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 {"dropdown-group-1":"D","dropdown-group-2":"D"}

Explanation

Cardiovascular abnormalities are a serious risk in clients with bulimia nervosa due to electrolyte imbalances, especially hypokalemia, which can lead to arrhythmias, weakened heart muscles, and potential heart failure. Hyponatremia (low sodium levels) can occur due to excessive vomiting, which leads to the loss of fluids and electrolytes, including sodium. Incorrect responses: Group 1: Hypoglycemia: Bulimia nervosa primarily causes electrolyte imbalances and acid-base disturbances due to vomiting, not significant alterations in blood sugar levels. Metabolic Acidosis: Vomiting leads to the loss of gastric acid, causing metabolic alkalosis. Hypotension: Hypotension could occur if the client experiences significant dehydration from vomiting. Hypotension would be a consequence of severe dehydration rather than a primary risk at this stage. Hyperglycemia: Hyperglycemia is not typically associated with bulimia nervosa or vomiting. It would be more relevant in conditions like diabetes. Group 2: Hyperkalemia: Hyperkalemia (high potassium) is unlikely in bulimia nervosa, where frequent vomiting usually leads to hypokalemia due to the loss of potassium in gastric secretions. Metabolic Acidosis: As mentioned before, vomiting leads to metabolic alkalosis, not acidosis, because of the loss of hydrochloric acid. Hypochloremia: Hypochloremia (low chloride levels) can occur with vomiting due to the loss of stomach acid, which contains chloride. While it is a possible outcome, metabolic alkalosis better captures the overall acid-base disturbance in the client.

A. Assess peripheral circulation hourly. B. Assess the client's mouth every 8 hr. C. Use humidification with oxygen therapy. Administer IV fluids. D. Raise the knee position on the client's bed. E. Use an automated blood pressure cuff on the client's arm. Prepare for platelet transfusion.

Correct Answer is ["A","B","C"]

Explanation

A. Assess peripheral circulation hourly. This is correct because clients with SCD are at risk of vaso-occlusive crisis, which can impair blood flow to the extremities and cause tissue ischemia and necrosis. The nurse should monitor for signs of poor circulation such as pallor, coolness, numbness, or pain.

B. Assess the client's mouth every 8 hr. This is correct because clients with SCD are prone to oral ulcers, infections, and dental problems due to chronic anemia and reduced oxygen delivery to the oral mucosa. The nurse should inspect the mouth for lesions, bleeding, inflammation, or infection and provide oral hygiene as needed.

C. Use humidification with oxygen therapy. Administer IV fluids. This is correct because clients with SCD need adequate hydration and oxygenation to prevent sickling of red blood cells and further complications. Humidification helps moisten the airways and prevent dehydration of the mucous membranes. IV fluids help maintain fluid and electrolyte balance and reduce blood viscosity.

D. Raise the knee position on the client's bed. This is incorrect because this can impede venous return and worsen peripheral circulation. The nurse should keep the client's extremities in a neutral position and avoid tight or restrictive clothing or devices.

E. Use an automated blood pressure cuff on the client's arm. Prepare for platelet transfusion. This is incorrect because this can cause mechanical trauma to the arm and trigger a vaso-occlusive crisis. The nurse should use a manual blood pressure cuff and avoid applying pressure to the arm. Platelet transfusion is not indicated for clients with SCD unless they have thrombocytopenia or bleeding.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has bulimia nervosa. Exhibits The client is at risk for developing dropdown and dropdown

Correct Answer is {"dropdown-group-1":"D","dropdown-group-2":"D"}

Explanation

Correct Answer is ["A","B","C"]

Explanation

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