A nurse is making shift assignments.
Which client is appropriate for a nursing assistant?
A newly admitted client with a seizure disorder.
A post-op laparotomy client who is waiting for discharge instructions.
A client who needs assistance with feeding.
A dehydrated client with an electrolyte imbalance.
The Correct Answer is C
Choice A rationale
A newly admitted client with a seizure disorder requires close monitoring and assessment, which is beyond the scope of practice for a nursing assistant.
Choice B rationale
A post-op laparotomy client who is waiting for discharge instructions requires specific education and assessment, which is beyond the scope of practice for a nursing assistant.
Choice C rationale
A client who needs assistance with feeding is the correct answer. Assisting with feeding is within the scope of practice for a nursing assistant.
Choice D rationale
A dehydrated client with an electrolyte imbalance requires close monitoring and assessment, which is beyond the scope of practice for a nursing assistant.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Ignoring the error, even if it does not affect patient care, is incorrect. Ignoring errors can lead to a culture of complacency and potentially more significant errors in the future. It is essential to address all errors to maintain accurate records and ensure patient safety.
Choice B rationale
Drawing a single line through the error, initialing, and dating it is the correct action. This method maintains the integrity of the medical record while clearly indicating that an error was made and corrected. It ensures transparency and accountability in documentation.
Choice C rationale
Leaving the error as is and informing the nurse manager is not the best practice. While informing the nurse manager is important, the error should be corrected in the medical record to prevent any potential confusion or miscommunication.
Choice D rationale
Erasing the incorrect entry and writing the correct one is incorrect. Erasing or obliterating entries in a medical record is not allowed as it can be seen as tampering with the record. It is crucial to maintain the original entry and make corrections transparently.
Correct Answer is B
Explanation
Choice A rationale
The client properly using a cane and demonstrating a steady gait indicates that the client has good mobility and balance. This is not likely to contribute to falls. Proper use of assistive devices like canes can actually help prevent falls by providing additional support and stability.
Choice B rationale
The client takes a sleeping pill. Many sleeping pills, especially those in the benzodiazepine class, can cause drowsiness, dizziness, and impaired coordination, which significantly increase the risk of falls. These medications can affect the central nervous system, leading to decreased alertness and slower reaction times, making it more likely for the client to fall.
Choice C rationale
The client uses a raised toilet seat. Raised toilet seats are designed to make it easier for individuals to sit down and stand up from the toilet, reducing the risk of falls in the bathroom. This adaptation is generally considered a fall prevention measure rather than a risk factor.
Choice D rationale
The client wears non-skid shoes. Non-skid shoes are designed to provide better traction and reduce the likelihood of slipping. Wearing such shoes is a preventive measure against falls, not a contributing factor.
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