A provider prescribes cold application for a client who reports ankle joint stiffness. Which of the following assessment findings should the nurse identify as a contraindication to the application of cold?
- A. Capillary refill of 4 seconds
- B. 7.5 cm (3 in) diameter bruise on the ankle
- C. Warts on the affected ankle
- D. 2+ pitting edema
Correct Answer: A
Rationale: The correct answer is A. Capillary refill of 4 seconds indicates poor circulation, which is a contraindication to cold application as it could worsen the condition by further reducing blood flow. Choice B, a 7.5 cm (3 in) diameter bruise on the ankle, does not directly contraindicate cold application but may need evaluation for possible underlying injuries. Choice C, warts on the affected ankle, do not necessarily contraindicate cold application. Choice D, 2+ pitting edema, is not a direct contraindication to cold application but may need to be addressed separately.
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A client with a history of severe anxiety is scheduled for surgery. Which preoperative medication is the most appropriate for the LPN/LVN to administer to this client?
- A. Lorazepam (Ativan)
- B. Morphine sulfate
- C. Meperidine (Demerol)
- D. Promethazine (Phenergan)
Correct Answer: A
Rationale: Lorazepam (Ativan) is the most appropriate preoperative medication for a client with severe anxiety. Lorazepam belongs to the benzodiazepine class and is commonly used to manage anxiety before surgical procedures due to its anxiolytic properties. Morphine sulfate and Meperidine (Demerol) are opioid analgesics, not typically indicated for preoperative anxiety. Promethazine (Phenergan) is an antihistamine used for nausea and vomiting, not anxiety management.
Which of the following should a group of community health nurses plan as part of a primary prevention program for occupational pulmonary diseases?
- A. Screening for early symptoms
- B. Providing treatment for diagnosed conditions
- C. Elimination of the exposure
- D. Increasing awareness of symptoms
Correct Answer: C
Rationale: The correct answer is C: 'Elimination of the exposure.' Primary prevention programs for occupational pulmonary diseases aim to prevent the development of these diseases by eliminating or minimizing exposure to harmful substances in the workplace. Screening for early symptoms (Choice A) focuses on secondary prevention, detecting diseases at an early stage. Providing treatment for diagnosed conditions (Choice B) is part of tertiary prevention, managing and treating established diseases. Increasing awareness of symptoms (Choice D) may help in early detection but does not directly address the prevention of exposure, which is crucial for primary prevention of occupational pulmonary diseases.
The pediatric clinic nurse examines a toddler with a tentative diagnosis of neuroblastoma. Findings observed by the nurse that are associated with this problem include which of these?
- A. Lymphedema and nerve palsy
- B. Hearing loss and ataxia
- C. Headaches and vomiting
- D. Abdominal mass and weakness
Correct Answer: D
Rationale: The correct answer is D: Abdominal mass and weakness. In neuroblastoma, the most common presenting signs are related to the mass effect of the tumor, leading to an abdominal mass and symptoms of weakness. Lymphedema and nerve palsy (Choice A) are not typically associated with neuroblastoma. Hearing loss and ataxia (Choice B) are more indicative of other conditions like neurofibromatosis or brain tumors. Headaches and vomiting (Choice C) are more commonly seen in conditions such as brain tumors or increased intracranial pressure, but they are not specific to neuroblastoma.
A client reports increased pain following physical therapy. Which of the following questions should the nurse ask to assess the quality of the pain?
- A. Is the pain sharp or dull?
- B. Does the pain feel like burning or aching?
- C. Is the pain constant or intermittent?
- D. Does the pain feel like throbbing or stabbing?
Correct Answer: A
Rationale: When assessing pain quality, asking if the pain is sharp or dull helps determine the nature of the pain. Sharp pain is often associated with acute conditions, while dull pain may indicate a chronic issue. Choices B, C, and D are incorrect as they do not directly address the quality of the pain in terms of sharpness or dullness.
A nurse is teaching an older adult client who has type 2 diabetes mellitus about how to care for corns and calluses on her toes. Which of the following statements by the client indicates an understanding of the teaching?
- A. I can place an oval corn pad over toes that have corns as long as I remove the pad weekly
- B. I should soak my feet in warm water daily to soften corns and calluses
- C. I can apply lotion to soften calluses as long as I don't put lotion between my toes
- D. I should use an over the counter liquid medication to remove corns
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.