A nurse is caring for a client who has bilateral eye patches in place following an injury. When the client’s food tray arrives, which of the following interventions should the nurse take to promote independence in eating?
Ask the client if she would prefer a liquid diet.
Assign an assistive personnel to feed the client.
Explain to the client that her tray is here and place her hands on it.
Describe to the client the location of the food on the tray.
The Correct Answer is D
Choice A rationale
Asking the client if she would prefer a liquid diet does not promote independence in eating. It may limit the client’s dietary options and does not address the need for the client to learn how to eat independently with bilateral eye patches.
Choice B rationale
Assigning an assistive personnel to feed the client does not promote independence. It makes the client reliant on others for feeding, which does not help in developing self-feeding skills.
Choice C rationale
Explaining to the client that her tray is here and placing her hands on it is a step towards promoting independence. However, it does not provide enough information for the client to locate and identify the food items on the tray independently.
Choice D rationale
Describing to the client the location of the food on the tray promotes independence by enabling the client to use her sense of touch and memory to locate and consume the food items without assistance.
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Correct Answer is A
Explanation
Choice A rationale
A phlebotomist who collects blood from clients who have HIV is at the greatest risk for contracting HIV. This is because they are frequently exposed to blood, which is a bodily fluid that can transmit HIV if proper precautions are not taken.
Choice B rationale
A nurse who works for an insurance company and collects urine samples from clients who have HIV is at a lower risk compared to a phlebotomist. Urine is not a common transmission route for HIV.
Choice C rationale
An occupational therapist who works with a client who has HIV is at a lower risk compared to a phlebotomist. Occupational therapists are not typically exposed to blood or other high-risk bodily fluids.
Choice D rationale
A personal trainer who works with a client who has HIV is at a lower risk compared to a phlebotomist. Personal trainers are not typically exposed to blood or other high-risk bodily fluids.
Correct Answer is C
Explanation
Choice A rationale
Erythema and edema of the affected ear are more commonly associated with external otitis (swimmer’s ear) rather than otitis media. Otitis media involves the middle ear, not the external ear canal.
Choice B rationale
Pain when manipulating the affected ear lobe is also indicative of external otitis. In otitis media, the pain is usually deeper and not affected by manipulation of the ear lobe.
Choice C rationale
Tugging on the affected ear lobe is a common sign in toddlers with otitis media. This behavior is due to the discomfort and pressure in the middle ear caused by the infection.
Choice D rationale
Clear drainage from the affected ear is not typical of otitis media. If there is drainage, it is usually purulent (pus-like) and indicates a ruptured eardrum.