The practical nurse (PN) receives change of shift report on a postpartum unit. Which client should receive the PN's attention first?
A client who needs to ambulate to the bathroom for the first time since the birth of her infant.
A client prepared for discharge who has a question about the teaching she received the day before.
A client with twins who is tired and would like her babies returned to the newborn nursery.
A post cesarean client with a prescription to have her indwelling urinary and intravenous
The Correct Answer is A
A. A client who needs to ambulate for the first time since delivery requires the PN’s immediate attention to ensure safety and prevent complications such as orthostatic hypotension or falls.
B. A client prepared for discharge who has a question about teaching is important but does not take precedence over immediate safety concerns related to the client’s physical activity.
C. A tired client with twins who would like her babies returned to the nursery is important for the client’s well-being, but it is not as urgent as ensuring the safety of a postpartum client beginning to ambulate.
D. Removing indwelling urinary and intravenous catheters is important but not as urgent as ensuring the safety of a client ambulating for the first time after birth.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","C","D","F","G"]
Explanation
A. Throw away soiled clothing.
Not Applicable
Throwing away soiled clothing does not address the issue of elder mistreatment and may not be relevant to the investigation of abuse or neglect. Instead, the focus should be on assessing the situation, documenting evidence, and ensuring the client’s safety. The PN’s role includes observing signs of mistreatment and reporting them, not managing personal items.
B. Report findings to Adult Protective Services.
Applicable
Reporting to Adult Protective Services is crucial for initiating a formal investigation into suspected elder mistreatment. These agencies are equipped to handle allegations of abuse and neglect through professional investigation and intervention. This step ensures that the client receives the appropriate protection and that any mistreatment is addressed legally.
C. Complete a comprehensive history.
Applicable
A comprehensive history helps the PN understand the client’s background, current living conditions, and any potential patterns of mistreatment. This information is essential for identifying signs of abuse or neglect and for making an informed report to the appropriate authorities. It also assists in documenting the client’s experiences and concerns.
D. Perform a thorough physical assessment.
Applicable
A thorough physical assessment allows the PN to identify and document signs of physical abuse or neglect, such as injuries or unsanitary conditions. This documentation is important for supporting the findings in the report to Adult Protective Services and for planning further interventions. The assessment provides evidence of mistreatment and helps in evaluating the client’s overall well-being.
E. Question the client in front of the suspected abuser.
Not Applicable
Questioning the client in front of the suspected abuser can be unsafe and may lead to further mistreatment of the client. It is important to conduct these discussions privately to protect the client and obtain accurate information. The PN should gather information discreetly and report findings to the authorities without risking the client’s safety.
F. Develop a safety plan.
Applicable
Developing a safety plan is essential for ensuring the client’s immediate safety and preparing for any potential risks of mistreatment. This plan addresses how the client can be protected from further harm and outlines steps for seeking help if needed. It is a proactive measure to safeguard the client’s well-being.
G. Take photographs to document the abuse or neglect.
Applicable
Photographs serve as objective evidence of abuse or neglect, which is valuable for investigations by Adult Protective Services. Documenting visual evidence helps in assessing the severity of the mistreatment and supports the report made to authorities. It provides a clear record of conditions that might otherwise be subjective or difficult to convey.
H. Confront the abuser about concerning actions.
Not Applicable
Confronting the abuser can escalate the situation and put the client at further risk of mistreatment. This action should be handled by professionals trained to manage such situations. The PN’s role is to observe, document, and report findings rather than directly addressing the suspected abuser
Correct Answer is ["2"]
Explanation
The prescription is for 0.25 mg of digoxin, and each tablet contains 0.125 mg.
By dividing the prescribed dose (0.25 mg) by the strength of each tablet (0.125 mg), we get 2.
Answer = 2
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