A community health nurse is performing a home visit for a client and is evaluating the home environment for safety. Which of the following findings would indicate to the nurse that the client has a proper understanding of safety in the home?
A single light fixture hangs along the sidewalk to the house.
A small area rug is placed at the front door.
The batteries in the smoke alarms are changed annually.
The water heater is set at 54° C (129.2° F).
The Correct Answer is C
A. A single light fixture along the sidewalk may not provide adequate lighting, increasing the risk of falls, and does not reflect proper home safety.
B. A small area rug at the front door can create a tripping hazard, indicating a need for improved safety measures.
C. Changing the batteries in the smoke alarms annually demonstrates that the client is maintaining functional smoke detectors, which is a key aspect of home safety. Regular maintenance of smoke alarms helps prevent fire-related injuries.
D. While a water heater set at 54° C (129.2° F) can prevent scalding, current safety recommendations suggest a slightly lower setting (around 49° C / 120° F) to maximize safety, so this is not the best indicator of proper understanding.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Rationale:
A. Prolonged QT interval: Morphine does not typically cause a prolonged QT interval. QT prolongation is more commonly associated with certain antiarrhythmic or psychotropic medications, not opioid toxicity.
B. Fluid retention: Morphine is not known to cause fluid retention. Signs of toxicity are primarily related to central nervous system and respiratory depression rather than cardiovascular fluid balance.
C. Hyperactive deep tendon reflexes: Morphine toxicity usually depresses neurological function, leading to decreased reflexes rather than hyperactivity. Hyperactive reflexes are not characteristic of opioid overdose.
D. Bradypnea: Respiratory depression, manifested as bradypnea, is a hallmark sign of morphine toxicity. Excessive morphine depresses the brainstem respiratory centers, reducing the rate and depth of respirations, which can be life-threatening if not addressed promptly.
Correct Answer is D
Explanation
Rationale:
A. Limit teaching sessions about the procedure to 20 min: While preschoolers have limited attention spans, the focus should be on using age-appropriate language and explanations rather than strictly timing the teaching session. The quality and clarity of instruction are more important.
B. Ask the parents to wait outside the room during the procedure: Preschoolers often feel safer and more cooperative when a parent is present. Removing parents can increase anxiety and resistance, so parental presence is encouraged.
C. Instruct the child in deep-breathing methods prior to the procedure: Deep-breathing exercises can help with relaxation, but preschoolers may have difficulty understanding or performing them effectively. Simple explanations and reassurance are more appropriate.
D. Explain in simple terms how the procedure will affect the child: Providing a clear, age-appropriate explanation helps the preschooler understand what to expect, reduces fear, and promotes cooperation. Using simple terms tailored to the child’s developmental level is the most effective preparation.
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