A nurse is preparing to teach clients. Which client finding will cause the nurse to postpone a teaching session? (Select all that apply)
The client is currently febrile with an oral temperature of 101.2°F
The client is mildly anxious about their condition.
The client is reporting feeling nauseated
The client's pain rated 8 out of 10 on a numerical scale
The client is asking questions about their health status.
Correct Answer : A,C,D
A. A febrile state indicates that the client may not be in an optimal condition to learn effectively, so postponing the session is appropriate.
B. Mild anxiety may not require postponement, as it can be addressed during teaching.
C. Nausea can significantly impair concentration and engagement in learning, warranting a delay.
D. A pain level of 8 out of 10 suggests significant discomfort, making it challenging for the client to focus on learning.
E. Asking questions indicates engagement and a readiness to learn, so this does not warrant postponing the session.
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Correct Answer is B
Explanation
A. Decreasing dietary protein does not directly affect the spread of respiratory infections. Protein is important for maintaining immune function.
B. Obtaining flu vaccines is an effective way to reduce the spread of respiratory infections, especially among older adults who are at higher risk.
C. Overhydration is not related to infection control and is not necessary in this context.
D. While handkerchiefs may help with containing respiratory droplets, disposable tissues are generally more hygienic.
E. Limiting daily activity is unnecessary for preventing respiratory infections and could negatively impact overall health.
Correct Answer is D
Explanation
A. A pulse of 60 is low but does not necessarily indicate a need to stop suctioning if the patient remains stable otherwise.
B. A pulse of 90 is within normal limits and does not require stopping suctioning.
C. An oxygen saturation of 92% is slightly low but still acceptable; suctioning can continue if the client is stable.
D. An oxygen saturation of 89% is below the acceptable threshold and indicates hypoxia, prompting the nurse to stop suctioning immediately to avoid further compromising the client's respiratory status.
E. A blood pressure of 130/80 is within normal limits and does not warrant cessation of suctioning.