The nurse reads in the patient chart the doctor's day round note. The doctor writes AOX3, the nurse knows this means the patient is oriented to: Select all that apply.

Background

Person

Situation

Place

Time

Answer and Explanation

Correct Answer : B,D,E

A) Background: Orientation to "background" is not a standard component of the "AOX3" (alert and oriented times three) assessment. Typically, orientation assessments focus on more specific elements such as person, place, and time, rather than background information.
B) Person: Orientation to "person" means that the patient is aware of who they are. This is a key aspect of the AOX3 assessment, which checks whether the patient can identify themselves correctly.
C) Situation: While awareness of the situation or current circumstances is important, "situation" is not included in the standard AOX3 assessment. The usual components are person, place, and time.
D) Place: Orientation to "place" means the patient knows where they are. This is a critical component of the AOX3 assessment, indicating that the patient can identify their current location.
E) Time: Orientation to "time" means that the patient is aware of the current date, day of the week, and time of day. This is another essential part of the AOX3 assessment, reflecting the patient's awareness of the temporal context.

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Correct Answer is ["B","C","D","E"]

Explanation

A) Wear socks when walking around the home: Wearing socks, especially if they have smooth soles, can increase the risk of slipping on hard surfaces. Non-slip footwear is recommended for preventing falls. Therefore, recommending socks for walking may not address the safety concerns effectively.
B) Install grab bars in the bathtub: Installing grab bars in the bathtub is a crucial safety measure for preventing falls and providing support for older adults while bathing. This helps reduce the risk of slips and injuries in a common high-risk area for falls.
C) Secure rugs with adhesive tape: Securing rugs with adhesive tape helps prevent them from slipping, which can significantly reduce the risk of tripping and falling. Loose or unsecured rugs are common hazards in the home environment.
D) Use nightlights along stairways and walkways: Using nightlights along stairways and walkways improves visibility and helps prevent falls during the night. Adequate lighting is essential for older adults to navigate their homes safely.
E) Install handrails on both sides of all stairways: Installing handrails on both sides of stairways provides additional support and stability, which is particularly important for older adults to prevent falls while using stairs. This enhancement helps ensure safer navigation of stairs.

A. Delirium B. Sundowning C. Alzheimers D. Dementia

Correct Answer is A

Explanation

A. Delirium: Delirium is characterized by a sudden onset of confusion, agitation, and fluctuating levels of consciousness. It often develops over a short period, such as hours to days, and is typically associated with an underlying medical condition, medication, or infection. The patient's rapid change from being oriented and calm to confused and agitated suggests a sudden onset, which is indicative of delirium.
B. Sundowning: Sundowning refers to a pattern of increased confusion and agitation that occurs in the late afternoon or evening, primarily in individuals with dementia. While it involves fluctuations in mental status, it does not usually present with a sudden onset of symptoms as described in this case.
C. Alzheimer’s: Alzheimer’s disease is a form of chronic dementia characterized by gradual and progressive cognitive decline over months to years. The sudden onset of confusion and agitation does not align with the gradual progression typical of Alzheimer's disease.
D. Dementia: Dementia is a general term for a decline in cognitive ability that affects daily life, usually developing gradually over time. Unlike delirium, dementia does not present with a sudden change in behavior or mental status, making it less likely in this scenario where the change was abrupt.

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The nurse reads in the patient chart the doctor's day round note. The doctor writes AOX3, the nurse knows this means the patient is oriented to: Select all that apply.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which of the following should the nurse include in her teaching plan to address home safety for an older adult client? (Select all that apply.)

Correct Answer is ["B","C","D","E"]

Explanation

Correct Answer is A

Explanation

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