Which intervention should the nurse implement for a client?

Choice A reason: Placing a mask on the client is unnecessary unless the rash is associated with a respiratory pathogen, which is unlikely for an abdominal rash. PPE, like gloves, is critical to protect the nurse from potential infectious causes, such as herpes zoster, ensuring safety during direct assessment of the rash.

Choice B reason: Determining if pain preceded cream application helps identify the rash’s cause but is not the first priority. Using PPE during assessment protects the nurse from infectious rashes, like herpes zoster, which is suggested by the painful, unilateral distribution. Safety during direct contact takes precedence over historical data collection.

Choice C reason: Questioning exposure to sick children may identify infectious causes like varicella but is secondary to nurse safety. A painful abdominal rash suggests herpes zoster, requiring PPE during assessment. Protecting the nurse from potential pathogens during physical examination is the immediate priority before gathering exposure history.

Choice D reason: Using PPE, such as gloves, is critical when assessing a painful abdominal rash, which may indicate herpes zoster, a contagious infection. PPE prevents nurse exposure to infectious agents during direct contact. This action ensures safety, aligning with infection control protocols, especially for unilateral, painful rashes suggestive of shingles.

Choice A reason: Monitoring heart rate to stay within a suggested range is correct, ensuring safe exercise intensity for older adults. This prevents overexertion, especially with cardiovascular conditions. The statement reflects understanding, as it aligns with evidence-based guidelines for safe exercise, requiring no further teaching on this point.

Choice B reason: Avoiding exercises that impact chronic conditions is overly restrictive and incorrect. Many chronic conditions, like arthritis or diabetes, benefit from tailored exercise to improve function and health. This statement suggests misunderstanding, requiring teaching to clarify that appropriate exercises can manage, not exacerbate, chronic conditions, per geriatric care guidelines.

Choice C reason: Focusing on balance exercises is appropriate for older adults to prevent falls, a major injury risk. This statement shows understanding, as balance training improves stability and safety. No further teaching is needed, as it aligns with evidence-based recommendations for exercise in aging populations to enhance mobility.

Choice D reason: Completing 30 minutes of exercise at least 3 times a week aligns with CDC guidelines for older adults, promoting cardiovascular health and strength. This statement reflects correct understanding of exercise frequency and duration, requiring no further teaching, as it supports safe, effective physical activity for health maintenance.