A nurse at a rehabilitation facility is contributing to the plan of care for a client who has had a below-the-knee amputation. Which of the following interventions should the nurse include in the plan of care? (Select all that apply.)

Restrict visitors to family members until the client is able to wear a prosthesis.

Encourage the client to talk with another client who completed rehabilitation for amputation.

Instruct the client to ignore phantom pain sensations.

Suggest that family members bring clothing for the client from home.

Ask the client to describe her feelings about the loss of the affected limb.

Answer and Explanation

Correct Answer : B,D,E

A. Restrict visitors to family members until the client is able to wear a prosthesis: Restricting visitors may increase isolation and hinder emotional support.
B. Encourage the client to talk with another client who completed rehabilitation for amputation: Peer support can provide emotional reassurance and motivate the client in their recovery process.
C. Instruct the client to ignore phantom pain sensations: Phantom pain is real and should not be dismissed; it requires management through medication or other interventions.
D. Suggest that family members bring clothing for the client from home: Familiar clothing can improve self-esteem and promote adjustment to body image changes.
E. Ask the client to describe her feelings about the loss of the affected limb: Exploring the client’s feelings helps address emotional and psychological aspects of coping with amputation.

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Correct Answer is D

Explanation

A. "I am only contagious while the lesions are present.": Viral shedding can occur even when lesions are not visible.
B. "The virus cannot spread to areas other than the genital area.": The virus can spread to other areas through autoinoculation or sexual contact.
C. "I can have unprotected sex as long as I am taking acyclovir.": Acyclovir reduces outbreaks but does not eliminate the risk of transmission.
D. "The lesions may reoccur in times of stress.": Herpes simplex virus type 2 is latent between outbreaks, but stress and other factors can trigger recurrences.

A. Hypernatremia B. Hypocalcemia C. Hyperkalemia D. Hyperphosphatemia

Correct Answer is A

Explanation

A. Hypernatremia: Excessive fluid loss through sweat, combined with insufficient fluid intake, can lead to hypernatremia (elevated sodium levels), often seen in heat exhaustion.
B. Hypocalcemia: Calcium levels are not typically affected by heat exhaustion.
C. Hyperkalemia: Potassium levels usually decrease due to sweating, not increase.
D. Hyperphosphatemia: Phosphate levels are not significantly altered in heat exhaustion.

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A nurse at a rehabilitation facility is contributing to the plan of care for a client who has had a below-the-knee amputation. Which of the following interventions should the nurse include in the plan of care? (Select all that apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reinforcing teaching with a client who has herpes simplex virus type 2. Which of the following statements by the client indicates an understanding of the teaching?

Correct Answer is D

Explanation

A nurse is admitting a client who reports excessive thirst, fever, and periods of confusion. The nurse suspects the client is experiencing heat exhaustion. Which of the following electrolyte imbalances should the nurse expect?

Correct Answer is A

Explanation

A nurse at a rehabilitation facility is contributing to the plan of care for a client who has had a below-the-knee amputation. Which of the following interventions should the nurse include in the plan of care? (Select all that apply.)

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