A nurse is preparing to bathe a client who has dementia. Which of the following actions should the nurse take?

Complete the bath even if the client is in distress.

Allow the client to select the temperature of the bath water.

Give detailed instructions for the client to follow.

Use distractions when bathing the client.

Answer and Explanation

The Correct Answer is D

A. Complete the bath even if the client is in distress. – Forcing the bath can increase agitation and damage trust. If the client becomes distressed, pause, reassure, and try again later.

B. Allow the client to select the temperature of the bath water. – Clients with dementia may have impaired sensory perception, increasing the risk of burns or discomfort. The nurse should check the water temperature to ensure safety.

C. Give detailed instructions for the client to follow. – Clients with dementia may struggle to process multiple steps, leading to frustration. Instead, use simple, one-step instructions and gentle guidance.

D. Use distractions when bathing the client. Clients with dementia may experience anxiety, agitation, or distress during bathing. Using distractions, such as playing soothing music, talking about familiar topics, or providing a comforting touch, can help make the experience less stressful and more cooperative.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is A

Explanation

The correct answer is that the nurse should place the base of a vibrating tuning fork on the top of the client's head when performing Weber's test. Weber's test is a screening test for hearing that can detect unilateral (one-sided. conductive hearing loss (middle ear hearing loss) and unilateral sensorineural hearing loss (inner ear hearing loss)².

Options b, c and d are not correct actions for performing Weber's test. Counting how many seconds a client can hear a tuning fork after it has been struck, placing the base of a vibrating tuning fork on the client's mastoid process and moving a vibrating tuning fork in front of the client's ear canals one after the other are not part of Weber's test.

A. Place the client in a semiprivate room. B. Have the client apply a mask when children are visiting. C. Cleanse hands with an alcohol-based hand rub before client contact. D. Use sterile gloves to provide perineal care.

Correct Answer is C

Explanation

When caring for an immunocompromised client, the nurse should prioritize infection prevention and control measures. One essential action is to cleanse hands with an alcohol-based hand rub before client contact. Hand hygiene is crucial in reducing the transmission of microorganisms and preventing infections. Using an alcohol-based hand rub is eﬀective in killing many types of germs, including bacteria and viruses.

Let's now discuss why the other

Options are not the correct answers:

a. Place the client in a semiprivate room: Placing the client in a semiprivate room increases the risk of exposure to potential infections from other individuals. Immunocompromised clients have a weakened immune system, making them more susceptible to infections. Therefore, it is recommended to provide them with a private room to minimize the risk of exposure to pathogens.

b. Have the client apply a mask when children are visiting: While it is generally important to take precautions when visitors are present, having the client wear a mask when children are visiting may not be sufficient to protect the immunocompromised client. Children can carry and transmit various infectious diseases, even without displaying symptoms. Therefore, it is more appropriate for healthcare providers and visitors, including children, to adhere to strict hand hygiene and other infection control measures to minimize the risk of infection transmission.

d. Use sterile gloves to provide perineal care: The use of sterile gloves is not necessary for routine perineal care unless there is a specific indication, such as an open wound or surgical site. For routine perineal care, clean, non-sterile gloves are sufficient. Using sterile gloves unnecessarily can contribute to the development of antimicrobial resistance and increase healthcare costs without providing any additional benefits.

In summary, when caring for an immunocompromised client, the nurse should prioritize infection prevention and control. Cleansing hands with an alcohol-based hand rub before client contact is an important action to reduce the risk of infection transmission. The other

Options, such as placing the client in a semiprivate room, having the client wear a mask when children are visiting, and using sterile gloves for routine perineal care, are not the appropriate actions in this scenario.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

A nurse is preparing to bathe a client who has dementia. Which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is testing a client for conduction deafness by performing the Weber's test. Which of the following actions should the nurse take when performing this test?

Correct Answer is A

Explanation

A nurse is caring for a client who is immunocompromised. Which of the following actions should the nurse take?

Correct Answer is C

Explanation

A nurse is caring for an older adult client who tells the nurse, "I have smoked one pack of cigarettes every day for the last 60 years." Which of the following actions should the nurse take next?

A visitor reports to a nurse that she slipped and fell in a client's room. The visitor denies any injury, but is walking with a slight limp. Which of the following actions should the nurse take?

A nurse is teaching a client how to self-administer daily low-dose heparin injections. Which of the following factors is most likely to increase the client's motivation to learn?

A nurse is planning to provide discharge instructions to a client who does not speak the same language as the nurse. Which of the following actions should the nurse take?

A nurse is preparing to palpate a client's systolic blood pressure using the brachial artery. After applying the blood pressure cuﬀ to the client's arm, identify the sequence of steps the nurse should follow. (Arrange the steps, placing them in the order of performance. Use all the steps.)

A nurse is providing end-of-life care for a client. Which of the following actions should the nurse take?

A nurse is caring for a group of clients whose primary languages are diﬀerent from the nurse's. For which of the following clients should the nurse provide written materials in the client's primary language?

A nurse is assessing a client who is receiving continuous IV ﬂuids through a peripheral IV. Which of the following findings indicates to the nurse that the client is experiencing ﬂuid overload?