A nurse is caring for a client at risk for falls. Which intervention is most important for fall prevention?

Placing a sign on the client's room door indicating fall risk.

b. Encouraging the client to use the call bell for assistance.

Providing a nonskid mat on the floor beside the client's bed.

Ensuring the client has adequate lighting in the room.

Answer and Explanation

The Correct Answer is B

nswer: b. Encouraging the client to use the call bell for assistance. Explanation: Encouraging the client to use the call bell for assistance is the most important intervention for fall prevention. It promotes the client's involvement in their own safety and ensures that help is readily available when needed.

Incorrect choices: a. Placing a sign on the client's room door indicating fall risk is a helpful visual reminder, but it does not actively prevent falls. c. Providing a nonskid mat on the floor beside the client's bed can reduce the risk of slipping but does not address other factors that contribute to falls. d. Ensuring the client has adequate lighting in the room is important for preventing falls, but it is not the most critical intervention. The client's ability to seek assistance when needed is more crucial.

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Correct Answer is ["C","E"]

Explanation

Choice A reason:

Chloride is not a major electrolyte that is affected by diabetic ketoacidosis (DKA) Chloride levels may be low, normal or high depending on the acid-base status and hydration of the client. Therefore, chloride is not a priority electrolyte to monitor for signs of imbalance.

Choice B reason:

Phosphate is also not a major electrolyte that is affected by DKA. Phosphate levels may be low due to insulin therapy or high due to renal impairment, but these are not directly related to DKA. Therefore, phosphate is not a priority electrolyte to monitor for signs of imbalance.

Choice C reason:

Bicarbonate is a major electrolyte that is affected by DKA. Bicarbonate levels are low in DKA due to metabolic acidosis caused by the accumulation of ketones in the blood. Low bicarbonate levels can lead to symptoms such as nausea, vomiting, abdominal pain, confusion and coma. Therefore, bicarbonate is a priority electrolyte to monitor for signs of imbalance.

Choice D reason:

Sulfate is not a major electrolyte that is affected by DKA. Sulfate levels are not routinely measured in clinical practice and have no significant role in DKA. Therefore, sulfate is not a priority electrolyte to monitor for signs of imbalance.

Choice E reason:

Potassium is a major electrolyte that is affected by DKA. Potassium levels can be high or low in DKA depending on several factors such as insulin therapy, fluid replacement, renal function and acid-base status. High or low potassium levels can cause cardiac arrhythmias, muscle weakness, paralysis and respiratory failure. Therefore, potassium is a priority electrolyte to monitor for signs of imbalance.

A. Pitocin B. Methergine C. Terbutaline D. Hemabate E. Magnesium sulfate

Correct Answer is ["A","B","D"]

Explanation

The correct answer isA. Pitocin, B. Methergine, and D. Hemabate.

Choice A rationale:

Pitocin (oxytocin) is a first-line medication used to manage postpartum hemorrhage by stimulating uterine contractions to reduce bleeding.

Choice B rationale:

Methergine (methylergonovine) is another uterotonic agent used to control postpartum hemorrhage by causing sustained uterine contractions.

Choice C rationale:

Terbutaline is a tocolytic agent used to relax the uterus and is not used to manage postpartum hemorrhage.It is actually used to delay preterm labor.

Choice D rationale:

Hemabate (carboprost) is a prostaglandin used to treat severe postpartum hemorrhage by inducing strong uterine contractions.

Choice E rationale:

Magnesium sulfate is used to prevent seizures in preeclampsia and is not indicated for the management of postpartum hemorrhage.

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A nurse is caring for a client at risk for falls. Which intervention is most important for fall prevention?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has diabetic ketoacidosis and is receiving intravenous fluids. Which of the following electrolytes should the nurse monitor closely for signs of imbalance? (Select all that apply.)

Correct Answer is ["C","E"]

Explanation

Medications used to manage postpartum hemorrhage (PPH) include (Select all that apply.):.Medications used to manage postpartum hemorrhage (PPH) include (Select all that apply.):

Correct Answer is ["A","B","D"]

Explanation

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