A home health nurse is planning care for a client who has Alzheimer's disease. Which of the following actions should the nurse include in the plan of care?

Encourage physical activity prior to bedtime

Wear clothing with zippers instead of buttons.

Replace the carpet with hardwood floors

Place locks at the tops of exterior doors.

Answer and Explanation

The Correct Answer is D

Rationale:

A. Encourage physical activity prior to bedtime: Stimulating activity close to bedtime can increase agitation and make it harder for clients with Alzheimer’s disease to settle for sleep. Calming routines in the evening are more appropriate to reduce nighttime confusion and restlessness.

B. Wear clothing with zippers instead of buttons: Although zippers are often easier than buttons, clients with Alzheimer’s may have difficulty with any fasteners. Simple clothing with Velcro or elastic waists is typically more suitable to promote independence.

C. Replace the carpet with hardwood floors: Carpets provide traction and cushioning, which can help prevent injuries from falls. Hardwood floors may be slippery or cause confusion due to glare or unfamiliar patterns, increasing fall risk.

D. Place locks at the tops of exterior doors: Clients with Alzheimer’s are at risk for wandering. Installing locks at the tops of doors—out of the client's usual line of sight—helps prevent elopement while preserving safety in the home environment.

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Correct Answer is C

Explanation

Rationale:

A. Inject into the vastus lateralis: The preferred injection sites for insulin are subcutaneous areas such as the abdomen, upper arms, thighs, or buttocks. The vastus lateralis is used for intramuscular injections, not subcutaneous insulin administration.

B. Roll the syringe gently to ensure mixture of the insulins: Only the NPH (cloudy) insulin should be rolled gently between the hands to mix it evenly before drawing it up. The syringe itself should not be rolled after both insulins are inside, as this may affect accuracy.

C. Draw up regular insulin prior to NPH insulin: When mixing insulins, regular (clear) insulin should be drawn up first to avoid contaminating the vial of regular insulin with the cloudy NPH insulin, which could alter its action and absorption.

D. Use a 15 angle for the injection: Insulin is administered subcutaneously using a 45- to 90-degree angle, depending on the client’s body habitus. A 15-degree angle is too shallow and is used for intradermal injections, not subcutaneous ones.

A. Drooling B. Hypoxia C. Fever D. Tachypnea E. Exudate on pharynx F. Wheezing upon auscultation

Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A,B"},"C":{"answers":"A,B,C"},"D":{"answers":"A,B"},"E":{"answers":"C"},"F":{"answers":"B"}}

Explanation

Rationale:

Drooling: Drooling is classic in epiglottitis due to severe throat pain and an inability to swallow. It is not commonly seen in RSV or streptococcal pharyngitis, where swallowing remains relatively intact.
Hypoxia: Both epiglottitis and RSV can cause hypoxia. In epiglottitis, airway obstruction can quickly compromise oxygenation. In RSV, hypoxia results from inflammation and mucus plugging in the small airways.
Fever: Fever is a nonspecific but common finding across all three conditions. It signals an inflammatory or infectious process, whether viral (RSV), bacterial (Streptococcus), or in epiglottitis (often Haemophilus influenzae type b if unimmunized).
Tachypnea: Tachypnea may occur in both epiglottitis and RSV as the body compensates for airway compromise and impaired gas exchange. It is not a typical feature of uncomplicated streptococcal pharyngitis.
Exudate on pharynx: Pharyngeal exudates are common in streptococcal pharyngitis and help differentiate it from viral causes. They are typically absent in RSV and epiglottitis, where the pathology lies elsewhere (lower airways or supraglottic structures).
Wheezing upon auscultation: Wheezing is a hallmark of RSV due to bronchiolar inflammation and narrowing. It is not seen in epiglottitis or streptococcal pharyngitis, as those conditions do not primarily affect the bronchioles.

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A home health nurse is planning care for a client who has Alzheimer's disease. Which of the following actions should the nurse include in the plan of care?

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Naxlex Comprehensive Predictor Exams

A nurse is providing teaching to a client who has a new diagnosis of type 1 diabetes mellitus about administering NPH insulin and regular insulin together in one injection. Which of the following instructions should the nurse include?

Correct Answer is C

Explanation

Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A,B"},"C":{"answers":"A,B,C"},"D":{"answers":"A,B"},"E":{"answers":"C"},"F":{"answers":"B"}}

Explanation

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