A nurse is caring for a client with a scheduled procedure. While preparing the client for the transport they appear anxious and ask the nurse where they should hide their cellphone during the procedure. The nurse offers to lock the item in a secure area. Which category of Maslow's hierarchy of needs is the nurse addressing?
Safety needs
Esteem needs
Love and belonging needs
Physiological needs
The Correct Answer is A
A) Safety needs:
In Maslow's hierarchy of needs, safety needs are the second level, after physiological needs, and include the need for security and protection from harm. In this scenario, the client’s concern about where to hide their cellphone during the procedure reflects anxiety related to the potential loss or theft of personal property, which relates to safety and security. By offering to lock the cellphone in a secure area, the nurse is addressing the client's need for safety and reassurance about their belongings while undergoing a medical procedure.
B) Esteem needs:
Esteem needs are related to feelings of self-worth, accomplishment, and respect from others. While a person’s sense of esteem can be affected by how others treat their belongings, this particular situation does not relate to the client seeking recognition or respect. The client’s anxiety about where to place the cellphone is more about feeling secure and protected, rather than about esteem or recognition from others.
C) Love and belonging needs:
Love and belonging needs are associated with the need for interpersonal relationships, affection, and social connections. While the nurse’s interaction with the client may help foster a sense of comfort and connection, the concern about the cellphone does not stem from a need for social support or relationships. Instead, it is related to safety and security.
D) Physiological needs:
Physiological needs represent the most basic level of Maslow's hierarchy and include things like air, food, water, and shelter. Although the client is preparing for a medical procedure, their concern about the cellphone does not fall under this category. The focus here is on the safety of the client’s belongings, which is a higher-level need than basic physiological survival.
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Correct Answer is C
Explanation
A) Muscle mass:
Passive range of motion (ROM) exercises do not directly increase muscle mass. These exercises primarily help maintain joint function and flexibility rather than build muscle tissue, which requires active resistance exercises and strength training.
B) Bone density:
While weight-bearing activities can help improve bone density, passive ROM exercises do not have a significant impact on bone density. Passive ROM helps preserve joint function and flexibility but does not address the strengthening of bones.
C) Joint flexibility:
Passive ROM exercises are specifically designed to improve and maintain joint flexibility. These exercises involve the nurse or caregiver moving the client’s joints through their full range of motion without the client’s active participation. The goal is to maintain or increase the joint's flexibility and prevent stiffness, especially in patients who are unable to move their limbs actively, such as those who have had a stroke.
D) Muscle strength:
Passive ROM does not increase muscle strength because the client is not actively engaging their muscles. Muscle strength is built through active movements or resistance exercises, where the client’s muscles work against a force. Passive ROM helps maintain joint mobility, not muscle strength.
Correct Answer is B
Explanation
A) Keep the head of the client’s bed elevated to 45 degrees:
Elevating the head of the bed to 45 degrees can actually increase the risk of pressure injuries, particularly in clients who are already at risk. This position can cause shearing forces and increase pressure on areas such as the sacrum, heels, and hips, making it more likely for pressure ulcers to develop.
B) Provide the client with a high-calorie diet:
A high-calorie diet is important for clients at risk of pressure injuries because adequate nutrition supports skin integrity and wound healing. Clients at risk for pressure injuries often have compromised nutritional status, and providing sufficient calories, protein, and other nutrients helps improve tissue regeneration and resilience. A high-calorie, high-protein diet helps prevent further breakdown of the skin and supports the healing process for any existing wounds.
C) Massage the client’s bony prominences:
Massaging bony prominences, such as the heels, elbows, and sacrum, is not recommended because it can cause tissue damage and increase the risk of pressure injury. Instead, the focus should be on minimizing pressure on these areas and using appropriate methods to redistribute pressure, such as repositioning the client or using pressure-relieving devices.
D) Reposition the client every 4 hours:
Repositioning the client every 4 hours may not be frequent enough for those at high risk for pressure injuries. For individuals who are immobile or at high risk, repositioning should typically occur at least every 2 hours to alleviate pressure on vulnerable areas of the body.
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