Which client has the greatest need for special mouth care?

A 37-year-old who has insulin-dependent diabetes mellitus.

A 58-year-old who wears dentures.

A 26-year-old who is on bed rest.

A 45-year-old who is NPO.

Answer and Explanation

The Correct Answer is A

A 37-year-old who has insulin-dependent diabetes mellitus has the greatest need for special mouth care. This is because diabetes can affect the blood vessels and nerves in the mouth, leading to dry mouth, gum disease, infections, and delayed healing. Special mouth care for this client would include regular brushing and flossing, using a soft toothbrush or foam brush, rinsing with water or saline, checking for signs of inflammation or infection, and avoiding sugary or acidic foods and drinks.

Choice B is wrong because a 58-year-old who wears dentures does not have a greater need for special mouth care than a diabetic client.

Dentures can be removed and cleaned with a soft toothbrush and denture cleaner, and soaked overnight in a denture solution. The gums and mouth should also be cleaned daily with a soft toothbrush or gauze.

Choice C is wrong because a 26-year-old who is on bed rest does not have a greater need for special mouth care than a diabetic client. Bed rest can cause dry mouth and plaque accumulation, but these can be prevented by regular brushing and rinsing, drinking water frequently, and using sugar-free gum or lozenges.

Choice D is wrong because a 45-year-old who is NPO (nothing by mouth) does not have a greater need for special mouth care than a diabetic client. NPO can cause dry mouth and bad breath, but these can be alleviated by regular rinsing with water or saline, applying water-based lip balm or moisturizer, and using artificial saliva products if needed.

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Correct Answer is B

Explanation

“My medication will be given at the scheduled times to best manage my pain.” This statement demonstrates understanding of the pain management plan because it shows that the client knows the importance of preventing pain from becoming severe by taking medication regularly. Scheduled administration of analgesics is more effective than administering them on demand.

Choice A is wrong because it implies that the client will wait until the pain is severe before asking for medication, which can make it harder to control.

Choice C is wrong because it suggests that the client expects to receive inadequate pain relief due to their history of opioid abuse, which is not ethical or evidence-based.

Choice D is wrong because it indicates that the client believes they will be denied any narcotics for pain, which is also not ethical or

evidence-based. Clients with a history of opioid abuse can still receive opioids for acute pain, but they may need higher doses or more frequent administration to achieve adequate analgesia.

Normal ranges for vital signs are as follows: respiratory rate 12-20 breaths per minute, heart rate 60-100 beats per minute, blood pressure 120/80 mmHg, temperature 36.5-37.5°C (97.7- 99.5°F).

A. Call for assistance. B. Give 2 rescue breaths. C. Check for apical pulse. D. Begin chest compressions.

Correct Answer is A

Explanation

This is because the nurse should first ensure that help is on the way before performing any other actions on an unconscious and unresponsive client. Calling for assistance may also alert someone who can bring an automated external defibrillator (AED) if needed.

Choice B is wrong because giving 2 rescue breaths is part of CPR, which should only be done after checking for a pulse and finding none or a weak one.

Giving rescue breaths to a client who has a pulse may cause harm.

Choice C is wrong because checking for apical pulse is not the most reliable way to assess circulation in an emergency situation. The nurse should check for a carotid pulse instead, which is easier to locate and more indicative of blood flow to the brain.

Choice D is wrong because beginning chest compressions is also part of CPR, which should only be done after calling for assistance and checking for a pulse and finding none or a weak one.

Chest compressions may cause harm to a client who has a pulse.

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Which client has the greatest need for special mouth care?

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