An older adult client returned to the nursing home after a lower limb amputation. The client is scheduled for a prosthesis fitting and states, “I am too old to learn how to manage this.” Which of the following responses from the nurse is appropriate?

I will call your provider so we can discuss it.

What are you thinking that you would like to do?

You have the right to refuse if you don’t think you can do this.

Many clients your age are able to adjust surprisingly well to a prosthesis.

Answer and Explanation

The Correct Answer is D

Choice A Reason: I will call your provider so we can discuss it

While this response shows the nurse’s willingness to involve the healthcare provider, it does not directly address the client’s concern about their ability to manage the prosthesis. It is important to provide immediate reassurance and encouragement to the client, which this response lacks.

Choice B Reason: What are you thinking that you would like to do?

This response is open-ended and encourages the client to express their feelings and thoughts. While it is a good approach to understand the client’s perspective, it does not provide the immediate reassurance and encouragement that the client needs to feel confident about managing the prosthesis.

Choice C Reason: You have the right to refuse if you don’t think you can do this

This response acknowledges the client’s autonomy but may inadvertently reinforce their doubts and fears about managing the prosthesis. It is important to encourage and support the client rather than focusing on their right to refuse.

Choice D Reason: Many clients your age are able to adjust surprisingly well to a prosthesis

This response is the most appropriate as it provides reassurance and encouragement to the client. By sharing that many clients of a similar age have successfully adjusted to a prosthesis, the nurse helps to build the client’s confidence and reduce their anxiety about managing the new situation. This positive reinforcement can be very motivating for the client.

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Correct Answer is ["A","C","D"]

Explanation

Choice A Reason:

Rubeola, also known as measles, is highly contagious and spreads through airborne transmission. The virus can remain infectious in the air for up to two hours after an infected person coughs or sneezes. This makes it one of the most easily spread diseases through airborne particles.

Choice B Reason:

Clostridium difficile (C. diff) is primarily transmitted through the fecal-oral route, not through airborne transmission. It spreads via spores that can survive on surfaces and be ingested, leading to infection.

Choice C Reason:

Varicella, or chickenpox, is transmitted through airborne particles. The virus can spread through direct contact with the fluid from the blisters or through respiratory droplets when an infected person coughs or sneezes. This makes it an airborne disease.

Choice D Reason:

Tuberculosis (TB) is caused by Mycobacterium tuberculosis and spreads through the air when an infected person coughs, speaks, or sings. The bacteria can remain suspended in the air for several hours, making TB an airborne disease.

Choice E Reason:

Staphylococcus aureus is not typically transmitted through airborne means. It spreads through direct contact with infected wounds, contaminated surfaces, or through respiratory droplets in some cases. However, it is not considered an airborne disease.

A. Instruct the client to wear a hospital gown every day, even when out of bed. B. Have the client remain in bed for self-care activities. C. Encourage the client to sit in the chair for all meals. D. Elevate the head of the bed to 30° to 45° for medication administration.

Correct Answer is D

Explanation

Choice A Reason: Instruct the client to wear a hospital gown every day, even when out of bed

This intervention does not directly address the prevention of complications related to immobility. Wearing a hospital gown may be necessary for medical reasons, but it does not promote mobility or prevent complications such as pressure ulcers, muscle atrophy, or deep vein thrombosis (DVT). Encouraging the client to wear regular clothes when out of bed might actually promote a sense of normalcy and encourage more movement.

Choice B Reason: Have the client remain in bed for self-care activities

Keeping the client in bed for self-care activities is counterproductive in preventing complications of immobility. Prolonged bed rest can lead to muscle atrophy, decreased joint mobility, and increased risk of pressure ulcers and DVT. Encouraging the client to get out of bed and perform self-care activities while standing or sitting can help maintain muscle strength and joint flexibility.

Choice C Reason: Encourage the client to sit in the chair for all meals

Encouraging the client to sit in a chair for meals is an effective intervention to prevent complications of immobility. Sitting up helps improve digestion and respiratory function and reduces the risk of pressure ulcers by changing the pressure points on the body. It also promotes muscle activity and circulation, which are crucial in preventing DVT and maintaining overall physical health.

Choice D Reason: Elevate the head of the bed to 30° to 45° for medication administration

While elevating the head of the bed can be beneficial for certain medical conditions and for medication administration, it does not significantly contribute to preventing complications of immobility. This position can help with respiratory function and prevent aspiration during medication administration, but it does not promote overall mobility or prevent muscle atrophy and pressure ulcers.

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An older adult client returned to the nursing home after a lower limb amputation. The client is scheduled for a prosthesis fitting and states, “I am too old to learn how to manage this.” Which of the following responses from the nurse is appropriate?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

An infection control nurse is teaching a class about the transmission of infectious agents. The nurse should include that which of the following diseases is transmitted via airborne transmission? (Select All that Apply.)

Correct Answer is ["A","C","D"]

Explanation

A nurse is caring for a hospitalized client at risk for complications of immobility. Which of the following interventions should the nurse include to prevent complications?

Correct Answer is D

Explanation

A nurse is caring for a client who acquired a Staphylococcus aureus infection from touching a contaminated towel. Through which of the following modes of transmission did the client acquire the infection?

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An older adult client returned to the nursing home after a lower limb amputation. The client is scheduled for a prosthesis fitting and states, “I am too old to learn how to manage this.” Which of the following responses from the nurse is appropriate?