The practical nurse (PN) is administering an analgesic to a client with low back pain. To promote the effectiveness of the medication, which is the best intervention for the PN to implement?

Assist the client to perform active range of motion and back exercises.

Force fluids and progress diet to include milk products.

Reposition the client with proper alignment and massage the lower back.

Encourage the client to take deep breaths and to ambulate frequently.

Answer and Explanation

The Correct Answer is C

A. Assist the client to perform active range of motion and back exercises: Active exercises can be beneficial in rehabilitation phases but may worsen pain if done too early or without proper pain control. Immediate strategies should focus on comfort and supporting medication effectiveness before promoting activity.
B. Force fluids and progress diet to include milk products: While hydration and nutrition are important for overall health, they do not directly enhance the immediate effectiveness of analgesics. This intervention is unrelated to managing or reducing the client's current low back pain.
C. Reposition the client with proper alignment and massage the lower back: Proper repositioning reduces strain on the spine, improves comfort, and enhances the action of analgesics. Gentle massage promotes circulation and relaxation, helping to amplify pain relief when combined with medication.
D. Encourage the client to take deep breaths and to ambulate frequently: Deep breathing and early ambulation are excellent for preventing complications like pneumonia and deep vein thrombosis especially in clients with decreased mobility due to pain but may not be appropriate as an initial intervention to maximize immediate pain relief from analgesics.

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Correct Answer is D

Explanation

A. Sacrum: The sacrum is a common site for pressure ulcers in a supine position, but once the client is turned onto the side, pressure shifts away from the sacrum to lateral body surfaces. It is not the most at-risk area in the new position.
B. Ischial tuberosities: The ischial tuberosities bear weight when sitting, not typically when lying in a lateral position. Therefore, they are less likely to be the first site to show erythema when turned onto the side.
C. Lateral malleolus: The lateral malleolus can be at risk when the lower legs rub against the bed, but it is a smaller surface area and would show signs later compared to larger, more pressure-exposed areas like the iliac crest.
D. Iliac crest: The iliac crest on the side the client is turned onto bears significant pressure in the lateral position. It is a major bony prominence directly exposed to force against the mattress, making it the most likely site to show early erythema.

A. Provide a PRN hypnotic medication. B. Reassure the client that it is still early. C. Evaluate the room environment. D. Close the door to the client's room.

Correct Answer is C

Explanation

A. Provide a PRN hypnotic medication: Administering a hypnotic should not be the first response without first assessing the underlying cause of the sleep difficulty. Non-pharmacological approaches are safer, especially for older adults who are more sensitive to sedative side effects.
B. Reassure the client that it is still early: Simply reassuring the client does not address the immediate concern of why the client cannot sleep. Dismissing the complaint without assessment may lead to prolonged distress and unresolved sleep disturbances.
C. Evaluate the room environment: Assessing the room for factors like noise, lighting, temperature, and comfort is a priority because environmental factors often contribute significantly to insomnia. Addressing modifiable conditions can promote natural sleep without immediately resorting to medications.
D. Close the door to the client's room: While closing the door might reduce noise, it is a single action that may not fully address all potential environmental issues affecting sleep. A complete evaluation of the environment is necessary first to identify and correct all possible disruptions.

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The practical nurse (PN) is administering an analgesic to a client with low back pain. To promote the effectiveness of the medication, which is the best intervention for the PN to implement?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The practical nurse (PN) turns a client with right sided paralysis from a supine to a left lateral position. Which bony prominence is most likely to manifest signs of erythema when first turned?

Correct Answer is D

Explanation

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Correct Answer is C

Explanation

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