When visiting a client's home, which action should the nurse take to ensure personal safety and respect the client's household values?
Always carry personal protective equipment in a visible manner.
Always start the visit by discussing the client's medical history.
Request the client to leave the room during the nurse's assessment.
Ask for permission before entering each room in the home.
The Correct Answer is D
A. Always carry personal protective equipment in a visible manner: While PPE is important for infection control, displaying it prominently may create fear or imply mistrust. PPE should be used appropriately without compromising rapport or household comfort.
B. Always start the visit by discussing the client's medical history: Beginning with medical history may overlook establishing rapport and respecting the client’s household norms. Initial engagement should prioritize trust, cultural sensitivity, and comfort before detailed health discussions.
C. Request the client to leave the room during the nurse's assessment: Asking the client to leave is unnecessary and may be perceived as disrespectful or intrusive. Assessments should involve the client when appropriate, maintaining privacy and dignity without excluding them unnecessarily.
D. Ask for permission before entering each room in the home: Seeking permission demonstrates respect for the client’s privacy, personal space, and household values. It establishes trust, supports safety, and aligns with culturally sensitive, patient-centered care practices.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Use positive facial expressions and open-ended questions: Active listening in pediatrics involves creating a supportive environment through nonverbal cues and open-ended questions that encourage the child to express thoughts and feelings at their own pace. This approach fosters trust and communication.
B. Focus on completing the assessment quickly: Rushing the assessment may increase the child’s anxiety and discourage disclosure. Active listening requires patience and attention rather than prioritizing speed.
C. Assure the child that their feelings are not important: Minimizing or dismissing the child’s emotions undermines trust and can exacerbate emotional distress. Recognizing feelings as valid is essential for effective communication.
D. Directly ask the child to explain their feelings: Direct questioning may feel confrontational or overwhelming, especially if the child is hesitant. Open-ended questions and supportive cues are more effective for eliciting responses in a non-threatening way.
Correct Answer is D
Explanation
A. Stage II: Stage II pressure injuries involve partial-thickness skin loss with exposed dermis. The injury may present as a blister, shallow ulcer, or abrasion. Since the skin in this case is intact, it does not meet Stage II criteria.
B. Stage IV: Stage IV pressure injuries are full-thickness tissue losses with exposed bone, tendon, or muscle. This severe stage is accompanied by extensive tissue damage, which is not present in this scenario.
C. Stage III: Stage III injuries involve full-thickness skin loss with damage or necrosis of subcutaneous tissue. The injury may extend down to, but not through, underlying fascia. The intact skin observed here does not qualify as Stage III.
D. Stage I: Stage I pressure injuries are characterized by non-blanchable erythema of intact skin, usually over a bony prominence. This is the earliest stage and indicates localized tissue damage without loss of skin integrity, matching the scenario described.
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