A nurse is working with an older adult and educating the client on how to ambulate with the aid of a walker. The nurse notes that the client appears disengaged and states, “I’m just too old to learn.” What would be most appropriate for the nurse to do to motivate this client?
Tell the client how to move the walker as the client ambulates
Describe how the walker can improve the client’s quality of life
Explain how the walker supports the client’s lower extremities
Fully discuss the rationale for using the walker
The Correct Answer is B
Choice A reason: Instructing on walker movement addresses the psychomotor domain, focusing on physical skills. This does not tackle the client’s emotional disengagement or belief of being “too old.” Without addressing motivation, technical instructions may be ineffective, as the client’s psychological barrier prevents engagement, reducing the likelihood of successful learning and adoption.
Choice B reason: Describing quality-of-life benefits targets the affective domain, addressing emotions and attitudes. By emphasizing enhanced independence, safety, and mobility, the nurse can counter the client’s defeatist mindset. This approach fosters motivation, making the client more receptive to learning walker use, as it connects the intervention to personal, meaningful outcomes.
Choice C reason: Explaining walker support for lower extremities focuses on the cognitive domain, providing technical knowledge. While informative, it does not address the client’s emotional disengagement. Without motivating the client by linking the walker to personal benefits, this approach may fail to overcome their resistance, as it lacks an emotional or motivational component.
Choice D reason: Discussing the rationale for walker use targets the cognitive domain, explaining its purpose. While this may enhance understanding, it does not address the client’s emotional barrier or lack of motivation. Without engaging the client’s feelings or highlighting personal benefits, the rationale alone is unlikely to inspire willingness to learn or use the walker.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Homeostasis is the body’s ability to maintain stable internal conditions, including fluid and electrolyte balance. Imbalances, like hypokalemia or hypernatremia, disrupt cellular function, potentially causing arrhythmias or neurological issues. Restoring homeostasis is the priority, as it addresses the root cause, ensuring proper organ function and preventing complications.
Choice B reason: Preventing infection is important but not the priority in fluid and electrolyte imbalances. Infections may occur secondary to other conditions, but the primary concern is correcting imbalances that affect cellular and organ function. Homeostasis must be achieved first to stabilize the client’s physiological state before addressing infection risks.
Choice C reason: Promoting mobility is relevant for overall health but not the priority in fluid and electrolyte imbalances. Imbalances can cause muscle weakness or arrhythmias, but restoring electrolyte levels takes precedence to ensure safe mobility. Without homeostasis, mobility efforts may be unsafe or ineffective due to physiological instability.
Choice D reason: Enhancing nutrition supports overall recovery but is secondary to correcting fluid and electrolyte imbalances. Nutritional deficiencies may contribute to imbalances, but the immediate goal is restoring homeostasis to prevent acute complications like cardiac or neurological dysfunction. Nutrition can be addressed once the client is stabilized.
Correct Answer is C
Explanation
Choice A reason: A chest X-ray may show secondary signs like atelectasis in pulmonary embolism but is not specific for diagnosis. It primarily rules out other conditions like pneumonia. Pulmonary embolism requires visualization of a clot, which X-rays cannot provide, making them insufficient for confirming the diagnosis.
Choice B reason: An ECG may show tachycardia or right heart strain in pulmonary embolism but is not diagnostic. It detects cardiac changes secondary to the embolism, not the clot itself. Specific imaging, like CT angiography, is needed to visualize the pulmonary artery obstruction for confirmation.
Choice C reason: CT pulmonary angiography is the gold standard for diagnosing pulmonary embolism, as it directly visualizes thrombi in pulmonary arteries using contrast-enhanced imaging. It confirms the presence, location, and extent of the clot, enabling rapid diagnosis and treatment to prevent life-threatening complications like right heart failure.
Choice D reason: Arterial blood gas may show hypoxemia or respiratory alkalosis in pulmonary embolism due to impaired gas exchange but is not diagnostic. It reflects physiological changes, not the clot itself. Imaging, like CT angiography, is required to confirm the presence of a pulmonary artery obstruction.
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