Nokea
A client being treated for a comminuted fractured tibia asks the nurse to explain what a comminuted fracture means. The nurse should give which response?
- A. It means the fracture is incomplete.
- B. It means the bone is partially fractured.
- C. It means the bone fractured with splintering of the bone into fragments.
- D. It means the skin or mucous membrane was broken when the fracture occurred.
Correct Answer: C
Rationale: A comminuted fracture is a complete fracture across the shaft of a bone, with splintering of the bone into fragments. A simple fracture is a fracture of the bone across its entire shaft with some possible displacement but without breaking the skin. A greenstick fracture is an incomplete fracture, which occurs through part of the cross section of a bone. One side of the bone is fractured, and the other side is bent. A compound fracture, also called an open fracture, is one in which the skin or mucous membrane has been broken, and the wound extends to the depth of the fractured bone.
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A client with a history of chronic renal failure is prescribed epoetin alfa (Epogen). The nurse should monitor the client for which of the following side effects?
- A. Hypotension.
- B. Hypertension.
- C. Hypoglycemia.
- D. Weight loss.
Correct Answer: B
Rationale: Epoetin alfa can cause hypertension due to increased red blood cell production, requiring close monitoring.
A client with a history of peptic ulcer disease is prescribed lansoprazole (Prevacid). The nurse should instruct the client to:
- A. Take the medication before meals.
- B. Take the medication with meals.
- C. Take the medication at bedtime.
- D. Stop the medication if heartburn resolves.
Correct Answer: A
Rationale: Lansoprazole is most effective when taken before meals to reduce acid production.
What condition should the nurse assess a client diagnosed with pernicious anemia for? Select all that apply.
- A. Weakness
- B. Constipation
- C. Shortness of breath
- D. Dusky lips and gums
- E. Smooth, sore, red tongue
Correct Answer: A,E
Rationale: Classic clinical indicators of pernicious anemia include weakness; mild diarrhea; and a smooth, sore, red tongue. The client may also have neurological findings, such as paresthesias, confusion, and difficulty with balance. Constipation is not a common finding with pernicious anemia. Pernicious anemia does not affect tissue oxygenation, so the mucous membranes do not become dusky, and the client does not exhibit shortness of breath.
Which type of anemia is diagnosed with a Schilling test?
- A. Aplastic
- B. Pernicious
- C. Megaloblastic
- D. Iron deficiency
Correct Answer: B
Rationale: The Schilling test is used to determine the cause of vitamin B12 deficiency, a potential precursor to pernicious anemia. This test involves the use of a small oral dose of radioactive B12 and a large nonradioactive intramuscular dose. A 24-hour urine specimen is then collected to measure the amount of radioactivity in the urine, and thus radioactive B12. This test is not helpful in diagnosing aplastic, megaloblastic, or iron-deficiency anemia.
A client with a diagnosis of major depressive disorder is prescribed fluoxetine (Prozac). The nurse should instruct the client that it may take how long to notice the full therapeutic effect?
- A. 1-2 days.
- B. 1-2 weeks.
- C. 3-4 weeks.
- D. 6-8 weeks.
Correct Answer: C
Rationale: Fluoxetine, an SSRI, typically takes 3-4 weeks to achieve its full therapeutic effect in treating depression.