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A client who has had a total hip replacement has a dislocated hip prosthesis. The nurse should first?
- A. Stabilize the leg with Buck's traction.
- B. Apply an ice pack to the affected hip.
- C. Position the client toward the opposite side of the hip.
- D. Notify the orthopedic surgeon.
Correct Answer: D
Rationale: Notifying the surgeon is the priority, as dislocation requires urgent medical intervention.
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There has been an increase in medication errors and errors in ordering laboratory studies in the emergency department. The nurse manager is conducting a staff education session on when to use "read-back" procedures. "Read-back" procedures should be performed in which of the following situations? Select all that apply.
- A. When a medication order or critical lab result is received with the current or critical lab result is received.
- B. When any verbal or phone order is received.
- C. Whenever a written order or printed critical test result is received.
- D. When the unit secretary takes a phone order.
- E. When the agency uses computerized health care records.
Correct Answer: A,B,D
Rationale: Read-back procedures are required for verbal, phone, or critical result communications to ensure accuracy, especially when relayed through staff like unit secretaries.
The nurse administers theophylline (TheoDur) to a client. To evaluate the effectiveness of this medication, which of the following drug actions should the nurse anticipate?
- A. Suppression of the client's respiratory infection.
- B. Decrease in bronchial secretions.
- C. Relaxation of bronchial smooth muscle.
- D. Thinning of tenacious, purulent sputum.
Correct Answer: C
Rationale: Theophylline relaxes bronchial smooth muscle, relieving bronchospasm in COPD. It does not suppress infection, reduce secretions, or thin sputum.
A client with diabetes mellitus asks the nurse to recommend something to remove corns from his toes. The nurse should advise the client to:
- A. Apply a high-quality corn plaster to the area.
- B. Consult a physician or podiatrist about removing the corns.
- C. Apply iodine to the corns before peeling them off.
- D. Soak the feet in borax solution to peel off the corns.
Correct Answer: B
Rationale: Corns should be professionally removed by a physician or podiatrist to avoid injury or infection, especially in diabetic clients with poor healing.
The nurse conducts a review course on older adults and medication elimination/excretion. It would be appropriate for the nurse to note which factor may impact drug elimination? Select all that apply.
- A. Diminished glomerular filtration
- B. Decreased hepatic enzyme functioning
- C. Decreased peristalsis
- D. Lower pH of the gastric secretions
- E. Increased acidity of the gastric secretions
- F. Low functioning nephrons
Correct Answer: A,B,F
Rationale: Diminished glomerular filtration, decreased hepatic function, and low-functioning nephrons impair drug elimination in older adults.
Thirty people are injured in a train derailment. Ineffective and the transported to the hospital first?
- A. A 20-year-old who is unresponsive and has a high injury to his spinal cord.
- B. An 80-year-old who has a compound fracture of the arm.
- C. A 10-year-old with a laceration on his leg.
- D. A 25-year-old with a sucking chest wound.
Correct Answer: D
Rationale: A sucking chest wound is a life-threatening condition that can impair breathing and requires immediate intervention, prioritizing this patient for transport over others with less urgent injuries.