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The unlicensed assistive personnel (UAP) tells the practical nurse (PN) that a resident of the long-term care facility is reporting eye pain and photophobia. The resident is being treated for bacterial conjunctivitis. Upon entering the resident's room, the PN observes that the UAP has darkened the room and placed a warm compress over the resident's eyes. Which action should the PN take?

Turn lights on in the room.

Remove the warm compress.

Elevate the head of the bed.

Offer an oral analgesic.

None

Answer and Explanation

The Correct Answer is B

The correct answer is choice B. Remove the warm compress.

Choice A rationale:

Turning the lights on in the room would likely exacerbate the resident’s photophobia (sensitivity to light), causing more discomfort. Photophobia is a common symptom of bacterial conjunctivitis, and keeping the room dim can help alleviate this discomfort.

Choice B rationale:

Removing the warm compress is the correct action. Warm compresses can sometimes be used to relieve symptoms of conjunctivitis, but they are generally more appropriate for viral or allergic conjunctivitis. In the case of bacterial conjunctivitis, warm compresses can potentially worsen the infection by providing a warm, moist environment that promotes bacterial growth. Instead, a cool compress is often recommended to reduce inflammation and discomfort.

Choice C rationale:

Elevating the head of the bed can help reduce swelling and promote drainage, but it is not directly related to the immediate relief of eye pain and photophobia in bacterial conjunctivitis. This action might be more relevant for conditions involving fluid retention or respiratory issues.

Choice D rationale:

Offering an oral analgesic could help manage the resident’s pain, but it does not address the underlying issue of the warm compress potentially worsening the bacterial infection. Pain management is important, but it should be combined with appropriate measures to treat the infection and alleviate symptoms.

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Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

Choice A rationale:

Reporting the incident to the family is not the first action the PN should take in this situation. It may be appropriate to inform the family later if necessary, but immediate action is needed to address the boundaries being crossed in the client's room.

Choice B rationale:

Requesting that the man get up and leave is not the first action the PN should take. This situation involves delicate and sensitive issues, and the PN should prioritize the client's privacy, dignity, and emotional well-being.

Choice C rationale:

The most appropriate first action is for the PN to exit the room and quietly close the door. This action respects the client's privacy and allows the couple to have some space and time to compose themselves.

Choice D rationale:

Asking when the nurse should return is not the first action to take. The PN needs to ensure the client's privacy and deal with the situation at hand discreetly. Later, the PN can discuss the incident with the client if necessary, or involve the appropriate authorities as per the facility's policy.

A. States the importance of maintaining current immunization schedule. B. Wears a mask each time when leaving the room. C. Demonstrates disposal of personal tissues in no-touch receptacle. D. Explains importance of wearing protective clothing when outdoors.

Correct Answer is D

Explanation

The correct answer is choiced. Explains importance of wearing protective clothing when outdoors.

Choice A rationale:

Maintaining a current immunization schedule is important for overall health, but it is not directly related to Lyme disease prevention or management, as there is no vaccine for Lyme disease in humans.

Choice B rationale:

Wearing a mask when leaving the room is a precaution for airborne diseases, not for Lyme disease, which is transmitted through tick bites.

Choice C rationale:

Disposal of personal tissues in a no-touch receptacle is a general infection control measure but does not specifically address Lyme disease prevention or management.

Choice D rationale:

Wearing protective clothing when outdoors is crucial for preventing tick bites, which are the primary mode of transmission for Lyme disease. This measure directly addresses the prevention of Lyme disease.

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Naxlex Comprehensive Predictor Exams

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?

Correct Answer is C

Explanation

The practical nurse (PN) is contributing to a care plan for an adult client with Lyme disease. Which client outcome is indicated for this client?

Correct Answer is D

Explanation

The practical nurse (PN) is caring for a client who has darkened membranes of the mouth and a smoky breath. Which priority nursing problem should the PN include in the plan of care?

Which statement by an older female client who lost her spouse two years ago should indicate to the practical nurse (PN) that the client may need bereavement counseling?

The practical nurse (PN) is assessing an older client with left-sided heart failure (HF). What intervention is most important for the PN to implement?

A client who is receiving a statin medication reports the onset of muscle soreness and fatigue, and the practical nurse (PN) notes that the client's skin is warm to the touch. Which action by the PN takes priority?

A client reports feeling numbness and tingling in the extremities. Which of the client's serum laboratory values should the practical nurse (PN) review before reporting the finding?

A 70-year-old male client who is convalescing from a hip replacement is identified as being at risk for developing a pressure ulcer. Which physical characteristic of aging contributes most to this risk factor?