ATI RN
Client Safety Alternatives to Restraints Quizlet Questions
Question 1 of 5
The nurse is developing a plan of care for a client with disturbed body image. Which interventions would the nurse most likely include in the plan? Select all that apply.
Correct Answer: A
Rationale: The correct answer is A (Establish rapport with the client) because building a trusting relationship is essential in addressing disturbed body image. By establishing rapport, the nurse can create a safe environment for the client to express their feelings and concerns. Choice B (Role model appropriate behavior) may not directly address the client's distorted body image issues and might not be as effective as building rapport. Choice C (Encourage client to make positive self-statements) may be helpful in boosting self-esteem, but it may not address the underlying causes of the disturbed body image. Choice D (Assist the client in accepting responsibility for own actions) is not directly related to addressing disturbed body image and may not be as effective as building rapport in this context.
Question 2 of 5
The nurse conducting a community health promotion class on sexuality includes that a person's biologic sex is determined by:
Correct Answer: B
Rationale: The correct answer is B because biologic sex is determined by both external and internal genitalia, which are physical characteristics present at birth. This is based on chromosomal and hormonal factors that dictate the development of male or female reproductive organs. Choice A is incorrect as sexual intercourse does not determine biologic sex. Choice C refers to gender identity, not biologic sex. Choice D pertains to sexual orientation, not biologic sex. In summary, the physical characteristics of external and internal genitalia are the key factors in determining a person's biologic sex.
Question 3 of 5
What is the leading cause of injury-related deaths in adults 65 and older?
Correct Answer: A
Rationale: The correct answer is A: Falls. Older adults are at higher risk of falls due to factors like decreased balance and mobility. Falls are the leading cause of injury-related deaths in this age group. Violence (B) is less common, alcoholism (C) is a health issue but not the leading cause of injury-related deaths, and MVAs (D) are more common in younger age groups.
Question 4 of 5
A nurse conducted an assessment of a new patient who came to the medical clinic. The patient is 82 years old and has had osteoarthritis for 10 years and diabetes mellitus for 20 years. He is alert but becomes easily distracted during the assessment. He recently moved to a new apartment, and his pet beagle died just 2 months ago. He is most likely experiencing:
Correct Answer: B
Rationale: The correct answer is B: Depression. The patient's symptoms such as being easily distracted, recent life changes, and the loss of his pet suggest a mood disorder rather than a cognitive impairment like dementia (A) or delirium (C). The patient's alertness and ability to engage in conversation indicate that he is not experiencing delirium. Additionally, the patient's medical history of diabetes makes a hypoglycemic reaction (D) less likely, as he is alert during the assessment. Depression is a common comorbidity in patients with chronic illnesses like osteoarthritis and diabetes, and the recent life stressors could exacerbate his depressive symptoms.
Question 5 of 5
When designing a plan for pain management for a postoperative patient, the nurse assesses that the patient's priority is to be as free of pain as possible. The nurse and patient work together to identify a plan to manage the pain. The nurse continually reviews the plan with the patient to ensure that the patient's priority is met. Which principle is used to encourage the nurse to monitor the patient's response to the pain?
Correct Answer: A
Rationale: Correct Answer: A: Fidelity Rationale: 1. Fidelity refers to the nurse's duty to uphold the patient's best interests and maintain trust. 2. By continually reviewing the pain management plan with the patient, the nurse demonstrates fidelity by ensuring the patient's priority of being free of pain is met. 3. Monitoring the patient's response to pain aligns with fidelity as it shows the nurse's commitment to the patient's well-being and trust. 4. Fidelity promotes a therapeutic nurse-patient relationship based on honesty and loyalty. Summary of Incorrect Choices: B: Beneficence - Focuses on doing good for the patient, but does not specifically address the nurse's duty to monitor and uphold the patient's priority of pain management. C: Nonmaleficence - Focuses on avoiding harm, but does not specifically address the nurse's role in monitoring and ensuring the patient's priority of pain management. D: Respect for autonomy - Focuses on respecting the patient's right to make