Nokea
Question 1 of 19
Which of the following best describes an appropriate outcome for a 75-yr-old patient with a history of Huntington's disease, which has developed contractures?
Correct Answer:
Rationale:
Question 2 of 19
The following scenario applies to the next 1 items
The nurse cares for a client who sustained a femur fracture twelve hours ago
Item 1 of 1
Nurses’ Notes
Client reports shortness of breath and stated, ‘something is not right.’ The client was assessed to have a respiratory rate of 25/min and oxygen saturation of 90% while on room air. Lung sounds had bilateral crackles throughout, and respirations were labored. Chest pain was reported that worsened with breathing. An emergent 12-lead electrocardiogram was obtained, and it was observed that the client had reddish-purple spots on their torso. A rapid response was called.
The client is demonstrating signs and symptoms of
The nurse cares for a client who sustained a femur fracture twelve hours ago
Item 1 of 1
Nurses’ Notes
Client reports shortness of breath and stated, ‘something is not right.’ The client was assessed to have a respiratory rate of 25/min and oxygen saturation of 90% while on room air. Lung sounds had bilateral crackles throughout, and respirations were labored. Chest pain was reported that worsened with breathing. An emergent 12-lead electrocardiogram was obtained, and it was observed that the client had reddish-purple spots on their torso. A rapid response was called.
Correct Answer:
Rationale:
Question 3 of 19
The nurse in the medical-surgical unit is caring for a newly admitted client.
Item 4 of 6
History and Physical
1930: Client is a 45-year-old male who has a one-and-a-half-week history of pain, redness, and swelling in his right foot. He reported that the symptoms began after he accidentally cut his foot while walking barefoot in his backyard. Over the next few days, he developed pain and swelling around the cut, accompanied by redness and warmth. He went to urgent care two days later and was diagnosed with cellulitis in his right foot. He was prescribed antibiotics but could not afford the treatment. Three days ago, the pain escalated and was described as throbbing and constant, with a severity rating of 7/10 on the Numerical Pain Rating Scale. He states, "the pain is now in the bone of my foot; I don't know how else to describe it." He also noted occasional fever 101°F (38.3°C), chills, and general malaise. On physical examination, his right foot was erythematous, swollen, and warm to the touch. A 3 cm ulcer was noted on the plantar aspect of the right foot, with moderate purulent discharge present. The ulcer appeared deep, and palpation of the surrounding tissue elicited tenderness. There was limited range of motion in the right ankle due to pain. The distal pulses were palpable 2+, and there were signs of neuropathy in the feet (decreased sensation to light touch and pinprick). He has a medical history of uncontrolled diabetes mellitus (type two), obesity, peripheral neuropathy in all extremities, hypertension, hyperlipidemia, and epilepsy.
Consultation
Infectious Disease Consultation
2050: Client was evaluated and I strongly suspect osteomyelitis in his right foot. Labs are pending. Agree with admission and will follow closely.
The nurse plans care for this client. For each potential intervention, click to specify whether the intervention is indicated or not indicated for the client.
Item 4 of 6
History and Physical
1930: Client is a 45-year-old male who has a one-and-a-half-week history of pain, redness, and swelling in his right foot. He reported that the symptoms began after he accidentally cut his foot while walking barefoot in his backyard. Over the next few days, he developed pain and swelling around the cut, accompanied by redness and warmth. He went to urgent care two days later and was diagnosed with cellulitis in his right foot. He was prescribed antibiotics but could not afford the treatment. Three days ago, the pain escalated and was described as throbbing and constant, with a severity rating of 7/10 on the Numerical Pain Rating Scale. He states, "the pain is now in the bone of my foot; I don't know how else to describe it." He also noted occasional fever 101°F (38.3°C), chills, and general malaise. On physical examination, his right foot was erythematous, swollen, and warm to the touch. A 3 cm ulcer was noted on the plantar aspect of the right foot, with moderate purulent discharge present. The ulcer appeared deep, and palpation of the surrounding tissue elicited tenderness. There was limited range of motion in the right ankle due to pain. The distal pulses were palpable 2+, and there were signs of neuropathy in the feet (decreased sensation to light touch and pinprick). He has a medical history of uncontrolled diabetes mellitus (type two), obesity, peripheral neuropathy in all extremities, hypertension, hyperlipidemia, and epilepsy.
Consultation
Infectious Disease Consultation
2050: Client was evaluated and I strongly suspect osteomyelitis in his right foot. Labs are pending. Agree with admission and will follow closely.
Correct Answer:
Rationale:
Question 4 of 19
The nurse is planning care for a client with a newly diagnosed fractured pelvis. Which action would lessen the risk of fat embolism syndrome (FES)?
Correct Answer:
Rationale:
Question 5 of 19
The following scenario applies to the next 1 items
Item 1 of 1
History and Physical
17-year-old male arrives at the emergency department following playing baseball. He slid into a base, felt a ‘pop’, and had pain in his right ankle. The client reports pain of 7 out of 10 in his right ankle, which is described as throbbing. Right pedal pulse was 2+, and the sensation was intact. The client had a limited and painful range of motion in his ankle. Significant swelling and bruising in the ankle were observed.
The client does not have a medical or surgical history. He takes no medications.
Diagnostic Results
X-Ray: bimalleolar fracture of the right ankle
Orders
Crutches
Non-weight bearing status
Apply a splint to the ankle
Acetaminophen-Oxycodone 5/325 mg PO
While teaching the client how to use crutches, the nurse should instruct the client to ambulate using the
Item 1 of 1
History and Physical
17-year-old male arrives at the emergency department following playing baseball. He slid into a base, felt a ‘pop’, and had pain in his right ankle. The client reports pain of 7 out of 10 in his right ankle, which is described as throbbing. Right pedal pulse was 2+, and the sensation was intact. The client had a limited and painful range of motion in his ankle. Significant swelling and bruising in the ankle were observed.
The client does not have a medical or surgical history. He takes no medications.
Diagnostic Results
X-Ray: bimalleolar fracture of the right ankle
Orders
Crutches
Non-weight bearing status
Apply a splint to the ankle
Acetaminophen-Oxycodone 5/325 mg PO
Correct Answer:
Rationale:
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