when in doubt about using restraints on an agitated patient it is prudent for nurses to when in doubt about using restraints on an agitated patient it is prudent for nurses to
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Gerontology Nursing Questions And Answers PDF

1. When in doubt about using restraints on an agitated patient, it is prudent for nurses to:

Correct answer: C

Rationale: The correct answer is C: 'Use alternatives such as a bed alarm with increased staff supervision.' The Omnibus Budget Reconciliation Act (OBRA) established strict standards on restraint use in long-term care facilities. Restraints can be considered a form of false imprisonment and neglect, leading to potential litigation. Therefore, it is advisable to avoid restraints whenever possible. A bed alarm coupled with enhanced staff supervision provides an effective and non-restrictive approach for managing an agitated patient. Choices A, B, and D are incorrect because restraining the patient, using minor restraints, or avoiding all devices without providing an alternative can pose risks to patient safety, violate regulations, or increase liability concerns.

2. Which of the following is a common symptom of borderline personality disorder?

Correct answer: D

Rationale: Individuals with borderline personality disorder often exhibit impulsive and self-destructive behaviors. These behaviors can include reckless driving, substance abuse, self-harm, and suicidal gestures. These actions are often attempts to cope with intense emotional pain or to avoid feelings of emptiness and abandonment. It is crucial for healthcare professionals to recognize and address these symptoms when diagnosing and treating borderline personality disorder.

3. A community health nurse is reviewing information about infectious diseases with the nurses on her team. The nurse should remind the team that which of the following diseases is included in the list of nationally notifiable infectious diseases?

Correct answer: C

Rationale: The correct answer is Gonorrhea. Gonorrhea is a reportable sexually transmitted disease, and healthcare providers must report cases to the CDC to track and prevent outbreaks. Influenza, Tuberculosis, and Hepatitis B are not nationally notifiable infectious diseases. Influenza is monitored for its epidemiology and impact on public health, but it is not classified as nationally notifiable. Tuberculosis and Hepatitis B are not included in the list of diseases that healthcare providers are required to report to public health authorities.

4. What are the key components of a respiratory assessment?

Correct answer: A

Rationale: The correct answer is A: Inspection, Palpation, Percussion, Auscultation. A focused respiratory assessment involves inspecting the chest for symmetry and signs of distress, palpating for tenderness or abnormal masses, performing percussion to assess underlying tissues, and auscultating lung sounds. Choice B is incorrect as observation is a broad term that can encompass both inspection and palpation. Choice C is incorrect as auscultation is usually performed after inspection and palpation. Choice D is incorrect as observation should be more specific, and auscultation is a key component that is typically done last in a respiratory assessment.

5. A patient is receiving education about taking clozapine. Which statement indicates the patient understands the side effects?

Correct answer: A

Rationale: The correct answer is A because patients taking clozapine should report signs of infection immediately due to the risk of agranulocytosis. Agranulocytosis is a potentially life-threatening side effect of clozapine characterized by a significant decrease in white blood cell count, which can leave the patient vulnerable to infections. Reporting signs of infection promptly is crucial to prevent serious complications.

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