and AP raise the bed to waist level is incorrect. This is a safe practice that prevents injury to the client and staff by reducing the need for bending and lifting.

C. The LPN and the AP grasp the client under his arms to lift him up in bed is correct. This is an unsafe practice that can cause injury to the client's shoulders, neck, and axillae by applying excessive pressure and friction. The LPN and AP should use a draw sheet or a mechanical lift device to move the client up in bed.

D. The LPN and the AP ask the client to flex his knees and push his heels into the bed as they lift is incorrect. This is a safe practice that encourages active participation from the client and reduces the workload for the staff by using leverage.

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Correct Answer is D

Explanation

A.PRN (as needed) restraint prescriptions are not appropriate because restraints should only be used in situations where there is an immediate need for safety and all other methods of de-escalation have failed. Restraint use must be based on a current assessment of the client's behavior, and a specific prescription should be obtained each time restraints are applied.

B.Restraints should be removed every 2 hours to assess the client's skin, circulation, and range of motion, and to provide an opportunity for toileting, hydration, and movement. Prolonged use without breaks increases the risk of complications such as skin breakdown or impaired circulation.

C.Attach the restraint to the bed's side rails. Restraints should not be attached to the bed's side rails because it can lead to serious injuries if the client attempts to climb over the side rails while restrained. Instead, restraints should be attached to specific restraint ties or straps that are part of the bed frame.

D.The client's condition, including circulation, skin integrity, and behavior, should be monitored and documented every 15 minutes while restraints are in use. This frequent assessment helps ensure the client’s safety and comfort, and allows for early identification of potential complications.

A. "I can use natural-skin condoms to prevent sexually transmitted infections." B. "I can use petroleum jelly as a lubricant with the condom." C. "I can re-use the condom one time after initial use." D. "I can store the condoms in the drawer of my nightstand."

Correct Answer is D

Explanation

Choice A reason

"I can use natural-skin condoms to prevent sexually transmitted infections." This statement is incorrect. Natural-skin or lambskin condoms are not recommended for preventing sexually transmitted infections (STIs). They may provide some protection against pregnancy but do not effectively protect against STIs. Clients should use latex or polyurethane condoms to reduce the risk of STIs.

Choice B reason

"I can use petroleum jelly as a lubricant with the condom." This statement is also incorrect. Petroleum jelly (Vaseline) and other oil-based lubricants can damage latex condoms, leading to a higher risk of breakage or failure. Clients should use water-based or silicone-based lubricants with latex or polyurethane condoms.

Choice C reason:

"I can re-use the condom one time after initial use." This statement is incorrect. Condoms are designed for single-use only. Reusing a condom increases the risk of breakage, failure, and the transmission of STIs or unwanted pregnancy. Clients should always use a new condom for each sexual act.

Choice D reason:

"I can store the condoms in the drawer of my nightstand." This statement is correct because it indicates that the client understands the proper storage of condoms. Storing condoms in a cool, dry place, such as a drawer or a condom case, helps protect them from damage or deterioration, ensuring they remain effective when needed.

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An RN is observing a licensed practical nurse (LPN) and an assistive personnel (AP) move a client up in bed. For which of the following situations should the nurse intervene?

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