A nurse is caring for a group of clients who have chronic pain. Which of the following clients should the nurse identify as a candidate for occupational therapy?

A client who has a PCA for chronic pain following a laminectomy

A client who has Alzheimer's disease and is experiencing abdominal pain

A client who has migraines and is experiencing nausea and vomiting

A client who has painful hands due to degenerative joint disease

Answer and Explanation

The Correct Answer is D

A. A client who has a PCA for chronic pain following a laminectomy: This client is receiving patient-controlled analgesia (PCA) to manage post-surgical pain. The primary focus is pharmacologic pain control, and occupational therapy is not the first-line intervention for acute post-surgical pain management.

B. A client who has Alzheimer's disease and is experiencing abdominal pain: Occupational therapy focuses on improving functional abilities, mobility, and daily activities rather than addressing acute internal pain such as abdominal pain. Management of this client’s pain would involve medical assessment and treatment rather than OT intervention.

C. A client who has migraines and is experiencing nausea and vomiting: Migraine management is primarily medical, focusing on pharmacologic therapy and symptom relief. Occupational therapy is not indicated for acute episodic pain like migraines with associated nausea and vomiting.

D. A client who has painful hands due to degenerative joint disease: Occupational therapy is appropriate for chronic musculoskeletal conditions like degenerative joint disease. OT can help the client maintain hand function, adapt daily activities, improve fine motor skills, and manage chronic pain through therapeutic techniques and assistive devices.

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Free Nursing Study Resources

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

Explanation

Rationale:

A. Encourage the client to drink 3000 mL of fluid daily: This is contraindicated because the client has heart failure with signs of fluid volume excess (crackles and 3+ pitting edema). Increasing fluid intake could worsen fluid overload.

B. Review the need for the indwelling urinary catheter daily: Daily assessment of catheter necessity allows for timely removal when it is no longer needed, which significantly decreases the risk of catheter-associated urinary tract infections (CAUTIs).

C. Empty the drainage bag when it is half-full: Keeping the drainage bag from becoming overfilled prevents urine backflow into the bladder, which can introduce bacteria and increase infection risk. Regular emptying is a key preventive measure.

D. Use soap and water to provide perineal care: Proper perineal hygiene with mild soap and water helps remove bacteria and maintain skin integrity, reducing the risk of urinary tract infection, especially in incontinent clients.

E. Place the drainage bag on the bed when transporting the client: The drainage bag should always remain below the level of the bladder and off the bed to prevent backflow of urine, which can introduce bacteria and increase infection risk.

F. Change the indwelling urinary catheter tubing every 3 days: Routine scheduled tubing changes are not recommended, as unnecessary manipulation of the system can increase infection risk. Tubing should only be changed when clinically indicated (e.g., contamination, obstruction).

A. Withhold the medication if the client does not appear to be in pain. B. Withhold the medication if the client has a fever. C. Count the current number of unit doses available in the medication dispensing system. D. Document administration of the medication upon removal from the medication dispensing system

Correct Answer is C

Explanation

A. Withhold the medication if the client does not appear to be in pain: Pain is subjective, and nurses must rely on the client’s self-report rather than appearance. Withholding analgesia based solely on observation may lead to undertreatment of pain.

B. Withhold the medication if the client has a fever: Fever is not a contraindication for hydromorphone administration. Pain management should be based on client need and assessment, while fever is monitored and treated separately if necessary.

C. Count the current number of unit doses available in the medication dispensing system: Counting controlled substances like hydromorphone ensures accurate inventory and accountability, which is a legal and safety requirement. This step helps prevent diversion and maintains compliance with regulations.

D. Document administration of the medication upon removal from the medication dispensing system: Documentation should occur after administration to accurately reflect what the client actually received. Recording upon removal can lead to errors if the medication is not given.

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A nurse is caring for a group of clients who have chronic pain. Which of the following clients should the nurse identify as a candidate for occupational therapy?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client in the medical-surgical unit. Which of the following actions should the nurse take to decrease the risks for urinary tract infection for this client? Select all that apply.

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

Explanation

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Correct Answer is C

Explanation

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