The nurse observes a client prepare a meal in the kitchen of a rehabilitation facility prior to discharge. What behavior(s) indicate the client understands how to maintain balance safely? Select all that apply.

Bends from the waist to pick trash off the floor.

Leans forward to pull a pan from a high shelf.

Locks knees while preparing food on the counter.

Widens stance while working near the sink.

Brings a heavy can close to body before lifting.

Answer and Explanation

Correct Answer : D,E

A.   Bending from the waist to pick up trash can cause imbalance and strain; it is safer to bend at the knees.

B.   Leaning forward to pull a pan from a high shelf can lead to loss of balance; using a step stool is safer.
C.   Locking the knees can lead to loss of balance and is not a recommended posture.

D. Widening the stance provides a stable base and helps maintain balance while working.
E. Bringing a heavy can close to the body before lifting uses proper body mechanics, reducing the risk of strain and promoting balance.

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Correct Answer is A

Explanation

A.Beginning with less sensitive questions helps establish trust and rapport with the client, making it easier to discuss more difficult topics later. This approach can make the client feel more comfortable and less threatened, thereby improving the quality of the information gathered.

B.Sharing personal values can introduce bias and potentially influence the client's responses, making the interview less objective.

C.Starting with the most difficult questions can make the client feel anxious and defensive, reducing the likelihood of obtaining honest and thorough responses.

D.Asking vague, non-specific questions can lead to ambiguous answers and fail to provide the detailed information needed for a proper assessment.

A. Advise the UAP to stop providing care so the nurse can assess the client's condition. B. Explain to the UAP that changes in a client's condition should be reported immediately. C. Determine why the UAP did not notify the nurse of the change in the client's condition. D. Ask the UAP to position the client so the oral medications can be administered.

Correct Answer is A

Explanation

A. The priority is to immediately intervene in the care being provided by the UAP and assess the client's condition to ensure prompt intervention if necessary.

B. While educating the UAP is important, immediate assessment and intervention for the client take precedence.
C. Investigating the reason for the UAP's actions can wait until after the client's condition has been assessed and stabilized.
D. Administering oral medications can wait until after the client's condition has been assessed and stabilized.

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The nurse observes a client prepare a meal in the kitchen of a rehabilitation facility prior to discharge. What behavior(s) indicate the client understands how to maintain balance safely? Select all that apply.

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