A nurse is assessing a client who is postoperative following a left leg below-the-knee amputation. Which of the following client statements indicates the potential need for a referral to an occupational therapist?

"I just don't think I can handle looking at my leg."

"I am worried about taking care of my toddler at home."

"I hope I can adjust to using crutches while I am recovering

"I am not sure how I will pay for all the therapy I will need."

Answer and Explanation

The Correct Answer is B

A.   Feeling discomfort or distress about looking at the amputated leg might indicate the need for psychological support or counseling but doesn't specifically indicate the need for occupational therapy.
B.   Expressing worry about managing childcare responsibilities at home suggests potential difficulty with daily activities, indicating a need for occupational therapy to assess and address these concerns.
C.   Hoping to adjust to using crutches during recovery indicates a concern related to
mobility, which might involve physical therapy but not necessarily occupational therapy.
D.   Expressing concern about affording therapy doesn't specifically indicate a need for occupational therapy; this might relate more to financial counseling or social work support.

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Correct Answer is D

Explanation

A. Reviewing facility policies is important but might not immediately address the reasons why the nurses are not taking breaks.
B. Discussing time management strategies might be helpful, but it's crucial to first understand the reasons behind the nurses' behavior.
C. Providing coverage for the nurses' breaks might be a short-term solution but doesn't address the underlying reasons for not taking breaks.
D. Determining the reasons the nurses are not taking scheduled breaks is the initial step to understand if it's due to workload, personal choice, or other factors. This information can guide appropriate interventions or support for the nurses.

A. Whether the client's refusal is based on religious belief B. Whether the partner is the client's durable power of attorney for health care C. Whether the client understands the risk of refusing the procedure D. Whether the facility ethics committee reaches a consensus on the case

Correct Answer is C

Explanation

A. While religious beliefs may influence a client's decision, they are not the deciding factor. Clients have the right to refuse treatment regardless of the reason, as long as they are competent and informed.

B. The partner’s role as the durable power of attorney for health care is only relevant if the client is unable to make decisions due to incompetence or incapacitation. If the client is competent, their decision takes precedence over the wishes of their partner or any legal proxy.

C. Ensuring the client understands the risks of refusing the procedure is the deciding factor. A competent client has the right to refuse any medical treatment, including surgery, after being informed of the potential consequences. The nurse and provider must ensure the client’s decision is informed and voluntary.

D. The facility ethics committee may provide guidance in complex cases, but they do not override a competent client’s autonomy. The client’s informed decision is the ultimate determinant in whether the surgery is performed.

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A nurse is assessing a client who is postoperative following a left leg below-the-knee amputation. Which of the following client statements indicates the potential need for a referral to an occupational therapist?

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