The nurse is caring for a patient admitted with weakness and has a history of osteoporosis and obesity. What nursing intervention should the nurse implement while providing hygiene care?

Inspect the patient's feet for a diabetic ulcer.

Expose the full body to ensure efficiency.

Encourage the patient to provide self-care.

Apply baby powder to the perineal area and skin folds.

Answer and Explanation

The Correct Answer is C

A. Inspect the patient's feet for a diabetic ulcer: Patients with obesity are at increased risk for skin breakdown, and foot ulcers may go unnoticed. Early detection prevents complications.

B. Expose the full body to ensure efficiency: Patients should be kept covered as much as possible to maintain dignity, privacy, and body temperature.

C. Encourage the patient to provide self-care: If the patient is able, self-care promotes independence and helps maintain mobility.

D. Apply baby powder to the perineal area and skin folds: Powder can clump and retain moisture, leading to skin irritation and fungal infections, especially in skin folds.

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Correct Answer is A

Explanation

A. "Let me teach you about antibiotics and their usage." This response provides education about antibiotics, including why they are not effective against viral infections. It acknowledges the client’s frustration while promoting understanding.

B. "Let me talk to the provider and see what we can do." This response suggests that the nurse might override the provider’s decision or negotiate an unnecessary prescription, which is inappropriate.

C. "Why do you think you need an antibiotic?" While this question encourages the client to express their thoughts, it may come across as dismissive or challenging rather than supportive.

D. "I understand your frustration. You need an antibiotic." This statement is incorrect because it reinforces a misconception that antibiotics are needed for viral infections, which can contribute to antibiotic resistance.

A. Placing an indwelling urinary catheter B. Administering medications through an NG tube C. Changing a sacral wound dressing D. Replacing an ostomy appliance

Correct Answer is A

Explanation

A. Placing an indwelling urinary catheter: Indwelling urinary catheters are a leading cause of catheter-associated urinary tract infections (CAUTIs), which are common healthcare-associated infections.

B. Administering medications through an NG tube: While NG tubes can introduce bacteria, they are not as high-risk as urinary catheters, which provide a direct route for infection.

C. Changing a sacral wound dressing: While wounds can become infected, proper wound care techniques minimize risk. Urinary catheters pose a greater risk due to prolonged exposure to bacteria.

D. Replacing an ostomy appliance: While maintaining hygiene is important, ostomy appliances are not a major source of healthcare-associated infections compared to urinary catheters.

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The nurse is caring for a patient admitted with weakness and has a history of osteoporosis and obesity. What nursing intervention should the nurse implement while providing hygiene care?

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Naxlex Comprehensive Predictor Exams

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