I'm confused about a test question. Help please

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I just had my first exam yesterday and I had a few problems but not many. This particular question I had a lot of trouble with and wanted someone’s opinion about what they thought the right answer would be.

A 63 year old man is in a nursing home for dementia and is often confused. The patient’s family inquires about the restraints being used on this patient. Which would be your response regarding the type of restraint that were being used on this patient.

A. Thumbless mitt restraints will be used keep patient from pulling out catheter

B, Full mummy restraint

C. Vest restraints to keep patient from falling out of bed

D. Restraints are the only way to keep a patient safe from injury.

I felt like this question didn’t provide enough information. It didn’t even state what the client was doing to need restraints. I agree that thumbless mitt restraints would keep the patient from pulling out a catheter however the question didn’t say he had a catheter. I didn’t think a full mummy restraint would be acceptable. I didn’t read much about the vest restraints, in lab we just practiced using them for a client in a wheelchair. And I didn’t pick the last answer because our book basically states that restraints are the last resort and that alternatives should be tried first.

Could someone help me out with what they think the answer to this question is.

Thanks

Sara

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Specializes in ER.

WOW.. tough question.. I agree with all of your rationales, because with restraints you want to go with the least restrictive and work your way up.. considering he has dementia I wouldnt put any of those restraints on , none of them seem right

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Specializes in PeriOp, ICU, PICU, NICU.

Tough one. I would have picked A. Vest restraint seemed to harsh-but who knows. You always do less restrictive-so maybe that is why I leaned towards A versus C

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D. I wouldn't agree with this statement

C. Vest restraints to keep patient from falling out of bed - I wouldn't use - why would the patient have to be kept in bed?

B. mummy restraints would limit this patient too much, so I would not agree to use them

A. mitt restraints - there is no mention that the patient has a catheter (are we to assume that all confused, demented patients have a catheter?) - it's about the least restrictive of the selections

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A. Thumbless mitt restraints will be used keep patient from pulling out catheter

B, Full mummy restraint

C. Vest restraints to keep patient from falling out of bed

D. Restraints are the only way to keep a patient safe from injury.

Excuse me for interjecting - I am not a nursing student... YET, but I am a former nursing home social worker.

A - Honestly I don't think mitt restraints would prevent a patient that was hell bent on pulling out a catheter from doing so. I have seen a lot in the nursing home, and I can just see some man putting one mitt on one side and another on another, give a tug and ... taaadaaa.. no more catheter!

B - No no no.. full mummy restraints are RARELY if ever used. Least restrictive restraint.

C - to me seems to be the mostly likely correct answer. Vest restraints WILL keep a wandering, CONFUSED, patient in bed AT NIGHT. Remember, dementia patients tend to wander at night.

D- is false. Restraints are not the ONLY way to keep a patient safe from injury.

I am interested in finding out the correct answer. Post when you know.

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Specializes in PeriOp, ICU, PICU, NICU.
Excuse me for interjecting - I am not a nursing student... YET, but I am a former nursing home social worker.

A - Honestly I don't think mitt restraints would prevent a patient that was hell bent on pulling out a catheter from doing so. I have seen a lot in the nursing home, and I can just see some man putting one mitt on one side and another on another, give a tug and ... taaadaaa.. no more catheter!

B - No no no.. full mummy restraints are RARELY if ever used. Least restrictive restraint.

C - to me seems to be the mostly likely correct answer. Vest restraints WILL keep a wandering, CONFUSED, patient in bed AT NIGHT. Remember, dementia patients tend to wander at night.

D- is false. Restraints are not the ONLY way to keep a patient safe from injury.

I am interested in finding out the correct answer. Post when you know.

Only problem here, you can't use own life experiences. Answers are what textbook world and NCLEX world want. Remember, in these worlds you have unlimited staff, equipment and it's well just perfect :lol2:

It's so hard not to read into questions and/or think what one has seen in practice..........;)

OP: So, what IS the correct answer as per your instructor?

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Only problem here, you can't use own life experiences. Answers are what textbook world and NCLEX world want. Remember, in these worlds you have unlimited staff, equipment and it's well just perfect :lol2:

It's so hard not to read into questions and/or think what one has seen in practice..........;)

OP: So, what IS the correct answer as per your instructor?

Well if the OP didn't leave any wording out of the question, why would the man have a catheter in the first place? According to the question, he is in the nursing home for dementia, and confusion. What is the catheter for? You can't catheterize a pt because they are incontinent, so its hard NOT to read into the question lol. I still say C, because vest restraints can be normal protocol for wandering, falling patients. Catheters and mitts are not, unless he is in the nursing home for something other than dementia. Very confusing question.

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Specializes in PeriOp, ICU, PICU, NICU.
Well if the OP didn't leave any wording out of the question, why would the man have a catheter in the first place? According to the question, he is in the nursing home for dementia, and confusion. What is the catheter for? You can't catheterize a pt because they are incontinent, so its hard NOT to read into the question lol. I still say C, because vest restraints can be normal protocol for wandering, falling patients. Catheters and mitts are not, unless he is in the nursing home for something other than dementia. Very confusing question.

It is very hard to read into them. But, I don't think it has to mention in the stem that he had a foley. Who knows, I may be brain fried from studying these crazy practice q's that I may be crazy..........lol

Depends where the instructor got her question from. At my school, they got it from various test banks and we had to assume there were standing orders if they were in answer choices.........so who knows.

It's kind of like the questions that say.........what would the nurse do next. The answer may be to give fluids etc but the stem didn't say they had an IV. I don't

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Specializes in med/surg, telemetry, IV therapy, mgmt.
a 63 year old man is in a nursing home for dementia and is often confused. the patient’s family inquires about the restraints being used on this patient. which would be your response regarding the type of restraint that were being used on this patient.

a. thumbless mitt restraints will be used keep patient from pulling out catheter

b, full mummy restraint

c. vest restraints to keep patient from falling out of bed

d. restraints are the only way to keep a patient safe from injury.

restraints are only to be applied for the safety of the patient. i would go back to the root of your question which says "the patient’s family inquires about the restraints being used on this patient." answer choices "a" and "c" are basically the same and the root of the question does not stipulate that the patient has a catheter or is confined to the bed, so i wouldn't assume either condition to exist. and, "b" makes absolutely no sense whatsoever. i say "d" is the answer although i don't like the use of the word "only" in it. having worked in ltc i know there are other ways besides restraints to keep patient's safe. however, it's the only logical choice i see that you can pick. i say it's a question with badly worded answer choices.

i'm giving you a link to the title 42 law on restraints in long term care.

http://a257.g.akamaitech.net/7/257/2422/09nov20051500/edocket.access.gpo.gov/cfr_2005/octqtr/42cfr483.358.htm

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Specializes in CNA; LPN Student.

Wow that is hard, I guess if I had to pick one I would of picked C, because he is confused and I guess you wouldn't want him to fall out of bed sooo, yeah LOL. But in reality I wouldn't pick any of them because you only use restraints as a last resort and only with a doctors order.

Which one did you pick?

ETA I like Daytonites answer better! LOL

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Specializes in Telemetry/Med Surg.

I would go with "D" as well....and I agree with Daytonite that I don't like the wording as 'the only way' to keep pt safe from injury.

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Or D if it said "the only way to keep 'this' patient safe" - "the only way to keep 'a' patient safe" implies that they are restraining everyone there! I was initially stuck between A and C as well, since you don't seem to have enough information, but according to my NCLEX books, you should always eliminate similar answer choices. Since you don't have enough information to determine what type of restraint he may have needed, D just might be the right answer. Did you type it exactly as it was on the exam? Please let us know when you find out what it was.

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