A nurse on a medical-surgical unit is caring for a client.
Exhibits
Drag words from the choices below to fill in each blank in the following sentence.
The client is at risk for developing dropdown and dropdown
The Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"B"}
The client is at risk for developing pressure injury and foot drop. Given the client's history of a recent cerebrovascular accident (CVA) and the inability to reposition themselves, there is a heightened risk for pressure injuries due to prolonged periods of immobility. Additionally, the observed occasional movement of the left arm and leg with the right side without movement suggests a potential for muscle weakness or paralysis, which can lead to foot drop, characterized by difficulty in lifting the front part of the foot.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Returning the excess medication to the secure cabinet is not appropriate as it can lead to contamination and safety issues.
B. Saving the excess medication for the next administration is not safe practice due to potential contamination.
C. Placing the excess medication in the sharps container is not the correct procedure for disposing of controlled substances.
D. Having a second nurse witness the disposal of the excess medication ensures proper documentation and accountability for controlled substances.
Correct Answer is A
Explanation
A. Discussing initiating hospice care is appropriate to address the client's desire to go home for end-of-life care and to provide support and resources for the family.
B. Extending the hospital stay may not align with the client's wishes for end-of-life care at home.
C. Placing the client in a nursing home may not be in line with the client's preference to go home.
D. While the family may provide palliative care, the nurse should also explore hospice care options for comprehensive support.
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