A nurse is reviewing home care with a client who has multiple sclerosis. Which of the following precautions should the nurse recommend to promote client safety?

Use a cane for support while walking.

Walk with feet close together for stability.

Avoid the use of orthotics.

Implement a rigorous range-of-motion exercise plan.

Answer and Explanation

The Correct Answer is A

Choice A reason: Using a cane provides stability and reduces fall risk for clients with multiple sclerosis, who often experience muscle weakness or balance issues. This assistive device promotes safe mobility, aligning with evidence-based safety strategies, making it the correct precaution for home care.
Choice B reason: Walking with feet close together decreases stability, increasing fall risk in multiple sclerosis due to impaired coordination. A wider stance is recommended for balance, making this precaution incorrect and potentially dangerous for the client’s safety.
Choice C reason: Avoiding orthotics is not advisable, as they can support mobility and prevent foot drop in multiple sclerosis. Orthotics improve safety and function, so discouraging their use is counterproductive, making this an incorrect recommendation for home safety.
Choice D reason: A rigorous range-of-motion exercise plan may cause fatigue or injury in multiple sclerosis, where moderated exercise is preferred. Overexertion exacerbates symptoms, so this plan is unsafe and inappropriate, making it incorrect for promoting client safety.

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Correct Answer is B

Explanation

Choice A reason: Advising over-the-counter medications as safe is incorrect, as many, like NSAIDs, increase warfarin’s bleeding risk by inhibiting platelets or affecting liver metabolism. Warfarin’s narrow therapeutic index requires careful management to prevent hemorrhage, making broad safety claims dangerous without specific evaluation.
Choice B reason: Consulting the pharmacist identifies interactions with warfarin, a vitamin K antagonist metabolized by CYP450 enzymes. Many drugs alter warfarin’s efficacy, risking thrombosis or bleeding. Pharmacist expertise ensures safe polypharmacy, maintaining therapeutic INR levels critical for managing pulmonary emboli effectively.
Choice C reason: Recommending warfarin with other medications ignores interaction risks and timing needs. Warfarin’s absorption is unaffected by timing, but CYP450 interactions can alter INR. This advice is irrelevant to safety, missing the need for individualized regimen assessment to prevent complications in anticoagulation therapy.
Choice D reason: Cranberry juice may enhance warfarin’s effect by inhibiting CYP2C9, increasing INR and bleeding risk. Advising its use without monitoring is unsafe, as dietary factors can destabilize anticoagulation, potentially causing hemorrhage in clients with pulmonary emboli, requiring careful dietary guidance.

A. Remove the thermometer from the client’s room for use on another client. B. Wear a gown when providing care. C. Wash hands with an alcohol-based cleaner. D. Wear an N95 respirator when in the room.

Correct Answer is B

Explanation

Choice A reason: Removing a thermometer for use on another client risks cross-contamination, as C. difficile spores are highly transmissible. Dedicated equipment is required to prevent spread, so this action is incorrect and violates infection control protocols.
Choice B reason: Wearing a gown during care prevents C. difficile spore transmission via contact, a key precaution for this infection. This aligns with CDC contact isolation guidelines, protecting staff and other patients, making it the correct action.
Choice C reason: Washing hands with alcohol-based cleaner is ineffective against C. difficile spores, which require soap and water to physically remove them. This action is incorrect and inadequate for infection control in this scenario.
Choice D reason: Wearing an N95 respirator is unnecessary, as C. difficile is not airborne. Contact precautions (gown, gloves) suffice, so this action is incorrect and overprotective, wasting resources without addressing the transmission mode.

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A nurse is reviewing home care with a client who has multiple sclerosis. Which of the following precautions should the nurse recommend to promote client safety?

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