A home health nurse is caring for an older adult client who is immobile. What question should the nurse ask to collect information about the client's safety?

"Who helps cook and clean for you? You don't do it all yourself, do you?"

"How do you get your daily exercise with your immobility limitations?"

"How do you usually get your medications each day?"

"Tell me about a typical day. Do you feel secure in your environment?"

Answer and Explanation

The Correct Answer is D

A. "Who helps cook and clean for you? You don't do it all yourself, do you?": This question assesses support for activities of daily living but does not directly address the client’s safety in their environment.

B. "How do you get your daily exercise with your immobility limitations?": This question explores physical activity and mobility, which can impact health, but it does not fully capture environmental safety or risk for injury at home.

C. "How do you usually get your medications each day?": Understanding medication management is important for adherence and safety, but it focuses on a single aspect of safety rather than the broader home environment.

D. "Tell me about a typical day. Do you feel secure in your environment?": This question directly addresses the client’s perception of safety and allows the nurse to identify potential hazards, falls risks, or other environmental concerns. It provides comprehensive information about the client’s safety and daily functioning.

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Correct Answer is D

Explanation

A. The client states, "My headache is an 8 out of 10 and throbbing.": This is subjective data because it reflects the client’s personal perception and experience of pain, which cannot be measured or observed by the nurse.

B. The client verbalizes, "I have a headache because I have not slept.": This is also subjective data as it represents the client’s opinion about the cause of their headache rather than observable facts.

C. The caregiver expresses concern about their infant crying all night: This is subjective information reported by the caregiver. It provides insight into the caregiver’s perspective but is not directly measurable or observed by the nurse.

D. The client exhibits facial grimacing and guards a swollen right forearm: This is objective data because it is observable and measurable behavior noted by the nurse. These physical signs can be verified independently of the client’s report.

A. Share their biases with colleagues to seek validation and reassurance about their feelings. B. Acknowledge biases but maintain those beliefs as they will not influence client care. C. Seek out education on cultural competency to better understand diverse populations D. Avoid clients from different cultures to prevent personal bias from affecting their care

Correct Answer is C

Explanation

A. Share their biases with colleagues to seek validation and reassurance about their feelings: While discussing biases may raise awareness, relying solely on colleagues does not provide the nurse with tools or strategies to manage biases effectively or improve client care.

B. Acknowledge biases but maintain those beliefs as they will not influence client care: Simply acknowledging biases without addressing them can allow them to unconsciously affect clinical decisions, undermining equitable and culturally competent care.

C. Seek out education on cultural competency to better understand diverse populations: Education and training in cultural competency equip the nurse with knowledge and strategies to recognize, manage, and minimize the influence of personal biases, promoting equitable, respectful, and effective care for all clients.

D. Avoid clients from different cultures to prevent personal bias from affecting their care: Avoiding clients is unethical and discriminatory, limiting access to care and failing to fulfill professional responsibilities. It does not address the underlying issue of implicit bias.

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A home health nurse is caring for an older adult client who is immobile. What question should the nurse ask to collect information about the client's safety?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which information documented by the nurse is considered objective data?

Correct Answer is D

Explanation

A nurse reflects on their personal biases and prejudices before client care. What action should the nurse plan to take to provide equitable care to all clients?

Correct Answer is C

Explanation

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