Nokea
A patient is discharged from the outpatient clinic following application of a synthetic fiberglass long arm cast for a fractured ulna. Before discharge, the nurse instructs the patient to do what?
- A. Never get the cast wet.
- B. Move the shoulder and fingers frequently.
- C. Place tape petals around the edges of the cast when it is dry.
- D. Use a sling to support the arm at waist level for the first 48 hours.
Correct Answer: B
Rationale: Moving the unaffected parts promotes circulation and reduces stiffness.
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A patient who was in an automobile accident 30 minutes ago reports that he or she is unable to move his or her legs. What is the best response?
- A. Swelling due to the initial trauma may make the injury seem more severe than it actually is. A more accurate assessment will be made once the swelling goes down.
- B. Swelling owing to the initial trauma prevents you from moving your legs.
- C. There are good rehabilitation centers that will help restore sensation to your legs.
- D. You should have been wearing your seatbelt.
Correct Answer: A
Rationale: Swelling after trauma can temporarily affect mobility and should be addressed before making long-term predictions.
What hormone is important in milk production and maintaining lactation?
- A. Estrogen
- B. Oxytocin
- C. Prolactin
- D. Adrenaline
Correct Answer: C
Rationale: Prolactin is the correct answer because it is the hormone produced by the pituitary gland that stimulates milk production in the mammary glands. During lactation, prolactin levels remain elevated to ensure a continuous supply of milk. While oxytocin is involved in milk ejection, prolactin is primarily responsible for milk synthesis and maintenance of lactation.
The patient with gout will have periodic exacerbations of painful joint inflammation. Acute episodes are treated with
- A. Nonsteroidal anti-inflammatory medications and colchicine.
- B. Allopurinol and aspirin.
- C. Antibiotics and acetaminophen.
- D. Bisphosphonates and calcium.
Correct Answer: A
Rationale: NSAIDs and colchicine are used for acute gout attacks, whereas allopurinol is used for long-term management.
A patient with a spinal cord injury at level C3-4 is being cared for in the ED. What is the priority assessment?
- A. Determine the level at which the patient has intact sensation.
- B. Assess the level at which the patient has retained mobility.
- C. Check blood pressure and pulse for signs of spinal shock.
- D. Monitor respiratory effort and oxygen saturation level.
Correct Answer: D
Rationale: Respiratory function is critical at this level of injury and must be assessed immediately.
Priority Decision: A patient is admitted to the emergency department with a possible cervical spinal cord injury following an automobile crash. During admission of the patient, what is the highest priority for the nurse?
- A. Maintaining a patent airway
- B. Maintaining immobilization of the cervical spine
- C. Assessing the patient for head and other injuries
- D. Assessing the patient's motor and sensory function
Correct Answer: B
Rationale: Immobilization prevents further injury.