As a nurse prepares an older adult client for bed on the first night of her hospital stay, the client says, "I am afraid that I may fall getting to the bathroom during the night. I tend to get a bit disoriented in new surroundings." Which of the following actions should the nurse take?

Offer to request a prescription for an indwelling urinary catheter.

Keep a night light on in the client's room.

Put the side rails up and tell the client to call for assistance to the bathroom.

Limit the client's fluid intake in the evening.

Answer and Explanation

The Correct Answer is B

A. Offer to request a prescription for an indwelling urinary catheter.

Indwelling urinary catheters come with their own set of risks and complications. It is generally not recommended to use them solely for the purpose of preventing falls unless there are other medical indications for their use. Catheters increase the risk of infection and other complications, and their use should be based on clear medical necessity.

B. Keep a night light on in the client's room.

This option directly addresses the client's concern about falling during the night. Providing a night light in the room helps to alleviate disorientation, making it safer for the client to navigate to the bathroom. It is a practical and non-invasive intervention.

C. Put the side rails up and tell the client to call for assistance to the bathroom.

While using side rails can be a fall prevention measure, it's important to consider that they are not without risks. Side rails can lead to entrapment or injury if not used appropriately. In addition, telling the client to call for assistance is good advice, but relying solely on this instruction may not address the immediate concern of disorientation in new surroundings.

D. Limit the client's fluid intake in the evening.

While limiting fluid intake in the evening might reduce the frequency of bathroom trips, it is not the most appropriate response to the client's concern. Dehydration can lead to other health issues and should not be used as the primary strategy for fall prevention.

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Free Nursing Study Resources

Correct Answer is ["10"]

Explanation

To calculate the dose of valproic acid oral solution, the nurse should use the following formula:

Dose (mL) = Desired dose (mg) / Concentration (mg/mL)

Plugging in the values from the question, we get:

Dose (mL) = 500 mg / (250 mg / 5 mL)

Simplifying the fraction, we get:

Dose (mL) = 500 mg / 50 mg/mL

Dividing both sides by 50, we get:

Dose (mL) = 10 mL

Therefore, the nurse should administer 10 mL of valproic acid oral solution.

A. Salmeterol B. Diazepam C. Misoprostol D. Penicillin G

Correct Answer is B

Explanation

A. Salmeterol:

Salmeterol is a long-acting beta-agonist bronchodilator used for respiratory conditions. While it does not directly cause sedation, the individual response may vary, and caution should be taken if the client experiences dizziness or lightheadedness.

B. Diazepam:

Diazepam is a medication that belongs to the benzodiazepine class and can cause sedation, drowsiness, and impaired coordination. These side effects increase the risk of falls, especially in older adults. Fall precautions may include measures such as bed alarms, non-skid socks, and close monitoring when the client is ambulating.

C. Misoprostol:

Misoprostol is a medication used to prevent gastric ulcers, and it does not typically cause sedation or affect coordination.

D. Penicillin G:

Penicillin G is an antibiotic and does not have sedative effects that would necessitate fall precautions.

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As a nurse prepares an older adult client for bed on the first night of her hospital stay, the client says, "I am afraid that I may fall getting to the bathroom during the night. I tend to get a bit disoriented in new surroundings." Which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer valproic acid 500 mg PO. Available is valproic acid oral solution 250 mg/5 mL. How many ml should the nurse administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Correct Answer is ["10"]

Explanation

A nurse is reviewing a client's medication administration record. For which of the following medications should the nurse place the client on fall precautions?

Correct Answer is B

Explanation

A nurse is preparing to administer amoxicillin 350 mg PO. Available is amoxicillin 250 mg/5 mL. How many ml. should the nurse administer? (Round to the nearest whole number.)

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A provider is discharging a client with a prescription for home oxygen therapy. The nurse should reinforce which of the following instructions with the client and his family? (Select all that apply.)