What was the item in the suicidal client's room during the safety exercise at school that was on the back of the chair? The:
Bed sheet
Patient gown
Beige jacket
Blow dryer
The Correct Answer is C
A. Bed sheet is a common item considered a safety risk in real clinical settings, but in this specific safety exercise, it was not the item identified as being on the back of the chair.
B. Patient gown is typically worn by the client and would not usually be placed on the back of a chair as a risk item during a safety evaluation.
C. Beige jacket is correct. In the safety exercise scenario, the beige jacket was on the back of the chair, and it could pose a ligature risk, making it a key item of concern in suicide prevention protocols.
D. Blow dryer may be a potential safety risk in general, but it was not the item noted on the back of the chair in the described scenario.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Polyphagia is incorrect. Polyphagia (excessive hunger) is typically associated with diabetes mellitus, not diabetes insipidus. In diabetes insipidus, the primary issue is excessive thirst and urination, rather than increased appetite.
B. Dehydration is correct. Diabetes insipidus causes the kidneys to excrete large volumes of dilute urine, leading to dehydration. Clients with this condition may experience excessive thirst (polydipsia) and urinate large amounts of water, leading to dehydration if fluid intake doesn't keep up with the loss.
C. Bradycardia is incorrect. Bradycardia (slow heart rate) is not a typical finding in diabetes insipidus. On the contrary, dehydration resulting from excessive urination could lead to tachycardia (increased heart rate) as a compensatory mechanism.
D. Hyperglycemia is incorrect. Hyperglycemia (high blood glucose) is characteristic of diabetes mellitus, not diabetes insipidus. In diabetes insipidus, blood glucose levels are typically normal since the condition does not involve insulin or glucose metabolism.
Correct Answer is A
Explanation
A. Monitor blood pressure closely for fluctuations is correct. After an adrenalectomy for pheochromocytoma, it is critical to closely monitor the client's blood pressure. Pheochromocytomas are tumors of the adrenal glands that cause excessive production of catecholamines (like epinephrine and norepinephrine), leading to severe hypertension. Postoperatively, the sudden removal of the tumor may cause blood pressure fluctuations, including hypotension after the excess catecholamines are no longer being produced. Monitoring blood pressure is key to detecting complications like hypotension or hypertensive crises early.
B. Check the client's urine output every hour is incorrect. While urine output is important to monitor in general postoperative care, it is not the priority in this case. The more immediate concern following adrenalectomy for pheochromocytoma is blood pressure control and hemodynamic stability, not just urine output.
C. Evaluate the client's pain level using a numeric scale is incorrect. While managing pain is essential, the priority assessment postoperatively for this particular procedure is to monitor for hemodynamic changes, particularly due to the risk of fluctuating blood pressure. Pain can be managed after addressing the primary concerns.
D. Assess the surgical site for signs of infection is incorrect. While infection is a concern for any postoperative patient, the most immediate risk after adrenalectomy for pheochromocytoma is hemodynamic instability due to catecholamine imbalance. Monitoring blood pressure takes precedence over checking for infection in the early postoperative period.
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