A home health nurse is assessing an older adult client who reports falling a couple of times over the past week. Which of the following findings should the nurse suspect is contributing to the client's falls?

The client has a nonslip bath mat in his shower.

The client uses a raised toilet seat.

The client takes alprazolam.

The client wears fitted slippers.

Answer and Explanation

The Correct Answer is C

A. A nonslip bath mat is a safety measure that should help prevent falls.
B. A raised toilet seat can help prevent falls by making it easier for the client to sit and stand.
C. Alprazolam, a benzodiazepine, can cause dizziness, drowsiness, and impaired coordination, increasing the risk of falls in older adults.
D. Wearing fitted slippers is generally a safety measure to prevent falls.

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Correct Answer is A

Explanation

A. Chlordiazepoxide can have teratogenic effects, so it is important to notify the provider if pregnancy is desired or suspected.
B. Doubling the dose can lead to overdose and severe side effects; medication should be taken exactly as prescribed.
C. Breast tenderness is not a known side effect of chlordiazepoxide.
D. Chlordiazepoxide can cause hypotension, not increased blood pressure.

A. Monitor the client for bradycardia following the injection. B. Have the client lie down for 30 min after the medication is injected C. Administer the medication using a tuberculin syringe. D. Assess the client for a sudden relapse of manifestations.

Correct Answer is B

Explanation

A. Bradycardia is not a typical immediate concern following haloperidol decanoate injection.
B. Clients may experience orthostatic hypotension following the injection; having them lie down can prevent falls.
C. Haloperidol decanoate should be administered using a larger syringe, not a tuberculin syringe, as it is a depot injection.
D. A sudden relapse of manifestations is not typically immediate; monitoring for effectiveness and side effects is more relevant.

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A home health nurse is assessing an older adult client who reports falling a couple of times over the past week. Which of the following findings should the nurse suspect is contributing to the client's falls?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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