A nurse is communicating with a family that includes an elder who has neurologic problems. What should the nurse suggest the family include in the home to lessen the likelihood of injury to the elder?
A) Scatter rugs rather than wall-to-wall carpeting
B) Soft, restful lighting in all areas
C) Kitchen chairs with wheels for easy movement
D) Smoke alarms with batteries that are replaced often
D
Feedback:
Dim lighting increases the possibility of falls as do loose scatter rugs and furniture with wheels. Smoke alarms are important in every home, but a fire can be especially dangerous to a patient who may respond slowly to danger.
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The nurse caring for a patient with a cerebral aneurysm notes an increase in ICP. Which of the following nursing interventions would be appropriate for this patient?
A) Range-of-motion exercises to prevent contractures B) Encourage independence with ADLs to promote self-esteem C) Encourage family visitation to decrease anxiety D) Absolute bed rest in a quiet nonstimulating environment
An adolescent boy has recently had an increase in his Lithium dosage. The parents call the clinic because their son has been ill with a fever and chest congestion that seems to be getting worse. The nurse should:
1. State that this is not a side effect of the medication, and their son was probably exposed to a virus. 2. State that the patient is adjusting to the medication, and this is normal. 3. Be seen by the doctor immediately because these are signs of lithium toxicity. 4. Encourage the parents to give the child Acetaminophen to see if the symptoms subside.
All of the following persons should receive a dose of the meningococcal vaccine except:
A. a 19-year-old who received a first dose at 12 years of age. B. a 22-year-old who has not received the vaccine and will be moving to a college dormitory. C. a 35-year-old who will be traveling to a country where meningococcal disease is hyperendemic. D. a 15-year-old who received a first dose at 11 years of age.
The nurse is caring for a client with a fever of 101.8°F oral. Which other vital signs should the nurse anticipate would be affected?
1. Pulse rate 2. Respiratory rate 3. Diastolic blood pressure 4. Systolic blood pressure 5. Oxygen saturation