A prescription for discharge is written for an elderly client who has asked to be discharged to home. The client lives alone and is able to walk 10 to 15 feet (3 to 4.5 meters) with assistance. Which action should the nurse implement first?

Review the home medication schedule with the client and family.

Provide the client with information about medical alert devices.

Arrange for a bedside commode to be delivered to the home.

Meet with the case manager to plan a home safety evaluation.

Answer and Explanation

The Correct Answer is D

A) Review the home medication schedule with the client and family:
While reviewing the home medication schedule is an important step in ensuring that the client understands their medications, it is not the immediate priority when considering the client's safety at home. The primary concern should be addressing the client’s ability to safely navigate their home environment.

B) Provide the client with information about medical alert devices:
Providing information about medical alert devices is valuable for enhancing the client’s safety. However, it should come after addressing the more immediate concern of assessing the home environment for safety issues. The client’s current ability to walk and potential home hazards need to be evaluated first.

C) Arrange for a bedside commode to be delivered to the home:
While a bedside commode can be helpful for the client’s convenience and safety, it is not the most critical action to address immediately. Ensuring that the overall home environment is safe and suitable for the client’s needs should take precedence.

D) Meet with the case manager to plan a home safety evaluation:
Meeting with the case manager to arrange a home safety evaluation is the most crucial initial step. A home safety evaluation will identify potential hazards and ensure that the living environment is adapted to the client’s needs, which is essential for preventing falls and other accidents. This assessment will help in planning for appropriate modifications and support services to ensure the client’s safety at home.

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Correct Answer is D

Explanation

A) Hepatitis B vaccine:
While Hepatitis B is a significant vaccine for many travelers, especially those at risk of bloodborne pathogen exposure or those planning extended stays, Hepatitis A is more commonly prioritized for short-term travel to developing nations where sanitation and food safety may be compromised.

B) Influenza vaccine:
The influenza vaccine is important for seasonal protection against flu, but it is not specifically targeted at the types of health risks commonly encountered in developing nations. It's generally recommended for annual protection but is not the primary concern for travel to developing countries.

C) Tetanus toxoid vaccine:
Tetanus is a concern for wound management and prevention of tetanus infection, but it is not specific to travel to developing nations. This vaccine is typically part of routine immunizations and might be updated based on injury or specific risk factors, rather than travel alone.

D) Hepatitis A vaccine:
Hepatitis A is crucial for travelers to developing nations because it is transmitted through contaminated food and water. In areas with poor sanitation and hygiene, the risk of Hepatitis A is high. Therefore, the Hepatitis A vaccine should be prioritized to prevent infection in these conditions.

A. Gather information about the client's recent exposure to pesticides. B. Obtain a blood sample to assess for possible lead paint exposure. C. Ask about the length of his workday and frequency of rest breaks. D. Determine the number and age of persons living in the mobile home.

Correct Answer is A

Explanation

A) Gather information about the client's recent exposure to pesticides:
This action is the highest priority because the symptoms described—dizziness, headaches, abdominal cramps, and difficulty breathing—are consistent with pesticide poisoning, which is a common risk for migrant farm workers. Gathering information about recent pesticide exposure will help in identifying if this is the cause of the client's symptoms and guide appropriate treatment or intervention.

B) Obtain a blood sample to assess for possible lead paint exposure:
While lead exposure could be a concern, particularly in older mobile homes, the symptoms described are more immediately suggestive of pesticide poisoning. Prioritizing assessment related to pesticide exposure is more relevant to the client's current symptoms.

C) Ask about the length of his workday and frequency of rest breaks:
While understanding work conditions is important for overall health, the acute symptoms the client is experiencing are more directly linked to chemical exposure. Addressing the potential for pesticide exposure is a more urgent concern.

D) Determine the number and age of persons living in the mobile home:
This information is useful for understanding the living conditions but does not directly address the acute symptoms the client is experiencing. The priority is to identify potential causes of the symptoms, such as pesticide exposure.

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A prescription for discharge is written for an elderly client who has asked to be discharged to home. The client lives alone and is able to walk 10 to 15 feet (3 to 4.5 meters) with assistance. Which action should the nurse implement first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client comes to the public health clinic requesting information about which immunizations to receive prior to visiting a developing nation. Which immunization should the nurse recommend as a priority for this client?

Correct Answer is D

Explanation

A migrant farm worker who lives in a mobile home with several other workers visits the Migrant Health Care Center. The client reports Increasing episodes of dizziness, headaches, abdominal cramps, and difficulty breathing. Which nursing action has the highest priority?

Correct Answer is A

Explanation

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