An adult client is admitted with AIDS and oral Candida albicans manifested by several painful mouth ulcers. The nurse delegates to the assistive personnel (AP) and discusses how to assist the client. Which instruction should the nurse provide?
Offer the client mouthwash for thorough cleansing after brushing teeth.
Assist with personal care, but leave oral care for the nurse to complete.
Provide a soft-bristled toothbrush for the client to use during oral care.
Wear sterile gloves when cleansing any areas of infected mucosa.
The Correct Answer is C
Choice A rationale
Offering mouthwash for thorough cleansing after brushing teeth can be too harsh for clients with painful mouth ulcers caused by Candida albicans. It may cause further irritation and discomfort.
Choice B rationale
While assistive personnel can help with personal care, oral care should not be left solely to the nurse. Providing appropriate tools and guidance for the client to perform oral care is essential.
Choice C rationale
Providing a soft-bristled toothbrush is appropriate for clients with oral Candida albicans. It helps in gentle cleaning without causing additional pain or damage to the mucosa.
Choice D rationale
Wearing sterile gloves is not necessary for routine oral care. Clean gloves are sufficient unless there is a specific need for sterility, such as in surgical procedures.
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Correct Answer is B
Explanation
Choice A rationale
Decreasing speaking speed may help with clarity, but it does not address the issue of hearing loss.
Choice B rationale
Over-enunciating word syllables can help the client understand speech better, especially if they have hearing difficulties. This technique makes it easier for the client to read lips and understand spoken words.
Choice C rationale
Raising voice volume to a shout can be uncomfortable and may not improve understanding. It can also be perceived as rude or aggressive.
Choice D rationale
Exaggerating nonverbal expressions may help with communication, but it is not as effective as over-enunciating word syllables for clients with hearing difficulties.
Correct Answer is C
Explanation
Choice A rationale
Palpating large joints for nodules is not the most effective technique for assessing early signs of rheumatoid arthritis (RA). Nodules typically appear in more advanced stages of RA and are not an early sign.
Choice B rationale
Observing the skin for lesions is not specific to RA. While skin lesions can be associated with other conditions, they are not a primary indicator of early RA1.
Choice C rationale
Observing the client’s fingers is crucial for detecting early signs of RA. Early RA often presents with swelling, tenderness, and stiffness in the small joints of the fingers.
Choice D rationale
Palpating the lymph nodes is not relevant for early RA assessment. Lymph node enlargement is not a typical early sign of RA1.