During a community health screening fair for older adults, a nurse notices a client with pale, bluish feet and sores on both lower extremities that are healing poorly.
What should the nurse’s intervention be?
Instruct the client to apply antibiotic ointment to the sores.
Create a list of foods that promote wound healing.
Refer the client to a healthcare provider for a complete evaluation.
Send the client to the emergency department for treatment.
The Correct Answer is C
Answer and explanation The correct answer is C. Choice A rationale
While applying antibiotic ointment to the sores might help prevent infection, it does not address the underlying issue causing the sores and poor healing.
Choice B rationale
Although a diet rich in nutrients can promote wound healing, it is not the most immediate need for this client. The client’s symptoms suggest a serious underlying condition that requires medical evaluation.
Choice C rationale
The client’s symptoms of pale, bluish feet and sores on both lower extremities that are healing poorly suggest a severe and untreated medical condition, possibly related to circulation or skin integrity. Therefore, the nurse should refer the client to a healthcare provider for a complete evaluation.
Choice D rationale
Sending the client to the emergency department for treatment might be necessary in some cases, but it is more appropriate to first refer the client to a healthcare provider for a complete evaluation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C","D","E"]
Explanation
Answer and explanation
The correct answers are Choices A, B, C, D, and E.
Choice A rationale
Feeding assistance may be necessary for an older adult with Parkinson’s disease due to motor symptoms like tremors or stiffness that can make self-feeding difficult. Special utensils and other dining aids can help these individuals maintain their independence during meals.
Choice B rationale
People with Parkinson’s disease can experience changes in their skin, such as becoming oily or flaky. While the term “fragile skin” is not typically used in the context of Parkinson’s, these individuals may have skin that is more susceptible to damage due to these changes.
Choice C rationale
Parkinson’s disease often leads to motor symptoms such as stiff muscles and balance impairment, which can increase the risk of falls. Therefore, measures to prevent falls should be a key part of the care plan for an older adult with Parkinson’s disease.
Choice D rationale
Chronic pain is twice as common in people with Parkinson’s disease as it is in people without the condition. This pain can be caused by various factors, including muscle stiffness and dystonia (painful muscle spasms), and should be addressed in the client’s care plan.
Choice E rationale
Depression is more common in people with Parkinson’s disease compared to the general population. It’s important to monitor for signs of depression in these individuals and provide appropriate treatment if necessary.
Correct Answer is D
Explanation
Answer and explanation
The correct answer is Choice D.
Choice A rationale
While older adults living in subsidized housing near an airport may have exposure to various environmental hazards, lead poisoning is not typically associated with these conditions. Lead poisoning is more commonly associated with exposure to lead-based paint, which is often found in older homes.
Choice B rationale
Young adults who frequently camp and hike in remote desert areas are not typically at high risk for lead poisoning. Lead exposure is more commonly associated with certain occupational environments and older residential buildings.
Choice C rationale
While a diet high in fish and other seafood can expose individuals to certain environmental contaminants, lead poisoning is not typically associated with these food sources. Lead exposure is more commonly associated with certain occupational environments and older residential buildings.
Choice D rationale
Families with young children living primarily in 100-year-old farmhouses would likely benefit most from a lead poisoning education and screening program. Older homes, particularly those built before 1978, often contain lead-based paint, which can pose a significant risk for lead poisoning, especially in young children.
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