A nurse is reviewing the medical record of an older adult client who is confused to place and time. Which of the following actions should the nurse plan to take?
Place the client on a low-protein diet
Restrict the client's intake of dietary sodium.
Ask the provider to decrease the magnesium hydroxide dosage.
Request a prescription to discontinue diphenhydramine.
The Correct Answer is C
Choice A rationale:
Placing the client on a low-protein diet is not appropriate based solely on the provided information.
Choice B rationale:
Restricting dietary sodium might be considered for specific conditions but is not directly related to the client's confusion.
Choice C rationale:
A high magnesium level can contribute to confusion in older adults. Requesting a reduction in the magnesium hydroxide dosage can help address this issue.
Choice D rationale:
Discontinuing diphenhydramine might be considered if it is contributing to the client's confusion, but there is no specific information provided to support this action.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale:
Radiation therapy is not typically the primary method of treatment for melanoma. Surgical excision and other therapies are often utilized.
Choice B rationale:
Metastasis in melanoma generally occurs from the outer layers of the skin to deeper levels and eventually to other parts of the body.
Choice C rationale:
Specific genetic mutations, such as mutations in the BRAF gene, are associated with an increased risk of developing melanoma.
Choice D rationale: Melanoma is a highly metastatic form of skin cancer that can spread quickly to other parts of the body. Early diagnosis and treatment are crucial to improve outcomes.

Correct Answer is A
Explanation
Choice A rationale:
Assessing for the presence of command hallucinations is a priority, as they can pose a risk to the client's safety and the safety of others.
Choice B rationale:
Consistent staff assignments can be important for clients with schizophrenia, but immediate safety concerns should take precedence.
Choice C rationale:
Administering medication is not the priority action unless there is a specific reason to do so based on the assessment.
Choice D rationale:
Using the client's name is respectful and helpful, but it is not the priority action in this scenario.
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