The nurse will be assisting the client to walk. What should the nurse do first?
Assist the client to a sitting position at the side of the bed
Determine the client's strength, coordination, and activity tolerance
Help the client into a standing position
Ask another nurse for assistance
The Correct Answer is B
B. Such an assessment helps in determining the level of assistance the client will need and ensures the safety of both the client and the nurse.
A. Helping the client to sit at the edge of the bed allows them to acclimate to being upright, assess their readiness to stand, and ensures their safety before attempting to walk. However, it is not the priority.
C. After assisting the client to a sitting position at the edge of the bed and assessing their readiness, the nurse can proceed to help the client into a standing position. However, it is not the priority.
D. This option may be necessary if the client requires two-person assistance due to their condition, mobility status, or safety concerns. However, asking for assistance typically comes after assessing the client's readiness and ensuring they are positioned correctly for ambulation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C","D"]
Explanation
A. Older adult skin is typically more fragile and prone to injury and tears due to decreased elasticity and thinning. Handling the skin gently helps prevent trauma, skin tears, and bruising, promoting skin integrity and comfort.
C. Older adults are more susceptible to temperature changes and may have difficulty regulating body temperature. Appropriate clothing that helps maintain warmth without causing overheating is essential. This includes wearing layers that can be easily adjusted and using fabrics that are breathable and comfortable.
D. Older adult skin tends to be drier due to decreased oil production and reduced hydration levels. Applying moisturizers after bathing helps replenish lost moisture, maintain skin hydration, and prevent dryness and cracking. It is important to choose moisturizers that are suitable for older adult skin and free from irritants.
B. Daily bathing may not be necessary or suitable for all older adults. Excessive bathing can strip the skin of natural oils, leading to dryness and irritation. Instead, the nurse should promote bathing frequency based on individual skin needs, such as using mild, moisturizing cleansers and lukewarm water.
E. Adequate hydration is crucial for maintaining skin health and overall well-being in older adults. While fluid needs vary among individuals, restricting fluid intake to such a low level (1000 mL) is generally not
appropriate unless medically indicated. Older adults should be encouraged to maintain adequate hydration to support skin elasticity, circulation, and overall health.
Correct Answer is C
Explanation
C. Yogurt contains probiotics, which are beneficial bacteria that can help restore and maintain a healthy balance of gut flora. Consuming yogurt with live cultures regularly is a recognized strategy to replenish beneficial bacteria in the gut, especially after a period of diarrhea or antibiotic use that may disrupt the normal gut microbiota.
A. This statement is related to the management of infection and antibiotic therapy, not specifically to reestablishing bowel flora. While stopping antibiotics appropriately is important for overall health and possibly reducing antibiotic-associated diarrhea, it does not directly address the replenishment of bowel flora.
B. Rice is often recommended during episodes of diarrhea to provide bland, easily digestible food. However, it does not actively contribute to reestablishing healthy bowel flora. It helps in managing symptoms but does not address the restoration of beneficial gut bacteria.
D. Hydration is essential during episodes of diarrhea to prevent dehydration. While adequate hydration supports overall health and can aid in recovery, it does not specifically address the restoration of bowel flora.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.
