Choice A reason: Occupational therapists focus on functional tasks and adaptive equipment, not pain management or sciatica-specific interventions like TENS unit application or therapeutic exercises. Their role is less relevant for addressing sciatic nerve pain, making this an incorrect referral choice.

Choice B reason: Physical therapists are trained to manage sciatica through exercises, posture correction, and TENS unit application, targeting pain relief and mobility. They develop tailored plans to reduce nerve compression, making this the appropriate referral for comprehensive sciatica care.

Choice C reason: Acupuncturists provide alternative pain relief, but their role is not standard for TENS unit management or sciatica treatment in conventional care. Physical therapy is more aligned with evidence-based practice for this condition, making this referral less appropriate.

Choice D reason: Chiropractors focus on spinal adjustments, which may not be suitable for all sciatica cases, especially with TENS unit prescriptions. Physical therapists offer targeted, evidence-based interventions, making them the preferred referral for managing sciatica and TENS therapy.

Choice A reason: Beginning charting with an evaluation skips the initial step of collecting and documenting raw data, such as health history and vital signs, which is critical for accurate admission records. This approach risks incomplete documentation, potentially leading to misinformed care plans and overlooking advance directives like a living will, essential for patient-centered care.

Choice B reason: Documenting vital signs from assistive personnel is routine but not the priority during admission. Noting a living will is more critical to ensure legal and ethical care preferences are addressed. Relying solely on delegated data risks missing comprehensive admission details, potentially compromising care coordination and patient autonomy in acute settings.

Choice C reason: Charting a summary at shift change is not specific to admission documentation, which requires detailed initial data, including advance directives like a living will. Summarizing later risks delaying critical information, such as legal preferences, potentially leading to care decisions that conflict with the patient’s wishes in acute care scenarios.

Choice D reason: Noting whether the client has a living will is a priority during admission to ensure advance directives are documented, guiding ethical and legal care decisions. This ensures patient autonomy, especially in acute settings where critical decisions arise. Addressing this upfront prevents oversight, aligning care with the client’s wishes and regulatory standards.

Choice A reason: This statement factually reports the omission of a prescribed dressing change without speculation or irrelevant details, adhering to incident report standards. It ensures clarity for follow-up actions, like wound assessment, to prevent infection or delayed healing, making it the appropriate documentation.

Choice B reason: Delaying provider notification until tomorrow is inappropriate, as omissions require prompt reporting to assess risks like infection. This statement includes unnecessary future actions, deviating from objective incident reporting, making it incorrect for proper documentation standards.

Choice C reason: Stating the report’s completion and placement in the medical record is procedural, not descriptive of the incident. Incident reports focus on the event (omission), not administrative actions, and are kept separate from medical records, making this statement incorrect.

Choice D reason: Justifying the omission with an unsoiled dressing is speculative and irrelevant. Incident reports require objective facts about the error, not assumptions about its impact, as wound status needs professional assessment, making this an inappropriate statement.

Choice A reason: Sterile gloves are unnecessary for ostomy pouch changes, as the procedure requires clean gloves to prevent infection. Sterile technique is reserved for invasive procedures, so this instruction is overly stringent and incorrect for routine ostomy care.

Choice B reason: Emptying the ostomy pouch when half full prevents leakage, skin irritation, and pouch detachment. This practical instruction ensures proper ostomy management, maintaining skin integrity and patient comfort, making it the correct teaching point for discharge.

Choice C reason: Moisturizing soap can leave residue, irritating the peristomal skin and affecting pouch adhesion. Plain soap or water is recommended to keep the area clean and dry, so this instruction is incorrect for safe stoma care practices.

Choice D reason: A pink, moist stoma is normal and healthy, not a cause for concern. Notifying the provider for this is unnecessary and may cause alarm, so this instruction reflects a misunderstanding of normal stoma appearance.

Choice A reason: Applying the scopolamine patch 4-6 hours before traveling ensures therapeutic levels to prevent motion sickness by blocking acetylcholine in the vestibular system. This proactive timing is critical for efficacy, reducing nausea and vertigo. Proper instruction enhances client compliance, ensuring comfort during travel and preventing symptoms that impair quality of life.

Choice B reason: Replacing a dislodged patch in the same location risks reduced adhesion and drug absorption, as skin oils or residue may interfere. A new site, like behind the ear, is recommended. Incorrect instruction could lead to ineffective treatment, increasing motion sickness symptoms and client discomfort during travel.

Choice C reason: Scopolamine patches are stored at room temperature, not refrigerated, to maintain stability. Refrigeration may alter efficacy or adhesion. Misinstructing on storage risks patch degradation, reducing effectiveness against motion sickness, potentially causing nausea or dizziness, and compromising client safety and comfort during travel activities.

Choice D reason: Scopolamine patches are applied behind the ear, not the upper arm, for optimal drug delivery near the vestibular system. Incorrect placement reduces efficacy, risking motion sickness symptoms. Misguiding the client could lead to treatment failure, increasing discomfort and impairing travel enjoyment, necessitating proper site instruction for effective management.

Choice A reason: The retainer clip should be at chest level, not the upper abdomen, to secure the harness and prevent injury. An abdominal position risks strap slippage, reducing safety, so this statement reflects incorrect car seat safety understanding.

Choice B reason: Car seats should remain rear-facing until at least age 2, not 1, per AAP guidelines, to protect the neck and spine. Turning forward-facing too early increases injury risk, making this statement incorrect for safe car seat use.

Choice C reason: Shoulder harness straps should be at or below the shoulders in rear-facing seats, not 3 inches above, to ensure proper restraint. This positioning risks poor fit, so the statement indicates a misunderstanding of car seat safety.

Choice D reason: Positioning the newborn at a 45-degree angle in a rear-facing car seat ensures airway patency and spinal alignment, per safety guidelines. This statement correctly reflects proper car seat installation, indicating accurate understanding of newborn car seat safety.

Choice A reason: The retainer clip should be at chest level, not the upper abdomen, to secure the harness and prevent injury. An abdominal position risks strap slippage, reducing safety, so this statement reflects incorrect car seat safety understanding.

Choice B reason: Car seats should remain rear-facing until at least age 2, not 1, per AAP guidelines, to protect the neck and spine. Turning forward-facing too early increases injury risk, making this statement incorrect for safe car seat use.

Choice C reason: Shoulder harness straps should be at or below the shoulders in rear-facing seats, not 3 inches above, to ensure proper restraint. This positioning risks poor fit, so the statement indicates a misunderstanding of car seat safety.

Choice D reason: Positioning the newborn at a 45-degree angle in a rear-facing car seat ensures airway patency and spinal alignment, per safety guidelines. This statement correctly reflects proper car seat installation, indicating accurate understanding of newborn car seat safety.

Choice A reason: Dizziness is unrelated to paralytic ileus, which involves impaired bowel motility post-surgery, causing distention. Dizziness may indicate hypovolemia or anesthesia effects. Assuming dizziness indicates ileus risks misdiagnosis, delaying interventions like nasogastric suction for ileus, potentially worsening bowel obstruction and client discomfort in postoperative care.

Choice B reason: Watery stool suggests diarrhea, not paralytic ileus, which causes absent bowel sounds and constipation due to motility loss. Misidentifying watery stool as ileus risks overlooking infectious causes, delaying appropriate treatments like antidiarrheals, while neglecting ileus interventions, critical for restoring bowel function post-orthopedic surgery.

Choice C reason: Abdominal distention is a hallmark of paralytic ileus, resulting from postoperative bowel motility cessation, leading to gas and fluid accumulation. Recognizing this guides interventions like bowel rest or decompression, critical for preventing complications like perforation, ensuring timely recovery, and reducing discomfort in clients post-orthopedic surgery.

Choice D reason: Oliguria (low urine output) indicates renal issues, not paralytic ileus, which presents with distention and absent bowel sounds. Assuming oliguria is ileus-related risks missing dehydration or kidney injury, delaying fluid management, while neglecting ileus treatments, critical for addressing postoperative bowel dysfunction and client recovery.

Choice A reason: Squeezing a tick’s body during removal can release infectious material, increasing Lyme disease risk. Proper removal uses fine-tipped tweezers to grasp the head, pulling steadily, so this statement is incorrect and harmful for Lyme prevention education.

Choice B reason: Testing for Lyme disease within 2 weeks of a tick bite is premature, as antibodies take 2-6 weeks to develop for reliable serologic testing. Early testing yields false negatives, so this statement is inaccurate for Lyme disease diagnostic guidance.

Choice C reason: Lyme disease symptoms, like rash or fever, typically appear 3-30 days after a tick bite, not 2 days. This statement underestimates the incubation period, misleading the public about when to monitor for symptoms, making it incorrect.

Choice D reason: Using DEET repels ticks, reducing bite risk in wooded areas where Lyme disease-carrying ticks are prevalent. This preventive measure is CDC-recommended, effective, and practical, making it the correct statement for a Lyme disease education program.

Choice A reason: Preeclampsia is not a contraindication for misoprostol; it may be used cautiously for labor induction in such cases under close monitoring. Transverse lie is a contraindication. Assuming preeclampsia contraindicates misoprostol risks unnecessary avoidance, potentially delaying necessary induction, critical for maternal and fetal safety in labor management.

Choice B reason: Transverse fetal lie is a contraindication for misoprostol, as it increases risks of uterine rupture or cord prolapse during labor induction due to improper fetal positioning. Cesarean delivery is preferred. Recognizing this prevents complications, ensuring maternal and fetal safety, critical in labor induction planning for malpresented fetuses.

Choice C reason: Intrauterine growth restriction is not an absolute contraindication for misoprostol; it may be used with caution if induction is indicated. Transverse lie is a clearer contraindication. Assuming restriction contraindicates risks delaying induction, potentially compromising fetal well-being, critical for timely labor management in growth-restricted pregnancies.

Choice D reason: Postterm pregnancy is an indication, not a contraindication, for misoprostol to induce labor and prevent fetal risks. Transverse lie is the contraindication. Assuming postterm contraindicates misoprostol risks delaying necessary induction, increasing risks like stillbirth, critical for ensuring safe delivery in prolonged pregnancies.