Nokea
A patient who has had a right below the knee amputation continues to complain of unpleasant sensation in the right foot. Which explanation will the nurse provide about this 'phantom pain'?
- A. It only exists in the mind.
- B. It is a complication following an amputation and can be clarified by the surgeon.
- C. It is related to the severed nerves that are still sending messages to the brain.
- D. It occurs when the person becomes focused on the loss of the limb.
Correct Answer: C
Rationale: Phantom pain (pain felt in the missing extremity as if it were still present) may occur and be frightening to the patient. Phantom pain occurs because the nerve tracts that register pain in the amputated area continue to send a message to the brain (this is normal). It is an actual problem and does not 'exist only in the mind'. The nurse can answer this question about phantom pain. Phantom pain does not occur when the patient becomes focused on limb loss.
You may also like to solve these questions
Which will the nurse stress to a patient who has had a knee replacement and is beginning strengthening exercises for the unaffected leg?
- A. Flex the knee and flex the foot.
- B. Lift the leg from the mattress and rotate the foot.
- C. Pull knee to chest and extend the foot.
- D. Push foot down against the footboard for a count of five.
Correct Answer: D
Rationale: The unaffected leg should be strengthened by pushing the foot down against the footboard for a count of five and repeating frequently during the day.
How is rheumatoid arthritis (RA) distinguished from osteoarthritis?
- A. Rheumatoid arthritis is an autoimmune, systemic disease; osteoarthritis is a degenerative disease of the joints.
- B. Rheumatoid arthritis is an autoimmune, degenerative disease; osteoarthritis is a systemic inflammatory disease.
- C. People with osteoarthritis are considered to be genetically predisposed; there is no known genetic component to rheumatoid arthritis.
- D. Osteoarthritis is often caused by a virus; viruses play no part in the pathogenesis of rheumatoid arthritis.
Correct Answer: A
Rationale: RA is thought to be a systemic, autoimmune disorder. Degenerative joint disease is also known as osteoarthritis.
Which will the nurse stress to a patient, who recently had a hip replacement, in quadriceps setting exercises?
- A. Push knee down to mattress and raise heel off the bed.
- B. Flex knee and extend foot.
- C. Adduct leg and flex foot.
- D. Lift leg and heel off the bed.
Correct Answer: A
Rationale: Pushing the knee down into the mattress and raising the heel will strengthen the quadriceps muscles. Flexing the knee and extending the foot will not strengthen the quadriceps muscles. Likewise, adducting the legs and flexing the knee will not strengthen the quadriceps muscles.
A patient has undergone a bipolar hip repair (hemiarthroplasty). Which is the appropriate instruction?
- A. Sit in whatever position is most comfortable.
- B. Sit in a firm, straight-backed chair at a 90-degree angle.
- C. Avoid crossing the legs.
- D. Begin full weight-bearing as soon as tolerated.
Correct Answer: C
Rationale: Instructing the patient not to cross the legs is important because crossing the legs can adduct the affected extremity and dislocate the hip. The patient should have the head of the bed elevated to a maximum of 45 degrees to avoid acute flexion of the hip and strain on the fixation device. The patient will have limited weight bearing for the amount of time specified by the surgeon. This may be as long as 3 months post surgery.
Certain foods may increase the pain associated with gout. Which foods have the highest concentration of purines?
- A. Brain, liver, kidney
- B. Lettuce, corn, potatoes
- C. Beef, pork, chicken
- D. Fruits and fruit juices
Correct Answer: A
Rationale: Foods high in purines, such as brain, kidney, liver, and heart should be avoided, as well as alcohol. Lettuce, meat that does not include organ meats, and fruits do not have a high concentration of purines.