Nokea
20-year old Mr. Ang fell off from his horse, and sustained a lft hip fracture. Buck’s extension traction is applied. The following statements are true about Buck’s extension traction except:
- A. used as a temporary measure in adults to control muscle spasm and pain
- B. applied by orthopedic surgeon under aseptic conditions using wires and pins
- C. The pulling force is transmitted to the musculoskeletal structures
- D. used definitively to treat fractures in children
Correct Answer: D
Rationale: The correct answer is D because Buck's extension traction is not used definitively to treat fractures in children due to their growing bones. Instead, it is used temporarily in adults to control muscle spasm and pain.
- A: Correct - Buck's extension traction is indeed used temporarily in adults to control muscle spasm and pain.
- B: Correct - Buck's extension traction is applied by an orthopedic surgeon under aseptic conditions using wires and pins.
- C: Correct - The pulling force in Buck's extension traction is indeed transmitted to the musculoskeletal structures.
Therefore, the incorrect option is D as Buck's extension traction is not used definitively to treat fractures in children.
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The nurse understands that which of the ff. best describes the action of enalapril maleate (Vasotec)?
- A. It decreases levels of angiotensin II
- B. It dilates the arterioles and veins
- C. It adjusts the extracellular volume
- D. It decreases cardiac output
Correct Answer: A
Rationale: Step-by-step rationale for why choice A is correct:
1. Enalapril maleate is an angiotensin-converting enzyme (ACE) inhibitor.
2. ACE inhibitors like enalapril maleate block the conversion of angiotensin I to angiotensin II.
3. By inhibiting the formation of angiotensin II, enalapril maleate decreases the levels of angiotensin II.
4. Angiotensin II is a potent vasoconstrictor, so decreasing its levels leads to vasodilation and decreased blood pressure.
Summary of why other choices are incorrect:
- Choice B: Enalapril maleate primarily dilates arterioles by decreasing angiotensin II levels, not veins.
- Choice C: Enalapril maleate does not directly adjust extracellular volume; it primarily affects the renin-angiotensin-aldosterone system.
- Choice D: Enalapril maleate
Which of the following patients should the nurse monitors because of increased risk for surgical complications?
- A. 25-year old with appendicitis
- B. patient 5’3” in height, weight 180 lbs
- C. 12-year old with fractured knee
- D. 17-year old with gallstone
Correct Answer: B
Rationale: The correct answer is B because the patient's Body Mass Index (BMI) indicates obesity, putting them at higher risk for surgical complications. Obesity is associated with increased risks of infections, delayed wound healing, respiratory issues, and cardiovascular problems post-surgery. Monitoring this patient closely is crucial.
Choice A is less likely to have increased surgical complications due to age and condition. Choice C, a 12-year-old, is less likely to have significant surgical complications compared to adults. Choice D, a 17-year-old with gallstones, may have risks but the BMI of the patient in choice B indicates a higher risk.
The nurse assesses for the characteristic movement of Parkinson’s disease which is a (n):
- A. Exaggerated muscle flaccidity that leads to frequent falls
- B. Hyperextension of the back and neck that alters normal movements
- C. Pronation- supination of the hand and forearm that interferes with normal hand activities
- D. Combination of all of the above
Correct Answer: C
Rationale: The correct answer is C because pronation-supination of the hand and forearm is a characteristic movement in Parkinson's disease called "pill-rolling tremor." This movement interferes with normal hand activities due to involuntary shaking.
A is incorrect because exaggerated muscle flaccidity does not lead to frequent falls in Parkinson's disease. B is incorrect as hyperextension of the back and neck is not a characteristic movement of Parkinson's disease. D is incorrect as it combines all options, which is not accurate.
For a client with newly diagnosed cancer, the nurse formulates a nursing diagnosis of Anxiety related to the threat of death secondary to cancer diagnosis. Which expected outcome would be appropriate for this client?
- A. “Client verbalizes feelings of anxiety.”
- B. “Client doesn’t guess at prognosis.”
- C. “Client uses any effective method to reduce tension.”
- D. “Client stops seeking information.”
Correct Answer: C
Rationale: The correct answer is C because it focuses on the client actively engaging in reducing tension, which is essential in managing anxiety. This outcome is measurable and client-centered.
A: Verbalizing feelings is important, but it does not necessarily lead to reduction in anxiety.
B: Not guessing prognosis is helpful, but it does not address the active management of anxiety.
D: Stopping seeking information may not be beneficial as knowledge can empower the client in coping with the diagnosis.
Which statement by a nurse indicates a good understanding about the differences between data validation and data interpretation?
- A. “Data interpretation occurs before data validation.”
- B. “Validation involves looking for patterns in professional standards.”
- C. “Validation involves comparing data with other sources for accuracy.”
- D. “Data interpretation involves discovering patterns in professional standards.”
Correct Answer: C
Rationale: The correct answer is C because data validation involves comparing data with other sources to ensure accuracy. This process helps in identifying any discrepancies or errors in the data. By cross-referencing with other sources, the nurse can verify the correctness of the data.
Rationale:
1. Data validation checks the accuracy of the data by comparing it with external sources.
2. Data interpretation involves analyzing and making sense of the data, not comparing it with other sources.
3. Option A is incorrect because data validation typically comes after data collection and precedes data interpretation.
4. Option B is incorrect as validation does not specifically involve looking for patterns in professional standards.
5. Option D is incorrect because data interpretation focuses on understanding trends and insights from the data, not patterns in professional standards.