A nurse is assisting in the care of a client who had an ischemic stroke. Which of the following observations by the nurse indicates a need for an occupational therapy referral?

The client becomes exhausted while brushing her teeth.

The client coughs while drinking from a straw.

The client is unable to bear her full weight while walking.

The client is having difficulty reading large print.

Answer and Explanation

The Correct Answer is A

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Correct Answer is A

Explanation

The correct answer is choice A, "Take a shower rather than a tub bath." This is a safety precaution to prevent infection . Choice B is incorrect because clients are encouraged to walk around after surgery to prevent blood clots. Choice C is incorrect because douching after surgery can increase the risk of infection. Choice D is incorrect because bright red vaginal bleeding after surgery warrants a followup with a healthcare provider. Choice B is not correct because clients are encouraged to walk around after surgery to prevent blood clots. Choice C is not correct because douching after surgery can increase the risk of infection. Choice D is not correct because bright red vaginal bleeding after surgery warrants a followup.

A. Review the signs of anaphylaxis with the client. B. Instruct the client to store the injector at room temperature. C. Inform the client to seek medical attention following administration of the injection. D. Have the client perform a return demonstration of the equipment.

Correct Answer is C

Explanation

The correct answer is c. Inform the client to seek medical attention following administration of the injection.

Choice A reason: Reviewing the signs of anaphylaxis with the client is important, but it’s not the priority. The client must first know what to do in case of an emergency.

Choice B reason: Instructing the client to store the injector at room temperature is a part of the storage instructions, but it’s not the immediate action to take during an anaphylactic reaction.

Choice C reason: This is the priority because anaphylaxis is a potentially life-threatening condition and even after administering epinephrine, it’s crucial to seek immediate medical attention.

Choice D reason: Having the client perform a return demonstration of the equipment is a good teaching method, but it’s not the immediate action to take when an anaphylactic reaction occurs.

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A nurse is assisting in the care of a client who had an ischemic stroke. Which of the following observations by the nurse indicates a need for an occupational therapy referral?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reinforcing discharge teaching with a client who had an abdominal hysterectomy 2 days ago. Which of the following instructions should the nurse include in the teaching?

Correct Answer is A

Explanation

A nurse is caring for a client who is at risk for anaphylaxis due to bee stings. When reinforcing teaching about the use of an automatic epinephrine injector, which of the following actions is the priority?

Correct Answer is C

Explanation

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