A nurse is assessing a client who wears partial dentures and reports mouth pain. Which of the following actions should the nurse take?

Provide the client with an alcohol-based mouthwash.

Instruct the client to brush their remaining teeth with a firm toothbrush.

Advise the client to rinse their mouth and dentures after each meal.

Swab the client's mouth with lemon-glycerin sponges at bedtime.

Answer and Explanation

The Correct Answer is C

A. Provide the client with an alcohol-based mouthwash: Alcohol-based mouthwashes can cause oral mucosa dryness and irritation, worsening mouth pain. They are not recommended for clients with oral discomfort or partial dentures.

B. Instruct the client to brush their remaining teeth with a firm toothbrush: A firm toothbrush can damage gum tissue and increase discomfort, especially in a client already experiencing pain. A soft-bristled toothbrush is safer for maintaining oral hygiene without causing trauma.

C. Advise the client to rinse their mouth and dentures after each meal: Rinsing after meals removes food particles and prevents bacterial buildup, reducing irritation and risk of infection. This promotse oral health and comfort in clients with partial dentures.

D. Swab the client's mouth with lemon-glycerin sponges at bedtime: Lemon-glycerin swabs can dry out the mucous membranes and cause irritation. They are no longer recommended in oral care because they worsen discomfort rather than relieve it.

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Correct Answer is D

Explanation

A. "VRE is transmitted through the air by coughing and sneezing.": VRE is not airborne; it spreads primarily through direct contact with contaminated surfaces or hands of healthcare workers. Airborne precautions are not required for this organism.

B. "VRE infection requires health care workers to wear an N95 respirator.": N95 respirators are required for airborne pathogens such as tuberculosis, not for VRE. Contact precautions, including gloves and gowns, are used for preventing transmission of VRE.

C. "VRE infection is treated with vancomycin antibiotics.": Vancomycin-resistant enterococci are resistant to vancomycin by definition, so other antibiotics such as linezolid or daptomycin are used instead. Treating with vancomycin would be ineffective.

D. "VRE is a common cause of health care-associated infections.": VRE is a significant pathogen in healthcare settings, often causing bloodstream, urinary tract, and wound infections. It is considered a common cause of health care–associated infections due to its resistance and ease of spread.

A. A client who has chronic back pain and a history of physical maltreatment B. A client who has chronic joint discomfort and a history of mild dementia C. A client who has chronic knee pain and a history of grand mal seizures D. A client who has chronic hip pain and a history of uterine cancer

Correct Answer is A

Explanation

A. A client who has chronic back pain and a history of physical maltreatment: Therapeutic touch involves close physical proximity and intentional hand movements, which may trigger psychological distress or trauma responses in individuals with a history of maltreatment.

B. A client who has chronic joint discomfort and a history of mild dementia: Clients with mild dementia may still tolerate therapeutic touch well, as it can provide comfort and reduce agitation. With careful explanation and reassurance, this intervention can be beneficial.

C. A client who has chronic knee pain and a history of grand mal seizures: Therapeutic touch does not induce seizures, as it is a noninvasive energy-based practice. It does not increase seizure risk in clients with a seizure history.

D. A client who has chronic hip pain and a history of uterine cancer: Having a history of cancer is not a contraindication to therapeutic touch. This approach does not involve deep tissue manipulation and can be safely applied to provide comfort and pain relief.

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Body System	Findings
Gastrointestinal	Client reports abdominal pain as a 9 on a pain scale of 0 to 10. Abdomen is distended and firm. Bowels sounds are distant and hypoactive.
Integumentary	Skin is warm and dry. Perianal skin is excoriated, and small ulceration is noted.
Fluid balance	Tenting of skin for 4 seconds is noted. Capillary refill is 2 seconds. Temperature 38.7° C (101.7° F) Mucous membranes are dry. Respiratory rate 20/min

A nurse is assessing a client who wears partial dentures and reports mouth pain. Which of the following actions should the nurse take?

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Naxlex Comprehensive Predictor Exams

A nurse manager is teaching a group of newly licensed nurses about vancomycin-resistant enterococci (VRE) infections. Which of the following information should the nurse manager include in the teaching?

Correct Answer is D

Explanation

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Correct Answer is A

Explanation

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