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A nurse is caring for a client who is on bed rest. The nurse should recognize that which of the following findings is a complication of immobility?

Increased blood pressure

Decreased serum calcium levels

Swollen area on calf

Urinary frequency

Answer and Explanation

The Correct Answer is C

A. Immobility more commonly leads to orthostatic hypotension rather than increased blood pressure.

B. Immobility typically leads to increased calcium levels due to bone demineralization.

C. A swollen area on the calf may indicate a deep vein thrombosis (DVT), a serious complication of immobility.

D. Urinary stasis and retention, rather than frequency, are common complications of immobility.

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Correct Answer is D

Explanation

A. Physical activity should be scheduled earlier in the day to prevent overstimulation and promote restful sleep.

B. Hardwood floors increase the risk of falls; carpets provide better traction and cushioning.

C. Zippers can be difficult for clients with Alzheimer's; clothing with Velcro or simple fasteners is preferred.

D. Placing locks at the tops of doors reduces the risk of wandering, a common safety concern in clients with Alzheimer's.

A. "There was a total of 10 sponges used during the procedure." B. "The client was intubated without complications." C. "The estimated blood loss was 250 milliliters." D. "The client is a member of the board of directors."

Correct Answer is C

Explanation

A. The number of sponges used during surgery is important but does not provide as much relevant information for postoperative care.

B. The intubation status is relevant to the immediate perioperative period, but the primary concern in hand-off is the current postoperative condition.

C. Estimated blood loss is an important clinical detail to convey during hand-off, as it may impact the client's recovery and need for monitoring.

D. The client’s position or professional role (e.g., being a board member) is not relevant to the care plan and should not be included in the hand-off report.

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A nurse is caring for a client who is on bed rest. The nurse should recognize that which of the following findings is a complication of immobility?

Nursing Test Bank

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