Care of Patients with Chronic Illnesses > Fundamentals
Exam Review
Collaborative Care in the Community Setting
Total Questions : 4
Showing 4 questions, Sign in for moreA nurse is caring for a client who has a history of recurrent urinary tract infections (UTIs). Which of the following actions should the nurse take to prevent UTIs in this client?
Explanation
The nurse should teach the client to urinate before and after sexual intercourse, as this can help flush out any bacteria that may have entered the urinary tract during sexual activity, reducing the risk of UTIs.
Incorrect options:
A) Encourage the client to drink cranberry juice daily. - This is an incorrect option, as there is insufficient evidence to support the use of cranberry juice for preventing or treating UTIs. Cranberry juice may also interact with some medications, such as warfarin, and increase the risk of bleeding.
B) Instruct the client to wipe from back to front after urination. - This is an incorrect option, as wiping from back to front can introduce bacteria from the anal area into the urethra, increasing the risk of UTIs. The client should be instructed to wipe from front to back after urination and bowel movements.
D) Advise the client to limit fluid intake to 1.5 L per day. - This is an incorrect option, as limiting fluid intake can reduce urine output and allow bacteria to multiply in the urinary tract, increasing the risk of UTIs. The client should be advised to drink at least 2 L of water per day, or more if advised by the health care provider, to promote adequate hydration and urinary elimination.
A nurse is conducting a home visit for a client who has diabetes mellitus and hypertension. The nurse notices that the client has several empty bottles of soda and bags of chips on the kitchen counter. Which of the following statements should the nurse make?
Explanation
The nurse should use an open-ended question to assess the client's dietary habits and preferences, as well as any barriers or challenges that may affect their food choices. This can help the nurse identify areas for education and intervention, and provide individualized and client-centered care.
Incorrect options:
A) "You should avoid eating these foods, as they can worsen your blood sugar and blood pressure levels." - This is an incorrect option, as it is a directive statement that may sound judgmental or accusatory, and may elicit resistance or defensiveness from the client. The nurse should avoid using "should" statements and instead use motivational interviewing techniques to elicit change talk from the client.
C) "These foods are high in calories, sugar, and sodium, which can have negative effects on your health." - This is an incorrect option, as it is an informative statement that may not address the client's readiness or motivation for change. The nurse should avoid providing information without first assessing the client's knowledge level and interest in learning.
D) "I can refer you to a dietitian who can help you plan a balanced diet that meets your nutritional needs." - This is an incorrect option, as it is a premature action that may not reflect the client's goals or preferences. The nurse should avoid making referrals without first exploring the client's needs and expectations.
A nurse is collaborating with a social worker to provide care for a client who has schizophrenia and lives alone in a low-income housing complex. The social worker reports that the client has been missing appointments and not taking medications as prescribed. Which of the following actions should the nurse take first?
Explanation
The nurse should use the nursing process to provide care for clients with mental health disorders. The first step of the nursing process is assessment, which involves collecting data about the client's physical, psychological, social, and environmental factors that may affect their health and well-being. By visiting the client at home, the nurse can directly observe the client's mental status and living conditions, and identify any potential problems or needs.
Incorrect options:
A) Contact the client's family members and ask them to check on the client regularly. - This is an incorrect option, as it is an intervention that should be implemented after assessing the client and determining their level of support and involvement from family members. The nurse should also respect the client's privacy and autonomy, and obtain their consent before contacting their family members.
B) Arrange for a home health aide to visit the client daily and administer medications. - This is an incorrect option, as it is an intervention that should be implemented after assessing the client and determining their level of functioning and adherence to medications. The nurse should also consider the client's preferences and resources, and collaborate with them to develop a realistic and individualized plan of care.
C) Call the client and express concern about their well-being and adherence to treatment. - This is an incorrect option, as it is an intervention that should be implemented after assessing the client and determining their level of engagement and motivation for treatment. The nurse should also avoid using confrontational or coercive language, and instead use therapeutic communication techniques to establish rapport and trust with the client.
A nurse is providing discharge teaching to a client who has chronic obstructive pulmonary disease (COPD) and uses supplemental oxygen at home. Which of the following instructions should the nurse include in the teaching?
Explanation
The nurse should instruct the client to avoid smoking or being near open flames while using oxygen, as this can pose a serious fire hazard and risk of injury. The nurse should also advise the client to keep a fire extinguisher nearby and post "no smoking" signs in their home.
Incorrect options:
A) "You should keep your oxygen flow rate between 2 to 4 L/min." - This is an incorrect option, as the oxygen flow rate should be prescribed by the health care provider based on the client's condition and oxygen saturation level. The nurse should instruct the client to follow the prescribed oxygen flow rate and not adjust it without consulting the health care provider.
B) "You should use a humidifier with your oxygen therapy." - This is an incorrect option, as the use of a humidifier with oxygen therapy depends on the type of oxygen delivery device and the client's comfort level. The nurse should instruct the client to follow the manufacturer's instructions for using a humidifier with their oxygen device, and monitor for signs of dryness or irritation in their nose or mouth.
D) "You should check your oxygen saturation level every 4 hours." - This is an incorrect option, as the frequency of checking the oxygen saturation level depends on the client's stability and response to oxygen therapy. The nurse should instruct the client to check their oxygen saturation level as directed by the health care provider, and report any changes or concerns.
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