Nokea
A client is undergoing computed tomography (CT) of a joint. What action by the nurse is most important before the test?
- A. Administer sedation as prescribed.
- B. Assess for seafood or iodine allergy.
- C. Ensure that the client has no metal on the body.
- D. Reinforce the dressing if it becomes saturated.
Correct Answer: B
Rationale: Because CT uses iodine-based contrast material, the nurse assesses the client for allergies to iodine or seafood (which often contains iodine). The other actions are not needed.
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A client had an arthroscopy 1 hour ago on the left knee. The nurse finds the left lower leg to be pale and cool, with 1+ pedal pulses. What action by the nurse is best?
- A. Assess the neurovascular status of the right leg.
- B. Document the findings in the clients chart.
- C. Elevate the left leg on at least two pillows.
- D. Notify the provider of the findings immediately.
Correct Answer: A
Rationale: The nurse should compare findings of the two legs as these findings may be normal for the client. If a difference is observed, the nurse notifies the provider. Documentation should occur after the nurse has all the data. Elevating the left leg will not improve perfusion if there is a problem.
A school nurse is conducting scoliosis screening. In screening the client, what technique is most appropriate?
- A. Bending forward from the hips
- B. Sitting upright with arms outstretched
- C. Walking across the room and back
- D. Walking with both eyes closed
Correct Answer: A
Rationale: To assess for scoliosis, a spinal deformity, the student should bend forward at the hips. Standing behind the student, the nurse looks for a lateral curve in the spine. The other actions are not correct.
The nurse is assessing four clients with musculoskeletal disorders. The nurse should assess the client with which laboratory result first?
- A. Serum alkaline phosphatase (ALP): 108 units/L.
- B. Serum aspartate aminotransferase (AST): 26 units/L.
- C. Serum calcium: 10.2 mg/dL.
- D. Serum phosphate: 2 mg/dL.
Correct Answer: D
Rationale: A serum phosphorus level of 2 mg/dL is below the normal range (2.5"?4.5 mg/dL), indicating a potential issue such as hypophosphatemia, which can affect bone health and requires immediate assessment. The other lab results are within normal ranges.
A nurse is providing community education about preventing traumatic musculoskeletal injuries related to car crashes. Which group does the nurse target as the priority for this education?
- A. High school football team
- B. High school home room
- C. Middle-aged men
- D. Older adult women
Correct Answer: A
Rationale: Young men are at highest risk for musculoskeletal injury due to trauma, especially due to motor vehicle crashes. The high school football team, with its roster of young males, is the priority group.
The clients chart indicates genu varum. What does the nurse understand this to mean?
- A. Bow-legged
- B. Fluid accumulation
- C. Knock-kneed
- D. Spinal curvature
Correct Answer: A
Rationale: Genu varum is a bow-legged deformity. A fluid accumulation is an effusion. Genu valgum is knock-kneed. A spinal curvature could be kyphosis or scoliosis.