A nurse is providing discharge teaching about safety considerations to an older adult client who lives at home. The client has heart failure and a new prescription for hydrochlorothiazide. Which of the following statements by the client indicates an understanding of the teaching?
"I will weigh myself once weekly."
"I will take my new medication in the evening."
"I will take a hot bath before going to bed."
"I will leave a light on in my bathroom at night."
The Correct Answer is D
A. "I will weigh myself once weekly." Clients with heart failure should weigh themselves daily to monitor for fluid retention. A sudden weight gain (e.g., 2-3 lbs in 24 hours or 5 lbs in a week) may indicate worsening heart failure and should be reported to the provider.
B. "I will take my new medication in the evening." Hydrochlorothiazide is a diuretic that increases urine output. Taking it in the evening can lead to nocturia and sleep disturbances. Instead, it should be taken in the morning to minimize nighttime urination.
C. "I will take a hot bath before going to bed." Hot baths can cause vasodilation, leading to a drop in blood pressure (orthostatic hypotension), which increases the risk of dizziness and falls, especially in older adults taking diuretics. A warm (not hot) bath is safer.
D. "I will leave a light on in my bathroom at night." Older adults, especially those taking diuretics like hydrochlorothiazide, are at increased risk for nocturia and falls due to frequent trips to the bathroom. Keeping a light on in the bathroom at night enhances visibility and reduces the risk of falls, which is a major concern in this population.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. "We can discuss what you can expect during your stay."
This statement acknowledges the client's feelings of anxiety and offers support by indicating a willingness to discuss what they can expect during their stay. Providing information about the facility's routines, procedures, and what to expect can help alleviate anxiety by giving the client a sense of control and understanding. It also opens the door for the client to ask questions and express any concerns they may have.
B. "Most people are scared their first time in a health care facility":
While this statement attempts to normalize the client's feelings by suggesting that it is common to feel scared, it may not effectively address the client's individual concerns or provide reassurance. Additionally, some clients may not find comfort in knowing that others are also scared.
C. "You have nothing to worry about. Everything will be fine":
This statement may come across as dismissive of the client's feelings and does not acknowledge or validate their anxiety. It also makes assumptions about the client's experience and may not be accurate for all clients. Providing blanket reassurances without addressing the client's specific concerns may not be effective in alleviating their anxiety.
D. "Why are you feeling scared about being in this facility?":
While it is important for the nurse to explore the client's feelings and concerns, asking a direct question like this may put pressure on the client to articulate their anxiety without offering immediate support or reassurance. It is better to provide a statement that offers support and opens the door for the client to express their concerns in their own time and comfort level.
Correct Answer is B
Explanation
A. Avoid pinching the skin when injecting the needle:
This instruction is not specific to the use of a prefilled, multidose pen for insulin administration. Pinching the skin may be necessary for some injection techniques but is not directly related to the use of a prefilled pen.
B. Use pen needles that have a safe-needle protection device attached.
Using pen needles with a safe-needle protection device attached ensures safe handling and disposal of the needle after use, reducing the risk of accidental needlestick injuries. These devices help prevent accidental needlesticks by covering the needle after use, reducing the risk of transmission of bloodborne pathogens.
C. Use the dominant hand to recap the needle before removing it from the pen device:
Recapping needles is not recommended as it increases the risk of needlestick injuries. Additionally, the use of the dominant hand for recapping is not essential and may not be safe practice.
D. Remove the needle from the pen device before placing the needle in a sharps container:
It's crucial to dispose of needles safely in a sharps container immediately after use without removing the needle from the pen device. Removing the needle before disposal increases the risk of needlestick injuries. The entire pen needle unit, including the needle, should be disposed of intact into an appropriate sharps container to minimize the risk of injury to healthcare workers and others handling the waste.
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