A nurse is planning discharge for a client who has rheumatoid arthritis. Which of the following statements by the client should the nurse identify as an indication that a referral to an occupational therapist is necessary?
I need some help planning my meals to maintain my weight
I'm having difficulty climbing the stairs at my house
I'm tired of having pain in my joints all the time
I need assistance with bathing
The Correct Answer is D
The correct answer is: d. I need assistance with bathing
Choice A Reason:
"I need some help planning my meals to maintain my weight" is not an indication for a referral to an occupational therapist. This statement is more relevant to a dietitian, who specializes in nutrition and meal planning. Dietitians can help clients with rheumatoid arthritis maintain a healthy weight, which is important for managing the disease, but this does not fall under the scope of occupational therapy.
Choice B Reason:
"I'm having difficulty climbing the stairs at my house" is not an indication for a referral to an occupational therapist. This statement suggests a need for physical therapy, as physical therapists focus on improving mobility, strength, and balance. They can provide exercises and strategies to help clients navigate stairs and other physical challenges.
Choice C Reason:
"I'm tired of having pain in my joints all the time" is not an indication for a referral to an occupational therapist. This statement is a general complaint about pain, which would be managed by the primary care provider or rheumatologist. They can adjust medications and provide treatments to help manage the pain associated with rheumatoid arthritis.
Choice D Reason:
"I need assistance with bathing" is an indication for a referral to an occupational therapist. Occupational therapists help clients with activities of daily living (ADLs), such as bathing, dressing, and eating. They can provide adaptive equipment and techniques to help clients perform these tasks more independently and safely. This statement indicates a decline in the client's ability to perform ADLs, which is a key reason for referring to an occupational therapist.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Asking the provider to delay the client's discharge home for a few more days is not an appropriate action for the nurse to take. This would not address the partner's concerns or the client's needs. It would also increase the risk of hospital-acquired infections and complications for the client.
Choice B reason: Seeking out another family member to assist the client's partner with care is not an appropriate action for the nurse to take. This would not respect the partner's autonomy or the client's wishes. It would also assume that there is another family member who is willing and able to provide care.
Choice C reason: Contacting a case manager to discuss hospice options is the appropriate action for the nurse to take. This would provide the client and the partner with information and support regarding end-of-life care. Hospice care focuses on improving the quality of life and comfort of clients with terminal illnesses and their families.
Choice D reason: Advising the partner to place the client in a long-term care facility is not an appropriate action for the nurse to take. This would not respect the partner's feelings or the client's preferences. It would also imply that the nurse is judging the partner's decision or ability to care for the client.
Correct Answer is C
Explanation
Choice A reason: Calling the provider if you note clubbing of the client's fingernails is not an instruction the charge nurse should include in the teaching. This is an unnecessary and inappropriate action, as clubbing is a chronic and irreversible sign of hypoxia that does not require immediate intervention. The nurse should document the finding and monitor the client's respiratory status.
Choice B reason: Having an assistive personnel ambulate the client just before meals is not an instruction the charge nurse should include in the teaching. This is a harmful and contraindicated action, as ambulation can increase the client's oxygen demand and cause dyspnea and fatigue. The nurse should schedule the client's activity and rest periods around the meals and provide supplemental oxygen as prescribed.
Choice C reason: Notifying the charge nurse if you observe that the client has distended neck veins is an instruction the charge nurse should include in the teaching. This is a necessary and appropriate action, as distended neck veins can indicate right-sided heart failure, which is a complication of COPD. The nurse should report the finding and assess the client for other signs of fluid overload, such as edema, weight gain, and crackles.
Choice D reason: Maintaining the client's oxygen saturation level above 95 percent is not an instruction the charge nurse should include in the teaching. This is an unrealistic and potentially harmful goal, as clients with COPD usually have lower oxygen saturation levels due to chronic hypoxia. The nurse should maintain the client's oxygen saturation level at the prescribed range, which is typically between 88 and 92 percent.
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