A nurse is reviewing a client's medical record. Which of the following findings should the nurse identify as a fall risk?
Inguinal hernia
Hyperlipidemia
Multiple sclerosis
Hyperthyroidism
The Correct Answer is C
A. Inguinal hernia: While an inguinal hernia can cause discomfort and potential complications, it is not typically considered a significant fall risk.
B. Hyperlipidemia: This condition affects cholesterol levels and is not directly related to an increased risk of falls.
C. Multiple sclerosis: MS can lead to muscle weakness, balance issues, and coordination problems, which significantly increase the risk of falls.
D. Hyperthyroidism: Although hyperthyroidism can cause symptoms like tremors and muscle weakness, it is less directly associated with fall risk compared to multiple sclerosis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","C","D"]
Explanation
A. Tell the client there is nobody else in the room: This action is not appropriate as it does not address the immediate clinical needs of the client. Providing comfort and managing symptoms is a priority at the end of life.
B. Turn the client on their side: This action helps in relieving pressure, preventing aspiration, and improving respiratory function, which is particularly beneficial when a client is experiencing irregular and shallow breathing.
C. Place a fan to blow lightly toward the client: A fan can help alleviate discomfort from labored breathing and provide a cooling effect, which can be soothing for the client and improve their comfort.
D. Administer an opioid narcotic to the client: Opioids can help manage pain and dyspnea in end-of-life care, improving the client's comfort and quality of life by relieving symptoms of distress.
E. Provide deep nasotracheal suctioning for the client: This action is typically not recommended at the end of life as it can cause discomfort and distress without significant benefit. Gentle suctioning, if necessary, should be performed cautiously and with attention to the client's comfort.
Correct Answer is B
Explanation
A. Inhibits release of endorphins: Exercise actually stimulates the release of endorphins, which are chemicals in the brain that help reduce pain and improve mood. Thus, this statement is incorrect.
B. Improves sleep: Exercise is known to enhance sleep quality by promoting better sleep patterns and reducing insomnia. This is a well-documented benefit of regular physical activity.
C. Decreases energy: Exercise typically increases overall energy levels rather than decreasing them. Regular physical activity helps in maintaining stamina and reducing fatigue.
D. Decreases stress: While exercise does help in managing stress, the primary benefit related to the is the improvement in sleep. Stress reduction is also a significant benefit but not the focus here.
E. Increases mood: Exercise can indeed elevate mood through the release of endorphins and other neurochemicals. However, improving sleep is a more direct and specific benefit related to the about exercise's benefits.
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