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A child sustains a greenstick fracture of the humerus from a fall out of a tree house. The nurse describes this type of fracture to the parents and should provide them with which picture? Refer to figures 1 to 4.
- A. fracture_1.PNG
- B. fracture_2.PNG
- C. fracture_3.PNG
- D. fracture_4.PNG
Correct Answer: A
Rationale: A greenstick fracture is an incomplete fracture where the bone bends and breaks on one side without breaking completely through, common in children due to their flexible bones. The nurse should select the picture that depicts this type of fracture, typically showing a bend with a partial break on one side of the bone. This distinguishes it from complete fractures or other types like comminuted or spiral fractures.
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The nurse who practices culturally sensitive nursing care incorporates which concepts into client care? Select all that apply.
- A. The expression of pain is affected by learned behaviors.
- B. Physiologically, all individuals experience pain in a similar manner.
- C. Ethnic culture has an effect on the physiological response to pain medications.
- D. Clients should be assessed for pain regardless of a lack of overt symptomatology.
- E. The use of a standardized pain assessment tool ensures unbiased pain assessment.
Correct Answer: A,C,D
Rationale: Pain and its expression are often affected by an individual's ethnic culture in ways that include learned means of pain expression, the physiological response to pain medications, and attitudes regarding acceptable ways of dealing with pain. Physiologically not all individuals, even those of the same ethnic culture, will respond to pain in a similar manner, and so a standardized pain assessment tool is not effective in measuring pain in all clients.
The nurse is admitting a client with a diagnosis of hypothyroidism. What assessment should the nurse perform to obtain data related to this diagnosis?
- A. Inspect facial features.
- B. Auscultate lung sounds.
- C. Percuss the thyroid gland.
- D. Inspect ability to ambulate safely.
Correct Answer: A
Rationale: Inspection of facial features will reveal the characteristic coarse features, presence of edema around the eyes and face, and the blank expression that are characteristics of hypothyroidism. The assessment techniques in options 2, 3, and 4 will not reveal information related to the diagnosis of hypothyroidism.
A client diagnosed with left pleural effusion has just been admitted for treatment. The nurse should plan to have which procedure tray available for use at the bedside?
- A. Intubation
- B. Paracentesis
- C. Thoracentesis
- D. Central venous line insertion
Correct Answer: C
Rationale: The client with a significant pleural effusion is usually treated by thoracentesis. This procedure allows drainage of the fluid from the pleural space, which may then be analyzed to determine the precise cause of the effusion. The nurse ensures that a thoracentesis tray is readily available in case that the client's symptoms should rapidly become more severe. A paracentesis tray is needed for the removal of abdominal effusion. Options 1 and 4 are not specifically indicated for this procedure.
The nurse is caring for a client diagnosed with heart failure who has a magnesium level of 0.75 mEq/L (0.375 mmol/L). Which action should the nurse take?
- A. Monitor the client for irregular heart rhythms.
- B. Encourage the intake of antacids with phosphate.
- C. Teach the client to avoid foods high in magnesium.
- D. Provide a diet of ground beef, eggs, and chicken breast.
Correct Answer: A
Rationale: The normal magnesium level ranges from 1.3 to 2.1 mEq/L (0.65 to 1.05 mmol/L); therefore, this client is experiencing hypomagnesemia. The client should be monitored for dysrhythmias because magnesium plays an important role in myocardial nerve cell impulse conduction; thus, hypomagnesemia increases the client's risk of ventricular dysrhythmias. The nurse avoids administering phosphate in the presence of hypomagnesemia because it aggravates the condition. The nurse instructs the client to consume foods high in magnesium; ground beef, eggs, and chicken breast are low in magnesium.
Which nursing assessment finding indicates the presence of an inguinal hernia on a child?
- A. Reports of difficulty defecating
- B. Reports of a dribbling urinary stream
- C. Absence of the testes within the scrotum
- D. Painless groin swelling noticed when the child cries
Correct Answer: D
Rationale: Inguinal hernia is a common defect that may appear as a painless inguinal (groin) swelling when the child cries or strains. Option 1 is a symptom indicating a partial obstruction of the herniated loop of intestine. Option 2 describes a sign of phimosis, a narrowing or stenosis of the preputial opening of the foreskin. Option 3 describes cryptorchidism.