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.
My first, off-the-cuff answer was "C", primarily because of the dementia/sundowners possibilities.
D is close, but like the previous posters, I don't like anything that says "only". It's not true; restraints are NOT the "only" way to keep a patient safe.
Critical thinking would say that 'D' is the only answer that works here, as you have to answer the family's question, meaning even if one of the first 3 answers were true, they do not explain that restraints are the ONLY way to keep the pt. from pulling out cath, staying in bed, etc.
In general, of course, restraints are not usually the only way to keep a pt. safe. However, if they are being used on a particular pt., as in the question, it is because a doctor has ordered their use due to his/her medical opinion (based on many factors), that in THIS case it is the only way.
So, if question tells you restraints are in use (it did), you don't need to know what part of the body is restrained (to answer the question, that is, although in reality you would know the particulars to FURTHER explain to the family), to answer the question you need to know that legally, the facility can only place a pt. in restraints if it is the only way to keep them safe, and this is the MOST important thing to tell the family FIRST.
Tricky question! What did your instructor say the answer was?
My vote is for "A" but my main reason for not going with D is the fact that my instructors have preached that other methods are to be used and restraints would be a last resort. "only way to keep pts safe" makes me think they are restraining everyone.
Critical thinking would say that 'D' is the only answer that works here, as you have to answer the family's question, meaning even if one of the first 3 answers were true, they do not explain that restraints are the ONLY way to keep the pt. from pulling out cath, staying in bed, etc.
Sorry BelLPN, but I disagree. Critical thinking would tell that "D" is NOT the right answer, only because restraints are NOT the only way to protect patients from injury. "C" is definately the correct answer because:
A) You cannot assume that all patients have catheters
B) You wouldn't use a mummy restraint on a patient with "just" confusion
D) Restraints are not the "only" option
C) Every patient sleeps in a bed, and as mentioned before, dementia patients are more of a flight risk in the evening.
That's my rationale. Let us know what the final answer is, inquiring minds want to know.
I'll get back to you guys when I get my test back and find out what the answer was. Someone asked if that was the exact wording. Yes it was because I read that question so many times that I have it memorized. Thanks to all who added their input. I'm having some trouble adjusting to critical thinking and was afraid the answer was obvious and I just wasn't getting it. I'll get back to you guys.
I'd have to go with C, mainly because my instructors have drilled into my head that questions with "only" are usually the incorrect answer. Dying to know what the correct answer is.....
Is it normal for questions on a nursing exam to be so ambiguous?
For me personally, that was my major issue my first year. I hated the questions on the tests...4 correct answers, which is the best. That stressed me out.
Crux1024
985 Posts
So whats the answer, OP???
Youve peaked my curiosity (sp?)