An older male resident of a long-term care facility is awake at 3:30 AM and wandering down the hall with his pajamas unbuttoned. Which intervention should the practical nurse (PN) Implement?

Address the client to determine his needs.

Administer a nighttime sedative.

Bring the client to sit in the nursing station.

Direct the client to go back to bed.

Answer and Explanation

The Correct Answer is A

A. Address the client to determine his needs: The most appropriate intervention is to calmly approach the resident, assess his orientation, and determine what he needs. Older adults may wander due to confusion, discomfort, or unmet needs such as hunger, toileting, or pain.

B. Administer a nighttime sedative: Sedatives should not be given without a clear medical indication or provider order, as they increase the risk of falls, confusion, and dependency in older adults. Medication is not the first-line approach for managing nighttime wandering.

C. Bring the client to sit in the nursing station: Bringing the resident to the nursing station may offer temporary supervision but does not address the underlying reason for wandering. It may also cause disorientation or agitation if the environment is bright or noisy.

D. Direct the client to go back to bed: Simply instructing the resident to return to bed may be ineffective and distressing if he is confused or restless. A calm, needs-based approach that prioritizes understanding the cause of the behavior is safer and more therapeutic.

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Correct Answer is B

Explanation

A. Dizziness and weakness: These symptoms are not common complications prevented by esomeprazole. They may occur as side effects of NSAID use or other conditions, but esomeprazole’s primary role is gastrointestinal protection.

B. Gastric ulceration: Esomeprazole, a proton pump inhibitor (PPI), decreases gastric acid secretion and helps protect the stomach lining from erosion caused by NSAIDs. Continuous NSAID therapy increases the risk of peptic ulcers and gastrointestinal bleeding, so adding a PPI reduces acid-related mucosal damage.

C. Joint stiffness and swelling: These symptoms are usually related to the underlying inflammatory condition for which NSAIDs are prescribed. Esomeprazole does not influence joint inflammation or musculoskeletal symptoms.

D. Excessive bruising: Bruising is typically associated with platelet inhibition or anticoagulant use, not NSAID-induced gastric effects. Esomeprazole does not affect coagulation or platelet function and therefore does not prevent bruising.

A. Encourage a warm sleeping environment. B. Keep fingernails trimmed short. C. Do not take any type of tub bath. D. Discourage use of skin lubricants

Correct Answer is B

Explanation

A. Encourage a warm sleeping environment: A warm environment can worsen pruritus by increasing skin dryness and stimulating itch receptors. Heat causes vasodilation, which may intensify itching and discomfort, making a cooler environment more beneficial for relief.

B. Keep fingernails trimmed short: Trimming fingernails helps reduce skin damage from scratching, preventing secondary infection and minimizing skin breakdown. Short nails also decrease the risk of excoriations that can lead to bacterial invasion and delayed healing.

C. Do not take any type of tub bath: Complete avoidance of tub baths is unnecessary. Instead, clients should take brief, lukewarm baths using mild soap and follow with immediate application of moisturizers to restore the skin barrier and relieve itching.

D. Discourage use of skin lubricants: Skin lubricants, such as emollients, are essential in managing pruritus by locking in moisture and soothing irritated skin. Discouraging their use would worsen dryness, exacerbate itching, and hinder comfort and skin integrity.

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An older male resident of a long-term care facility is awake at 3:30 AM and wandering down the hall with his pajamas unbuttoned. Which intervention should the practical nurse (PN) Implement?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The practical nurse (PN) notes that a client who is receiving continuous nonsteroidal antiinflammatory drug (NSAID) therapy has a new prescription for esomeprazole. The PN tells the client that the new medication should reduce the client's risk for which complication?

Correct Answer is B

Explanation

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Correct Answer is B

Explanation

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