Exhibits
For each potential nursing action, click to indicate whether the action is indicated, contraindicated, or nonessential for this client's plan of care. Each row must have only one option selected.
Instruct incentive spirometry use every hour.
Encourage consumption of protein and vitamin C.
Apply thromboembolism deterrent stockings (TED).
Use Petroleum based lotion on legs
The Correct Answer is {"A":{"answers":"C"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"B"}}
Instruct incentive spirometry use every hour (Nonessential): There is no indication of respiratory compromise, so incentive spirometry is not a priority for this client.
Encourage consumption of protein and vitamin C (Indicated): These nutrients support wound healing and immune function, which are important in managing infection and preventing further complications.
Apply thromboembolism deterrent stockings (TED) (Contraindicated): TED stockings may worsen symptoms if the client has cellulitis or a deep vein thrombosis (DVT), as compression can increase pain and impede circulation in an already swollen and inflamed limb.
Use petroleum-based lotion on legs (Contraindicated): Petroleum-based products can trap moisture and create an environment for bacterial growth, which is not suitable for a client with cellulitis or diabetes. Instead, a diabetic-safe moisturizer should be used while avoiding open wounds.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Obtain at least 8 to 10 hours of sleep per night. Adequate sleep is important for overall health, but it is not a primary recommendation for cancer prevention. There is some evidence linking sleep disturbances to cancer risk, but maintaining a healthy weight and exercising have stronger associations with cancer prevention.
B. Refrain from alcohol. Limiting alcohol intake is recommended, but complete abstinence is not necessary for everyone. Moderate alcohol consumption is associated with an increased risk of certain cancers (e.g., breast, liver, esophageal), but maintaining a healthy weight and exercising have broader, more significant cancer prevention benefits.
C. Maintain a healthy weight and exercise regularly. Obesity and a sedentary lifestyle are major risk factors for multiple types of cancer, including breast, colon, and endometrial cancer. Regular physical activity reduces inflammation, improves immune function, and regulates hormones, all of which lower cancer risk.
D. Know the four warning signs of cancer. While recognizing cancer warning signs is important for early detection, prevention strategies are more effective in reducing overall cancer risk. There is no universally agreed-upon list of "four" warning signs, as different cancers present with different symptoms.
Correct Answer is B
Explanation
A. Developmental stage. While understanding the client’s psychosocial needs is important, the ability to perform daily activities and remain independent is more critical in determining the best living environment.
B. Functional capacity. The ability to perform activities of daily living (ADLs) and instrumental activities of daily living (IADLs) is the most important factor in determining the appropriate living environment. Clients with limited mobility, cognitive decline, or difficulty managing self-care may require assisted living or skilled nursing care.
C. Age and gender. Age and gender alone do not determine the need for a particular living environment. Some older adults remain independent well into their later years, while others may require assistance at a younger age due to functional decline.
D. Medical diagnoses. While medical conditions influence care needs, they do not solely determine living arrangements. A client with a chronic illness who maintains functional independence may still live at home, whereas a client with minimal medical issues but significant functional decline may require assisted care.
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