CDM FINAL EXAM NCLEX Questions & Answers

CDM FINAL EXAM NCLEX Questions & Answers-The nurse is planning care for a client who has severe arthritis and has very limited fine motor hand dexterity. Which of the following would the nurse identify as the most relevant defining characteristic for this client for the nursing diagnosis of Self-Care Deficit: Dressing? Inability to choose clothing Inability to maintain appearance Inability to use zippers Impaired ability to obtain clothing - Inability to use zippers- With limited fine motor dexterity in the hands, the client would most likely have trouble with using zippers, an action that requires fine motor skills. There is no information that suggests the client is unable to choose clothing, maintain appearance, or obtain clothing. The nurse is developing a plan of care for a client who has advanced dementia. The nurse recognizes that there is a Self-Care Deficit: Dressing related to which of the following? Anxiety Cognitive impairment Environmental barriers Weakness - Cognitive impairment- A client with advanced dementia has significant cognitive impairment that could hinder dressing. There is no information about the client having anxiety, weakness, or environmental barriers that make dressing difficult. The nurse is planning care during rehabilitation for a client who experienced left sided weakness following a stroke. Which of the following outcomes would be the most desirable for this client's nursing diagnosis of Self-Care Deficit: Dressing? Client will dress and groom self to optimal potential. Client will identify types of assistive technology. Client will be dressed by a caregiver. Client will explore potential barriers to dressing. - Client will dress and groom self to optimal potential- Dressing and grooming oneself shows the most independence of all the options and therefor is the most desirable outcome. Identifying asistive technology and exploring barriers to dressing assists in developing independence. Being dressed by a caregiver is the least optimal choice as it shows maximal dependence on others. A client had a recent fall and has residual dizziness. What action by the nurse best promotes safety for the client during dressing? Have the client sit for as much dressing as possible. Perform the majority of dressing for the client. Teach the client to hold the bed with one hand. Use a gait belt in case the patient falls during dressing. - Have the client sit for as much dressing as possible- For safety, a patient with dizziness and a history of falls should sit for as much of dressing as possible as this activity can be tiring. Using a gait belt does help prevent falls, but sitting is a better option. Holding the bed with one hand limits the amount of self-dressing the client can do. The nurse performing most of the dressing does not help the client gain or maintain independence. The nurse is teaching a client who has right sided weakness due to a stroke methods for easier dressing. Which of the following interventions should the nurse include in this teaching session? Stand while dressing. Use clothing that fastens in the back. Use smart machine-based prompting. Dress the affected side first. - Dress the affected side first- Dressing the affected side allows for easier manipulation of the client's clothing. A client with weakness may prefer to sit during dressing. Machine-based prompting is helpful for clients with cognitive problems. Clothes that fasten in the back are more difficult to manipulate. The nurse is developing a plan of care for a right hand dominant client who had a right rotator cuff repair. The nurse recognizes that there is a Self-Care Deficit: Feeding related to which of the following? Environmental barriers Musculoskeletal impairment Neuromuscular impairment Perceptual impairment - Musculoskelet