A client develops pressure injuries because turning and positioning were not done as ordered. The nurse is aware that this is an example of which type of liability?

Battery

Negligence

Assault

Felony

Answer and Explanation

The Correct Answer is B

B. Negligence refers to the failure to exercise reasonable care that results in harm to another person. It occurs when a healthcare provider fails to perform their duties according to the standard of care expected in their profession, leading to injury or harm to the patient. In the scenario described, the failure to follow orders for turning and positioning, resulting in pressure injuries, is an example of negligence. Negligence can result from actions (acts of commission) or omissions (acts of omission).
A. Battery refers to the intentional harmful or offensive touching of another person without their consent. In healthcare, battery may occur if a medical procedure is performed on a patient without their informed consent or if a procedure goes beyond the scope of what was consented to. In the context of the scenario provided, the development of pressure injuries due to inadequate turning and positioning is not an example of battery because it does not involve intentional harm.

C. Assault refers to the intentional threat of harm or the creation of fear of imminent harm in another person. In healthcare, assault may occur if a healthcare provider threatens a patient with harm or performs a procedure without their consent, creating fear or apprehension in the patient. In the context of the scenario provided, the development of pressure injuries due to inadequate turning and positioning is not an example of assault because it does not involve intentional threats or actions creating fear in the patient.
D. A felony is a serious criminal offense punishable by imprisonment or death. It typically involves actions that are considered extremely harmful or dangerous to society. The scenario described does not involve actions that rise to the level of a felony offense.

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Correct Answer is A

Explanation

A. Vomiting results in loss of hydrochloric acid (HCl) from the stomach, leading to a loss of chloride ions (Cl-) and hydrogen ions (H+) from the body. This loss of hydrogen ions can result in an accumulation of bicarbonate ions (HCO3-) relative to hydrogen ions, leading to metabolic alkalosis. Therefore, this client is at risk for developing metabolic alkalosis due to prolonged vomiting.
B. Client who has had diarrhea for the past 24 hours: Diarrhea leads to loss of bicarbonate ions (HCO3-) from the body along with fluid and electrolytes. However, metabolic alkalosis is less likely to occur with diarrhea alone because the loss of bicarbonate ions is usually balanced by the loss of chloride ions (Cl-) and hydrogen ions (H+). Therefore, while diarrhea can lead to metabolic acidosis in some cases, it is less likely to cause metabolic alkalosis.
C. Client who has overdosed on heroin: Heroin overdose is not directly associated with metabolic alkalosis. In the context of heroin overdose, respiratory depression leading to respiratory acidosis is a more immediate concern. Therefore, this client is not at risk for developing metabolic alkalosis due to heroin overdose.
D. Client who is admitted with an asthma exacerbation: Asthma exacerbation can lead to respiratory alkalosis due to hyperventilation and excessive elimination of carbon dioxide (CO2) from the body. However, metabolic alkalosis is not a typical consequence of asthma exacerbation alone. Therefore, while this client may experience respiratory alkalosis, they are not at risk for developing metabolic alkalosis solely due to asthma exacerbation.

A. Increased muscle tension B. Altered sleep patterns C. Increased peristalsis D. Impaired immunity

Correct Answer is D

Explanation

D. Impaired immunity is a serious complication of prolonged stress that can have significant implications for overall health and susceptibility to illness. Chronic stress has been linked to dysregulation of the immune system, leading to decreased immune function and increased susceptibility to infections, autoimmune disorders, and other illnesses. Impaired immunity can compromise the body's ability to fight off pathogens and may contribute to the development or exacerbation of various health conditions.
A. Increased muscle tension is a common physiological response to stress but it is not typically considered a serious complication. Prolonged muscle tension can lead to discomfort, headaches, and musculoskeletal issues, but it is not usually life-threatening or associated with severe complications.
B. Altered sleep patterns, such as insomnia or disrupted sleep, can be significant consequences of prolonged stress. Chronic sleep disturbances can negatively impact physical health, cognitive function, and emotional well-being. While altered sleep patterns can have serious implications for overall health and quality of life, they are not typically considered life-threatening in the short term.
C. Increased peristalsis refers to heightened movement of the gastrointestinal tract, which can result in symptoms such as diarrhea or gastrointestinal discomfort. While gastrointestinal disturbances are common manifestations of stress, they are generally not considered the most serious complication of prolonged stress. However, severe or persistent gastrointestinal symptoms may warrant medical evaluation and management.

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A client develops pressure injuries because turning and positioning were not done as ordered. The nurse is aware that this is an example of which type of liability?

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Naxlex Comprehensive Predictor Exams

The nurse identifies which client to be at risk for developing metabolic alkalosis? The client who:

Correct Answer is A

Explanation

The nurse is assessing a client who has been experiencing prolonged stress. For which most serious complication should the nurse monitor the client?

Correct Answer is D

Explanation

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