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CASAL 1 OA Remediation Quiz 2023 Graded A+ Actual test $9.49   Add to cart

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CASAL 1 OA Remediation Quiz 2023 Graded A+ Actual test

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CASAL 1 OA Remediation Quiz 2023 Graded A+ Actual test Which risk factor would the nurse identify as the most significant indicator for increased risk for patient falls? A client with prior history of falling. A client with visual and hearing impairment. A client who grabs onto furnit...

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  • February 19, 2023
  • 13
  • 2022/2023
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CASAL 1 OA Remediation Quiz 2023 Graded A+ Actual
test
Which risk factor would the nurse identify as the most significant indicator for increased
risk for patient falls?


A client with prior history of falling.

A client with visual and hearing impairment.

A client who grabs onto furniture as an ambulatory aid.

A client experiencing urinary incontinence and urgency.
A client who grabs onto furniture as an ambulatory aid.

Rationale
All options are indicators, but according to the Morse Fall Scale Assessment a client
who uses furniture as an ambulatory aid is rated as "30" points versus prior history of
falls is rated as "25 points".
What should the nurse do to demonstrate proper body mechanics when assisting a
client to a standing position from a sitting position? (Select all that apply.)


Rock their own body weight as they pull the client up towards them.

Keep their own knees locked as they lift the client in a smooth motion.

Stand in front of the client, move their own feet apart and bend at the knees.

While standing behind the client, secure their own arms around the client's chest and lift
upward.

Assess the client and determine whether or not another care provider is needed to
assist.
Rock their own body weight as they pull the client up towards them.
Stand in front of the client, move their own feet apart and bend at the knees.
Assess the client and determine whether or not another care provider is needed to
assist.

Rationale
Pulling is easier than lifting and the momentum by rocking the nurse's body uses that
body weight to enhance the force of arm muscles. Moving feet apart widens the base of
support and bending knees lowers the center of gravity. These actions are elements of

, safe body mechanics. When possible, use teams to lift clients ast is decreases the
incidences of lower back injuries in healthcare workers and is safer for the client.
What nursing interventions should be implemented for a client whose absolute
neutrophil count (ANC) is below 500?


Admit to a reverse isolation room.

Begin bleeding precaution protocol.

Caution against any cut flowers in client's room.

Screen and limit individuals wishing to visit.

Provide only fresh organic fruits and vegetables.
Admit to a reverse isolation room.
Caution against any cut flowers in client's room.
Screen and limit individuals wishing to visit.

Rationale
The client has neutropenia and is at risk for infection. A reverse isolation, positive
pressure room is teh best choice for these clients. Cut flowers and live plants, along
with fruits and vegetables have been shown to carry organisms that could cause harm
to the immuno-compromised client. Visitors of these clients need to be limited and
screen for possible signs of infection which could be lethal to an immuno-compromised
client.
Which questions are best for the nurse ask to assess for "disuse syndrome" in clients
diagnose with neuromuscular diseases such as muscular dystrophy or multiple
sclerosis? (Select all that apply.)

What is included in a typical day for you?

Do you feel you are financially stable?

In what part of town is your home located?

How much assistance do you need to move around?

On a scale 1-10, how would you rate overall pain level?
What is included in a typical day for you?
How much assistance do you need to move around?
On a scale 1-10, how would you rate overall pain level?

Rationale
These questions are open-ended and will give insight to the client's activity level
throughout the day and eating habits; whether or not their living environment is adaptive

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