The nurse would recognize which of the following patients would be at highest risk for developing an infection?
74 year old female with malnutrition and a foley catheter in place
54 year old female admitted for chest pain observation
34 year old male admitted for seizure observation
78 year old male with right sided hemiplegia following a stroke
The Correct Answer is A
A. 74-year-old female with malnutrition and a foley catheter in place:
Malnutrition can weaken the immune system, making the individual more susceptible to infections. Additionally, the presence of a foley catheter increases the risk of urinary tract infections.
B. 54-year-old female admitted for chest pain observation:
Chest pain observation does not inherently increase the risk of infection.
C. 34-year-old male admitted for seizure observation:
Seizure observation does not inherently increase the risk of infection.
D. 78-year-old male with right-sided hemiplegia following a stroke:
While the hemiplegia following a stroke may pose mobility challenges, the presence of malnutrition and a foley catheter in option A puts the patient at a higher risk for infection.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Protect the muscles of the lower extremities from atrophy:
This statement is not the primary purpose of sequential compression devices (SCDs) and compression stockings. While these devices can help maintain muscle tone by promoting blood circulation, their primary function is to prevent blood pooling and reduce the risk of deep vein thrombosis (DVT).
B. Keep the blood from pooling in lower extremities to avoid clots:
This is the correct purpose of sequential compression devices and compression stockings. They are designed to promote venous return and prevent blood from pooling in the lower extremities, thereby reducing the risk of blood clots, especially in individuals at risk for deep vein thrombosis (DVT).
C. Keep the patient from getting sores on the skin:
Preventing sores on the skin is not the primary purpose of these devices. While improved circulation may contribute to skin health, preventing skin sores is not the primary therapeutic goal of SCDs and compression stockings.
D. Keep the patient’s joints in working order:
Maintaining joint function is not the primary purpose of sequential compression devices and compression stockings. These devices primarily focus on promoting venous circulation and preventing complications related to blood pooling and clot formation.
Correct Answer is C
Explanation
A. 30 degrees:
This angle does not meet the criteria for a High Fowler's position, which requires a more upright position.
B. 15 to 20 degrees:
This angle is lower than what is generally considered as High Fowler's position. High Fowler's is a more upright position.
C. 90 degrees:
High Fowler's position involves elevating the head of the bed to 90 degrees. This position is often used for better lung expansion and respiratory function.
D. 45-60 degrees:
While this range is higher than a semi-Fowler's position, it is not as upright as the 90-degree elevation in a High Fowler's position.
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