Nokea
A client who is treated for a meniscal injury to the knee is advised prolonged immobility. To help prevent skin breakdown and infections, the nurse should instruct the client to increase the intake of which of the following?
- A. Protein
- B. Fiber
- C. Calcium
- D. Liquid
Correct Answer: A
Rationale: Protein aids in wound healing and preventing skin breakdown.
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There are ________ layers of meninges around the brain and spinal cord.
- A. one
- B. two
- C. three
- D. four
Correct Answer: C
Rationale: The brain and spinal cord are protected by three layers of meninges: the dura mater, arachnoid mater, and pia mater. These layers provide structural support, cushioning, and protection against physical injury. The dura mater is the outermost layer, the arachnoid mater is the middle layer, and the pia mater is the innermost layer. Therefore, three is the correct answer as it accurately describes the number of meningeal layers.
A 70-year-old alcoholic patient with acute lethargy, confusion, and incontinence is admitted to the hospital ED. His wife tells you that he fell down the stairs about a month ago, but 'he didn't have a scratch afterward.' She feels that he has become gradually less active and sleepier over the last 10 days or so. Which of the following collaborative interventions will you implement first?
- A. Place on the hospital alcohol withdrawal protocol.
- B. Transfer to radiology for a CT scan.
- C. Insert a retention catheter to straight drainage.
- D. Give phenytoin (Dilantin) 100 mg PO.
Correct Answer: B
Rationale: A CT scan is needed to rule out a subdural hematoma, which could explain the symptoms.
Which statement describes osteosarcoma?
- A. High rate of local recurrence
- B. Very malignant and metastasizes early
- C. Arises in cancellous ends of long bones
- D. Develops in the medullary cavity of long bones
Correct Answer: B
Rationale: Osteosarcoma is highly malignant and metastasizes early.
A myelogram is ordered for Mr. Tucker to determine the extent of injury. Which of the following would be avoided following this procedure?
- A. Watching him for a possible sensitivity reaction
- B. Elevating his head and thorax 15-30° for 8 hours
- C. Restricting fluid intake for 12 hours
- D. Administering aspirin for headache
Correct Answer: C
Rationale: Fluid restriction can increase the risk of complications after a myelogram.
The nurse practitioner is assessing an adult patient with a seizure disorder that is well controlled on phenytoin (Dilantin). What new finding indicates that a phenytoin drug level assessment is needed?
- A. Hypertrophic gums
- B. Vitamin D supplements
- C. BP 125/78 mmHg and pulse 95 bpm
- D. Flat affect and anxiety
Correct Answer: D
Rationale: The correct answer is D because a flat affect and anxiety can indicate potential phenytoin toxicity, which warrants a drug level assessment. Phenytoin toxicity can manifest as neurological symptoms such as mood changes and cognitive impairment. Options A and B are unrelated to phenytoin levels. Option C indicates normal vital signs and is not a specific indicator of phenytoin toxicity.