Nokea
A nurse has been ordered to set-up Buck's traction on a patient's lower extremity due to a femur fracture. Which of the following applies to Buck's traction?
- A. A weight greater than $10 \mathrm{lbs}$. should be used.
- B. The line of pull is upward at an angle.
- C. The line of pull is straight
- D. A weight greater than $20 \mathrm{lbs}$. should be used.
Correct Answer: C
Rationale: A straight line of pull is indicated with Buck's traction.
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Levothyroxine (Synthroid) is the drug of choice for thyroid replacement therapy in clients with hypothyroidism because:
- A. it is chemically stable, nonallergenic, and can be administered orally once a day.
- B. it is available in a single 25 mg tablet, which makes dosing simple.
- C. it is not a prodrug.
- D. it has a short half-life.
Correct Answer: A
Rationale: Levothyroxine is safe and effective with virtually no side effects when dosed properly. A single, daily dose is possible because of the long half-life (7 days). Levothyroxine tablets are available in a wide range of concentrations to meet individual client requirements. Levothyroxine (T4) is a prodrug of T3.
A healthcare professional reviewing a client's health care record notes documentation that the client has Heberden nodes of the distal interphalangeal joints. Which disorder does the healthcare professional determine that the client has?
- A. Scoliosis
- B. Osteoarthritis
- C. Rotator cuff lesions
- D. Carpal tunnel syndrome
Correct Answer: B
Rationale: The correct answer is Osteoarthritis. Osteoarthritis is characterized by hard, nontender nodules of 2 to 3 mm or larger. These osteophytes (bony overgrowths) of the distal interphalangeal joints are called Heberden nodes. In this disorder, when these nodes occur on the proximal interphalangeal joints, they are called Bouchard nodes. Heberden nodes are not associated with scoliosis, rotator cuff lesions, or carpal tunnel syndrome. Therefore, choices A, C, and D are incorrect.
The LPN has been asked to help a client taking Risperdal with activities of daily living in the morning. Which of these tasks is most likely to be potentially impacted by this medication?
- A. eating breakfast
- B. drinking fluids
- C. getting out of bed to use the bathroom
- D. brushing teeth
Correct Answer: C
Rationale: The correct answer is 'getting out of bed to use the bathroom.' Risperdal can cause orthostatic hypotension, leading to a drop in blood pressure when changing positions from lying down to standing up. This effect increases the risk of falls, emphasizing the need to assist the client with this task to prevent potential harm. Choices A, B, and D are less likely to be directly impacted by the medication, unlike the significant risk of orthostatic hypotension associated with changing positions.
When a client who is 25 years of age asks the nurse when she should seek fertility counseling, the best response by the nurse is:
- A. Fertility counseling should be sought when you have been unable to conceive after 1 year of unprotected intercourse.'
- B. Fertility counseling should be sought when you have not been able to conceive after 6-9 months of unprotected intercourse.'
- C. The average time it takes someone your age to conceive is 5-12 months, so if you haven't conceived by then, we can refer you.'
- D. We can give you some guidance now on how to increase your chances of conceiving and then refer you if it doesn't happen within a year.'
Correct Answer: D
Rationale: The guidelines for a fertility workup are to refer after the couple has not conceived after one year of unprotected intercourse. So, Choice 1 is technically correct, but it doesn't consider the immediate need for the couple to have some counseling. Choice 4 is the best answer because it gives the couple guidance now and the referral at the appropriate time. If the woman is over the age of 35, an earlier referral, at six to nine months of unprotected intercourse, is appropriate. It is true that the average time it takes a 25-year-old woman to conceive is 5.3 months, but that does not address the concern the client is expressing. Choice 4 is still the most caring and correct answer. Couples conceive within the first month of unprotected intercourse 20% of the time.
The LPN is taking care of a client who is on Phenelzine (Nardil) for depression. Which meal would the nurse encourage the client to avoid?
- A. steak and potatoes
- B. prosciutto and cheese plate
- C. orange juice and toast
- D. carbonated water, shrimp and rice
Correct Answer: B
Rationale: The correct answer is 'prosciutto and cheese plate.' Phenelzine (Nardil) is an MAOI (Monoamine Oxidase Inhibitor), and clients on these drugs should avoid foods high in tyramine due to the risk of dangerous elevations in blood pressure. Prosciutto and aged cheeses are examples of foods rich in tyramine, so they should be avoided. Choices A, C, and D do not contain high levels of tyramine and are considered safe to consume while on Phenelzine.