What environmental changes should the nurse make for a client who is experiencing perceptual alterations?

Provide bright lighting and check on the client's mental status hourly.

Keep the lights dim and keep a radio on continuously.

Have the client sit by the nurse's desk while awake and provide rest periods in a room with the television on.

Provide a well-lit room without glare or shadows and limit noise.

Answer and Explanation

The Correct Answer is D

Choice A Reason:
Bright lighting can be overwhelming for clients experiencing perceptual alterations. While regular checks on the client's mental status are important, excessive brightness can exacerbate sensory overload. The goal is to create an environment that is calming and reduces sensory stimuli to manageable levels.

Choice B Reason:
Keeping the lights dim may help to soothe some clients, but continuous noise from a radio can contribute to sensory overload. It's crucial to tailor the environment to the individual needs of the client, which often means providing a quiet space with minimal auditory distractions.

Choice C Reason:
Having the client sit by the nurse's desk may provide necessary supervision, but it can also expose the client to high levels of activity and noise, which can be disorienting. Rest periods with the television on can be distracting and may not offer the tranquil environment needed for a client with perceptual alterations.

Choice D Reason:
Providing a well-lit room without glare or shadows and limiting noise is the most appropriate environmental change for a client with perceptual alterations. This approach helps to reduce the risk of misperceptions and hallucinations, which can be triggered by shadows and glare. A quiet and well-lit environment supports better sensory processing and helps to maintain orientation.

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Correct Answer is A

Explanation

Choice A Reason:
Sodium levels in the blood should normally be between 135 and 145 mEq/L. A level of 152 mEq/L is considered high and can be indicative of hypernatremia, which requires prompt medical attention to address potential dehydration, kidney issues, or other underlying conditions.

Choice B Reason:
Potassium levels should be within the range of 3.5 to 5.2 mEq/L for adults. A result of 3.8 mEq/L falls within the normal range, indicating no immediate concern regarding potassium levels.

Choice C Reason:
Calcium levels in the blood are typically between 8.6 and 10.2 mg/dL for adults. Therefore, a calcium level of 10.0 mg/dL is within the normal range and does not require urgent reporting to a physician.

Choice D Reason:
Creatinine levels in the blood should be between 0.6 to 1.3 mg/dL in adults, depending on factors such as age, gender, and muscle mass. A level of 1.2 mg/dL is at the higher end of the normal range but is not typically considered critical unless there are other signs of kidney dysfunction.

A. Obesity B. The client drinks several glasses of beer every night. C. Use of a thiazide diuretic. D. Depression. E. Hypertension.

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

Explanation

Choice A reason:
Obesity is a significant risk factor for gout. It can lead to increased production and decreased excretion of uric acid, which in turn can cause gout attacks. The normal body mass index (BMI) range is 18.5 to 24.9, and a BMI of 30 or above is considered obese.

Choice B reason:
Regular consumption of beer can increase the risk of gout. Beer is high in purines, which the body breaks down into uric acid, and alcohol can reduce the excretion of uric acid by the kidneys. Moderation in alcohol consumption is advised, with the recommendation being up to one drink per day for women and up to two drinks per day for men.

Choice C reason:
Thiazide diuretics are associated with an increased risk of gout. They can decrease the kidney's ability to remove uric acid from the body, leading to its accumulation. When prescribing thiazide diuretics, healthcare providers often monitor uric acid levels and consider alternative medications if the patient has a history of gout.

Choice D reason:
Depression is not directly identified as a risk factor for developing gout. However, some lifestyle factors associated with depression, such as poor diet and inactivity, could indirectly increase the risk.

Choice E reason:
Hypertension is a known risk factor for gout. High blood pressure can impair kidney function, which is responsible for excreting uric acid, thus leading to hyperuricemia and gout. The normal range for blood pressure is considered to be below 120/80 mmHg.

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What environmental changes should the nurse make for a client who is experiencing perceptual alterations?

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