A nurse is conducting an initial home health assessment for an older adult who has a new diagnosis of moderate Alzheimer's disorder and lives with their caregiver. For which of the following findings should the nurse obtain a referral to a physical therapist?

The client has gained 4.5 kg (10 lb) over 8 weeks.

The caregiver reports that recently the client is incontinent of urine during the day.

The client is unable to climb the stairs to their bedroom.

The caregiver reports the client needs assistance with activities of daily living such as bathing

Answer and Explanation

The Correct Answer is C

A. The client has gained 4.5 kg (10 lb) over 8 weeks: Weight gain may indicate changes in diet, activity, or medication, but it does not directly suggest a need for physical therapy. A nutritionist or primary care provider might be more appropriate for follow-up.

B. The caregiver reports that recently the client is incontinent of urine during the day:
Urinary incontinence in clients with Alzheimer's is typically addressed by primary care or urology. It may be related to cognitive decline rather than physical impairment, so physical therapy is not the priority referral.

C. The client is unable to climb the stairs to their bedroom: This mobility limitation increases the risk for falls and functional decline. A physical therapist can assess strength, balance, and coordination, and develop a mobility plan or recommend assistive devices or home modifications.

D. The caregiver reports the client needs assistance with activities of daily living such as bathing: This indicates a need for occupational therapy to enhance independence in daily tasks. While physical therapy may support mobility, ADL support is better addressed by an occupational therapist.

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Correct Answer is B

Explanation

A. Cross legs at the ankles: Crossing legs, even at the ankles, can increase the risk of hip dislocation following total hip arthroplasty by placing stress on the joint and is generally discouraged during recovery.

B. Use an elevated toilet seat: An elevated toilet seat helps maintain hip precautions by preventing excessive hip flexion, reducing dislocation risk, and promoting safety and comfort during toileting.

C. Take baths instead of showers: Baths require more hip flexion and increased risk of falling, so showers are preferred postoperatively to minimize hip strain and improve safety.

D. Use a walker on the stairs: Using a walker on stairs is unsafe due to limited maneuverability; crutches or a cane are usually recommended for stair navigation during hip recovery.

A. "What are your hopes and plans for the future?" B. "How long did you know the person who died?" C. "Have you thought about harming yourself?" D. "What do others do for you that helps you the most?"

Correct Answer is D

Explanation

A. "What are your hopes and plans for the future?" This question helps assess the client's coping and outlook, which is important in grief counseling, but it does not directly provide information about the client's support systems.

B. "How long did you know the person who died?" This question explores the depth and duration of the relationship, which can help gauge the intensity of grief. However, it does not provide insight into who the client relies on now for emotional or practical support.

C. "Have you thought about harming yourself?" This is a critical safety question to assess for suicidal ideation, which should always be asked if there are concerns about the client’s mental health. However, it does not identify support systems; rather, it screens for immediate risk.

D. "What do others do for you that helps you the most?" This question directly explores the actions of support persons and reveals who is actively providing emotional or practical assistance. It helps the nurse understand the client's support network and the quality of that support, making it the best option for assessing support systems.

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A nurse is conducting an initial home health assessment for an older adult who has a new diagnosis of moderate Alzheimer's disorder and lives with their caregiver. For which of the following findings should the nurse obtain a referral to a physical therapist?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A home health nurse is caring for a client who is postoperative following a total hip arthroplasty. Which of the following interventions should nurse recommend to promote recovery?

Correct Answer is B

Explanation

A nurse is caring for a client who is grieving. Which of the following questions should the nurse ask to identify the client's support systems?

Correct Answer is D

Explanation

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