An 82-year-old client was admitted to the hospital on isolation precautions 3 days ago for C diff. The client begins to demonstrate irritability, confusion, and paranoia.
Which of the following is the best reason for the assessment findings?
Mood disorder.
Sensory deprivation.
Anxiety.
Cerebral vascular accident (CVA).
The Correct Answer is B
Sensory deprivation is a condition in which a person experiences a lack of sensory input or stimulation.
This can result from isolation, confinement, or loss of sensory function. Sensory deprivation can cause psychological and physiological changes, such as irritability, confusion, paranoia, hallucinations, depression, anxiety, and cognitive impairment.
Choice A is wrong because mood disorder is a general term for a group of mental health conditions that affect a person’s emotional state, such as depression, bipolar disorder, or anxiety disorder. Mood disorder is not likely to be caused by isolation precautions for C diff.
Choice C is wrong because anxiety is a feeling of nervousness, worry, or fear that interferes with daily functioning. Anxiety can be triggered by stress, trauma, or other factors, but it is not a direct consequence of isolation precautions for C diff.
Choice D is wrong because cerebral vascular accident (CVA), also known as stroke, is a sudden interruption of blood flow to the brain that causes neurological damage. CVA can cause symptoms such as weakness, numbness, slurred speech, vision loss, or confusion, but it is not related to isolation precautions for C diff.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
This is because the nurse’s reply does not address the client’s fear of radiation therapy, but rather provides factual information that may not be relevant or helpful to the client.
The nurse is not using a therapeutic communication technique, such as reflecting, exploring, or validating the client’s feelings.
Instead, the nurse is shutting down the communication and missing an opportunity to learn more about the client’s concerns and needs.
Choice A is wrong because the nurse is not confronting a painful subject, but rather avoiding it.
The nurse is not acknowledging the client’s fear or inviting the client to talk more about it.
Choice C is wrong because the nurse is not recognizing that the client needs information, but rather assuming that the client does.
The nurse is not asking the client what he or she wants to know about radiation therapy, but rather telling the client what he or she should know.
Choice D is wrong because the nurse is not perceiving that the client is ready to hear more about the treatment, but rather imposing information on the client.
The nurse is not assessing the client’s readiness to learn, but rather giving unsolicited advice.
Correct Answer is C
Explanation
This action would cause the nurse to intervene because it increases the risk of choking and aspiration for a client with dysphagia, which is difficulty swallowing. The nurse would instruct the UAP to feed the client small amounts of food slowly, allowing time for chewing and swallowing.
Choice A is wrong because offering thickened liquids is a safe practice for a client with dysphagia. Thickened liquids allow for easier swallowing and less choking, thus decreasing the chance of aspiration.
Choice B is wrong because placing the client in an upright position is also a safe practice for a client with dysphagia. This position helps prevent food from entering the airway and facilitates swallowing.
Choice D is wrong because allowing ample time between bites is another safe practice for a client with dysphagia. This helps the client avoid feeling rushed or overwhelmed and reduces the risk of aspiration.
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