Basic Care and Comfort Practice Question
Question
The nurse is caring for a client with impaired sensation and is focused on elimination care scenario 12. Which nursing action is most appropriate?
Answer choices
- A. Delay assessment until the next scheduled round if the client is not calling for help.
- B. Promote privacy, hydration, mobility, and ordered bowel or bladder interventions.
- C. Delegate the clinical assessment and nursing judgment to assistive personnel.
- D. Document the concern without notifying the appropriate provider or care team member when escalation is needed.
Correct Answer
B. Promote privacy, hydration, mobility, and ordered bowel or bladder interventions.
Explanation
The priority action for elimination care is to promote privacy, hydration, mobility, and ordered bowel or bladder interventions. NCLEX-style prioritization favors safety, assessment, appropriate delegation, timely escalation, and client-centered teaching.
Question details
- Difficulty: medium
- Domain: Basic Care and Comfort
- Objective: elimination care