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. Apply lotion to sacrum: Applying lotion may help with general skin hydration but does not directly address pressure relief, which is the primary intervention needed to prevent worsening of a stage one pressure injury.
B. Use wet-to-dry dressings daily: Wet-to-dry dressings are used for wounds with necrotic tissue that need debridement. A stage one pressure injury involves intact skin without an open wound, so such dressings are not appropriate.
C. Elevate head of bed 30 degrees: Elevating the head of the bed slightly can reduce aspiration risk but also increases pressure on the sacrum if maintained for long periods. Position changes are more critical to relieve sacral pressure.
D. Change positions every 2 hours: Repositioning every two hours is essential to relieve pressure on the sacrum and promote circulation. This practice helps prevent progression of the pressure injury and is a cornerstone of effective pressure ulcer prevention.

A. Show the UAP how to use a transfer belt to safely move the client. B. Work with the UAP to use a mechanical lift and sling for the transfer. C. Instruct the UAP to use a pivot technique when moving the client. D. Notify the charge nurse that the client can not be transferred.

Correct Answer is B

Explanation

A. Show the UAP how to use a transfer belt to safely move the client: A transfer belt is useful for clients who can bear some weight and follow instructions. Since the client is confused and cannot bear weight, using a transfer belt is unsafe and increases the risk of injury.
B. Work with the UAP to use a mechanical lift and sling for the transfer: A mechanical lift provides the safest method for transferring a confused, non-weight-bearing client. It minimizes the risk of injury to both the client and staff while ensuring the transfer is done safely and correctly.
C. Instruct the UAP to use a pivot technique when moving the client: Pivot techniques require the client to bear weight and follow simple directions, neither of which is appropriate given the client's confusion and inability to bear weight.
D. Notify the charge nurse that the client cannot be transferred: While updating the charge nurse may eventually be needed, the immediate action is to modify the transfer method to ensure the client's needs are safely met using appropriate equipment.

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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

An older adult client with a stage one sacral pressure wound is discharged with instructions for home care. Which information should the practical nurse reinforce with the client?

Correct Answer is D

Explanation

The practical nurse (PN) assigns an unlicensed assistive personnel (UAP) the task of transferring an alert client from the bed to the chair. The UAP reports to-the PN that the client is confused and cannot bear weight. Which action should the PN implement?

Correct Answer is B

Explanation

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