A client was involved in a multi-car collision six days ago.

Sustained a liver laceration, right rib fracture, and right femur fracture. The liver laceration was repaired.

An intramedullary rod was placed to repair the femur fracture. The client is progressing.

The nurse is implementing the plan of care to increase mobility.

Complete the diagram by dragging from the choices area to specify which type of exercises the client needs, two actions the nurse should take to facilitate the exercises, and two parameters the nurse should monitor to assess the client’s progress.

Answer and Explanation

The Correct Answer is []

The correct answer is: Type of Exercises: Isometric exercises Isotonic exercises Actions to Take: Support the extremity Encourage active range of motion exercises Parameters to Monitor: Pain level Range of motion Rationale:

Isometric exercises: These exercises involve contracting the muscle without moving the joint. They are beneficial for maintaining muscle strength and preventing muscle atrophy, especially when the client is unable to perform full range of motion exercises due to pain or limited mobility. Isotonic exercises: These exercises involve moving the joint through its full range of motion with muscle contraction. They help improve muscle strength, endurance, and joint mobility. Isotonic exercises are important for clients who are progressing in their recovery and are able to tolerate more movement. Support the extremity: Providing support to the extremity during exercises helps prevent injury and reduces pain. It also ensures that the client performs the exercises correctly and safely. Encourage active range of motion exercises: Active range of motion exercises involve the client moving their own joints through their full range of motion. These exercises help improve joint mobility, muscle strength, and overall function. Encouraging the client to perform these exercises promotes independence and active participation in their recovery. Pain level: Monitoring the client’s pain level is important to ensure that the exercises are not causing excessive discomfort or injury. Pain management is crucial for promoting compliance with the exercise regimen and facilitating recovery. Range of motion: Assessing the client’s range of motion helps determine the effectiveness of the exercises and the progress of the client’s recovery. It also helps identify any limitations or areas that need further attention

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Correct Answer is D

Explanation

Choice A rationale

Providing a back rub at bedtime can help promote relaxation and improve sleep quality. However, it does not directly address the issue of wandering, which poses a safety risk for the client. The primary concern should be ensuring the client’s safety by preventing wandering.

Choice B rationale

Applying wrist restraints to prevent wandering is not an appropriate first intervention. Restraints should be used as a last resort when other measures have failed, and they can cause physical and psychological harm to the client. The focus should be on non-restrictive interventions to ensure safety.

Choice C rationale

Administering a PRN sedative prescription may help the client sleep, but it should not be the first intervention. Sedatives can have side effects and may not address the underlying cause of the client’s wandering. Non-pharmacological interventions should be tried first.

Choice D rationale

Leaving the door to the client’s room open slightly allows the client to see and hear staff members as they pass by, which can help reduce feelings of isolation and anxiety. This intervention addresses both the client’s sleep issues and wandering behavior by providing a sense of security and supervision.

A. Insert a rectal tube at specified intervals. B. Assist to a bedside commode 30 minutes after meals. C. Encourage the use of incontinence briefs. D. Administer a glycerin suppository 15 minutes after meals. E. Administer a glycerin suppository 15 minutes after meals.

Correct Answer is B

Explanation

Choice A rationale

Inserting a rectal tube at specified intervals is not a standard practice for bowel training regimens. This intervention is typically reserved for specific medical conditions and is not recommended for routine management of chronic fecal incontinence.

Choice B rationale

Assisting the client to a bedside commode 30 minutes after meals leverages the natural gastrocolic reflex, which stimulates bowel movements after eating. This intervention helps establish a regular bowel routine and is a key component of bowel retraining programs.

Choice C rationale

Encouraging the use of incontinence briefs does not address the underlying issue of bowel incontinence and may not help in establishing a regular bowel routine. This intervention is more focused on managing the symptoms rather than treating the condition.

Choice D rationale

Administering a glycerin suppository 15 minutes after meals can stimulate bowel movements, but it is not the first-line intervention for establishing a bowel training regimen. This approach may be used as an adjunct to other bowel retraining techniques.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A confused older adult client is having trouble sleeping at night and is sometimes found wandering in the hallway. Which nursing intervention should the nurse implement first?

Correct Answer is D

Explanation

A client with chronic fecal incontinence is crying because of being embarrassed for not getting to the bathroom in time to avoid soiling the bed and clothing. When establishing a bowel training regimen, which intervention should the nurse implement?

Correct Answer is B

Explanation

The nurse is demonstrating three-point gait crutch walking to an older adult client who broke a foot while playing soccer with the grandchildren. Which behavior indicates that the client understands proper crutch walking?

The nurse is using guided imagery with a client who is experiencing chronic pain. The nurse should direct the client’s attention on which focus?

An older adult female client tells the clinic nurse about frequently awakening during the night and not being able to go back to sleep. What action(s) should the nurse suggest to the client to help improve sleep? Select all that apply.

The nurse attaches a pulse oximeter to a client’s finger and obtains an oxygen saturation reading of 91%. Which assessment finding most likely contributes to this reading?

When assessing a client with a serum potassium level of 7.5 mEq/L (7.5 mmol/L), which intervention is most important for the nurse to implement?

An older adult client with heart failure has a signed do not resuscitate (DNR) form in the medical record. The unlicensed assistive personnel (UAP) reports that the client is not breathing, and the nurse confirms the UAP’s findings. Which action should the nurse take next?

A nurse is preparing to give an emergency sedative injection to an agitated client. Which action by the nurse comprises a violation?

The nurse plans to use the Situation, Background, Assessment, and Recommendation (SBAR) format of communication during which interaction?