The nurse is repositioning a patient who has a spinal injury and notes reddened areas on the heels of both feet. The nurse should place the patient in which of the following positions?
Lateral heels offloaded with pillows
Supine heels offloaded with pillows
Fowler's heels offloaded with pillows
Prone ankles offloaded with pillows.
The Correct Answer is A
A. Lateral heels offloaded with pillows: Positioning the patient laterally with heels offloaded helps reduce pressure on the heels and prevent pressure sores.
B. Supine heels offloaded with pillows: Although offloading the heels is important, the supine position may still exert pressure on the heels and does not provide as effective offloading as the lateral position.
C. Fowler's heels offloaded with pillows: Fowler’s position may still place some pressure on the heels, even with pillows for offloading.
D. Prone ankles offloaded with pillows: The prone position is generally not recommended for patients with spinal injuries, and it does not effectively address heel pressure.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. The client who is recovering from a motor vehicle collision. This situation involves an acute stressor related to trauma, which is significant but not a developmental stressor.
B. The client that is recently divorced. Divorce is a significant life event that can contribute to developmental stress, especially if it involves major life changes and adjustment issues.
C. The client experiencing the symptoms of menopause. Menopause is a normal developmental phase, though it can be stressful. However, it is less likely to be classified as a significant risk factor compared to other life events.
D. The client newly diagnosed with lung cancer. A new cancer diagnosis is a major stressor and can contribute to significant emotional and psychological stress, but it is more of an acute stressor than a developmental one.
Correct Answer is A
Explanation
A. Sexually transmitted infections: This is relevant for young adults as preventive measures can help avoid STIs, which is an important health issue in this age group.
B. Communicable diseases: While important, communicable diseases are a broader category and might not be as specific to the preventive focus for young adults.
C. Cardiovascular disease: Cardiovascular disease becomes a more significant concern in middle adulthood, so it is less relevant to preventive measures for young adults.
D. Mental health alterations: Mental health issues are significant and relevant for young adults, but cardiovascular disease is more specific to preventive measures for the transition into middle adulthood.
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