When examining an older patient in the home, the home health nurse notices irregular patterns of bruising at different stages of healing on the patient’s body. Which action should the nurse take first?

Correct Answer: C

Rationale: Step 1: Talking with the patient alone allows for open communication and assessment of the situation. Step 2: Asking about the bruising can provide insight into the cause, such as potential abuse or neglect. Step 3: It is essential to gather information directly from the patient to ensure their safety and well-being. Step 4: This action prioritizes the patient's autonomy and right to disclose information. It also demonstrates a patient-centered approach. Summary: Option C is correct because it focuses on communication and assessment to address potential safety concerns. Options A and B address fall prevention, which is not the immediate concern. Option D jumps to radiographs without understanding the situation.

Correct Answer: A

Rationale: The correct answer is A: Thinning of the affected skin. High-potency topical corticosteroids can lead to skin atrophy, causing thinning of the skin with prolonged use. This adverse effect is important to assess for as it can increase the risk of skin fragility and potential for skin tears or bruising. Choice B: Alopecia of the affected areas is not typically associated with the use of topical corticosteroids, so it is an incorrect choice. Choice C: Dryness and scaling are common symptoms of atopic dermatitis itself, not directly caused by the corticosteroid ointment, making this choice incorrect. Choice D: Reddish-brown skin discoloration is not a common adverse effect of topical corticosteroids and is not typically seen with their use, making this choice incorrect.

Correct Answer: C

Rationale: The correct answer is C because applying a thick layer of corticosteroid cream can lead to overuse and potential side effects such as skin thinning. The appropriate amount of cream should be applied thinly and evenly to the affected area. Choice A is correct as taking a tepid bath can help cleanse the area before application. Choice B is correct as spreading the cream in a downward motion can prevent further irritation. Choice D is incorrect as covering the area with a dressing is not recommended for corticosteroid cream application, as it can lead to increased absorption and potential side effects.

Correct Answer: B

Rationale: The correct answer is B. A significant height loss in the patient's mother with aging suggests potential osteoporosis, a musculoskeletal issue common in older women. This would prompt a more focused assessment of the patient's musculoskeletal system to evaluate for osteoporosis risk factors, such as family history. Choices A, C, and D do not directly relate to musculoskeletal health or risk factors for musculoskeletal conditions. A past ankle sprain at age 13 is not a current issue; taking ibuprofen for headaches is more related to the neurological system, and the father's cause of death does not provide relevant information for assessing the patient's musculoskeletal health.

Correct Answer: D

Rationale: The correct answer is D because a history of recent loss of balance and fall in an elderly patient may indicate potential underlying issues such as vestibular dysfunction, neurological problems, medication side effects, or musculoskeletal issues. Further assessment and intervention are crucial to prevent future falls and ensure patient safety. A: Symmetric joint swelling of fingers is common in older adults and may be related to arthritis or other degenerative conditions, but it does not necessarily require immediate intervention. B: Decreased right knee range of motion could be due to age-related changes or arthritis, which may warrant assessment but does not pose an immediate safety risk. C: Report of left hip aching when jogging may indicate musculoskeletal issues or overuse injury, but it does not pose an immediate safety concern that requires urgent intervention.