The nurse is working in a clinic and sees a resident of a long-term-care facility, age 82 years, who has come in to be checked by her physician.
The caregiver accompanying her reports that the client has been displaying the following: drowsiness, excessive sleeping, decreased attention span, irritability, and signs of depression.
The client's daughter and family, who usually visit her, moved away from the area 6 weeks ago due to the husband's job.
The nurse suspects which problem?

Choice A rationale

Relying solely on written communication can be time-consuming and may not be suitable for all situations or for clients with low literacy. While it can be a useful adjunct, it shouldn't replace verbal communication entirely.

Choice B rationale

Reducing time spent with the client can hinder effective communication and relationship building. It doesn't address the communication barrier and may leave the client feeling unheard and uncared for.

Choice C rationale

Speaking loudly can distort sounds and make it harder for someone with a hearing deficit to understand. It can also be perceived as disrespectful or condescending. The approach should focus on clarity, not volume.

Choice D rationale

Background noise, such as a television, can significantly interfere with a hearing-impaired person's ability to understand speech. Reducing or eliminating such distractions creates a clearer auditory environment, facilitating better comprehension of verbal communication.

Choice A rationale

Nurse practice acts, established at the state level, delineate the scope of nursing practice. They define the specific actions, duties, and responsibilities that nurses are legally authorized to perform based on their education, licensure, and experience. These acts also outline what activities fall outside the permissible boundaries of nursing practice to protect patient safety and maintain professional standards.

Choice B rationale

A primary objective of state nurse practice acts is to safeguard the public by regulating the practice of nursing. Through licensure requirements, standards of care, and disciplinary procedures, these acts ensure that only qualified and competent individuals provide nursing care. This regulation helps to maintain accountability within the profession and protect patients from potential harm due to unqualified or unethical practice.

Choice C rationale

The regulation of nursing practice primarily falls under the jurisdiction of individual state governments, not the federal government. Each state has its own board of nursing or similar regulatory body that is responsible for developing and enforcing the state's nurse practice act. While federal laws may influence healthcare, the direct oversight and regulation of nursing licensure and practice are state responsibilities.

Choice D rationale

Student nurses are held to the same standards of care as licensed nurses when providing patient care. Although they are still in the learning process and work under supervision, they are expected to adhere to established safety protocols and ethical principles. Their actions can have consequences, and they are accountable for the care they provide, just as licensed nurses are.

Choice E rationale

If a student nurse faces disciplinary action by a state board of nursing due to violations of nursing practice standards or unprofessional conduct, it can indeed impact their eligibility to take the National Council Licensure Examination (NCLEX). State boards have the authority to determine who is eligible for licensure, and disciplinary actions can lead to delays or even prohibition from taking the examination, depending on the severity of the infraction.