A home health nurse is reviewing messages from a group of clients. Which of the following clients should the nurse contact first?
Client reports that her new colostomy stoma appears purple.
Client who has COPD and reports an oxygen saturation of 90.
Client reports feeling a vibration in his new internal arteriovenous graft for dialysis.
Mother reports that her son vomited after a dose of methylphenidate.
The Correct Answer is A
A stoma that turns dark red, purple, or even black in color can be a sign of a problem with blood supply to the stoma 1. This can be a serious issue that requires immediate medical attention.
Choice B is not the correct answer because an oxygen saturation of 90 for a client with COPD is within an acceptable range.
Choice C is not the correct answer because feeling a vibration in a new internal arteriovenous graft for dialysis is not necessarily a cause for immediate concern.
Choice D is not the correct answer because vomiting after a dose of methylphenidate may be a side effect of the medication and may not require immediate attention.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Cognitive behavioral therapy (CBT) is a type of psychotherapy that can be effective in treating alcohol use disorder.
CBT helps individuals identify and change negative thought patterns and behaviors related to their alcohol use.
Choice A is not the answer because naloxone is a medication used to treat opioid overdose and is not used to treat alcohol use disorder.
Choice B is not the answer because methadone is a medication used to treat opioid addiction and is not used to treat alcohol use disorder.
Choice C is not the answer because chelation therapy is a medical treatment used to remove heavy metals from the body and is not used to treat alcohol use disorder.
Correct Answer is C
Explanation
This outcome addresses the ethical principle of distributive justice by ensuring that resources, in this case Medicare benefits, are distributed fairly and equitably to those who are eligible to receive them.
Choice A, “Clients verbalize their right to refuse treatment,” addresses the ethical principle of autonomy, which is the right of individuals to make decisions about their own healthcare.
Choice B, “Clients understand their right to confidentiality,” addresses the ethical principle of confidentiality, which is the obligation to protect a client’s personal health information.
Choice D, “Clients demonstrate completion of advance directives,” addresses the ethical principle of autonomy by allowing clients to make decisions about their future healthcare.
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