A home health nurse is conducting an initial environmental evaluation for an older adult client. Which of the following recommendations should the nurse make?

Set the hot water heater to 54.4° C (130° F).

Place a throw rug on the kitchen floor.

Remove the raised seat from the toilet.

Install a grab bar on the wall next to the toilet.

Answer and Explanation

The Correct Answer is D

A. Set the hot water heater to 54.4° C (130° F): This temperature is too high and poses a serious burn risk, especially for older adults with decreased skin sensitivity or delayed reaction times. The recommended safe setting is 48.9° C (120° F) or lower to prevent scalding injuries.

B. Place a throw rug on the kitchen floor: Throw rugs are a major tripping hazard for older adults and significantly increase the risk of falls. The nurse should recommend removing loose rugs or securing them with non-slip backing if they are necessary.

C. Remove the raised seat from the toilet: A raised toilet seat helps older adults with limited mobility or joint pain to sit and stand more easily, reducing the risk of falls or strain. Removing it would make toileting more difficult and unsafe.

D. Install a grab bar on the wall next to the toilet: Grab bars improve stability and reduce fall risk in key areas like the bathroom. They are a recommended safety measure for older adults, especially during toileting and bathing activities.

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Correct Answer is C

Explanation

A. "Give your son plenty of alone time with his sister." While supervised interaction is important, unsupervised alone time is not recommended for preschoolers and newborns due to safety concerns. Young children may not fully understand appropriate handling or boundaries.

B. "Plan for your son to meet his sister for the first time at home." Introducing the baby at the hospital is generally encouraged, as it allows for early bonding in a supportive environment. Waiting until home may delay adjustment and could create feelings of exclusion.

C. "Give your son a little gift from his new sister." This strategy helps reduce feelings of jealousy and promotes positive associations with the new baby. It can make the older sibling feel acknowledged and included in the family transition.

D. "Hold your daughter when your son first meets her." Holding the baby during the first introduction may make the older child feel displaced. Allowing the parent to focus attention on the older sibling during the initial meeting can foster reassurance and connection.

A. Zolpidem 10 mg PO HS B. Heparin 10,000 u subcutaneously TID C. Docusate 100 mg PO QD D. Lorazepam 2 mg PO BID

Correct Answer is A

Explanation

A. Zolpidem 10 mg PO HS:This is the correct and acceptable documentation format. It includes the full drug name, dosage, route, and timing abbreviation ("HS" for bedtime), all of which are permitted and clear in medical documentation.

B. Heparin 10,000 u subcutaneously TID:The abbreviation "u" for units is considered unsafe and prone to misreading (e.g., as a zero). Instead, "units" should be written out to prevent medication errors.

C. Docusate 100 mg PO QD:"QD" is a dangerous abbreviation that can be misread as "QID" (four times daily). The Joint Commission recommends writing "daily" instead to ensure clarity and patient safety.

D. Lorazepam 2 mg PO BID:While mostly acceptable, using "BID" can be risky because it may be misinterpreted. Current best practices encourage writing "twice daily" to reduce ambiguity in documentation.

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A home health nurse is conducting an initial environmental evaluation for an older adult client. Which of the following recommendations should the nurse make?

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