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Following 2 weeks of IV antibiotic therapy, a patient with acute osteomyelitis of the tibia is prepared for discharge from the hospital. The nurse determines that additional instruction is needed when the patient makes which statement?
- A. I will need to continue antibiotic therapy for 4 to 6 weeks.
- B. I shouldn't bear weight on my affected leg until healing is complete.
- C. I can use a heating pad on my lower leg for comfort and to promote healing.
- D. I should notify the health care provider if the pain in my leg becomes worse.
Correct Answer: C
Rationale: Heating pads are contraindicated in osteomyelitis.
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A patient with a fractured tibia accompanied by extensive soft tissue damage initially has a splint applied and held in place with an elastic bandage. What early sign should alert the nurse that the patient is developing compartment syndrome?
- A. Paralysis of the toes
- B. Absence of peripheral pulses
- C. Distal pain unrelieved by opioid analgesics
- D. Skin over the injury site is blanched when the bandage is removed
Correct Answer: C
Rationale: Unrelieved pain despite opioids is a hallmark of compartment syndrome.
What is the strongest known risk factor for MS?
- A. cigarette smoking
- B. genetics
- C. obesity
- D. living in northern climates
Correct Answer: B
Rationale: Genetics is the strongest known risk factor for multiple sclerosis (MS). While environmental factors like vitamin D deficiency and smoking can influence risk, having a family history of MS significantly increases an individual's likelihood of developing the condition.
A patient says, I feel detached and weird all the time, like I'm looking at life through a cloudy window. Everything seems unreal. These feelings really interfere with my work and study. Which term should the nurse use to document this complaint?
- A. Depersonalization
- B. Hypochondriasis
- C. Dissociation
- D. Malingering
Correct Answer: A
Rationale: Correct Answer: A. Depersonalization
Rationale:
1. Depersonalization involves feeling detached from oneself or reality, as described by the patient.
2. The patient's description of feeling like they are looking through a cloudy window aligns with depersonalization symptoms.
3. Interference with work and study suggests significant distress, a common feature of depersonalization disorder.
Summary of other choices:
B. Hypochondriasis: Involves excessive worry about having a serious illness, which is not indicated in the patient's complaint.
C. Dissociation: While depersonalization is a type of dissociative symptom, it specifically refers to feeling detached and unreal, not necessarily a broader dissociative disorder.
D. Malingering: Involves feigning or exaggerating symptoms for secondary gain, which is not evident in the patient's genuine distress and impairment.
Mr. Smith develops signs of increased intracranial pressure. Which of the following medications is likely to be ordered for Mr. Smith?
- A. Mannitol
- B. Insulin
- C. Morphine sulfate
- D. Penicillin
Correct Answer: A
Rationale: Mannitol is an osmotic diuretic used to reduce intracranial pressure.
You are caring for a patient who is preoperative and is NPO. The patient takes carbamazepine (Tegretol), 200 mg PO BID for a seizure disorder. Which of the following actions should you take?
- A. Give the oral dose of carbamazepine with a sip of water.
- B. Give carbamazepine IV.
- C. Withhold the carbamazepine.
- D. Administer half the usual morning dose of carbamazepine.
Correct Answer: A
Rationale: It is important to continue the oral carbamazepine to maintain therapeutic blood levels and to prevent seizure activity. You should notify the anesthesiologist and should give the patient the carbamazepine with a sip of water. Carbamazepine is not available IV. Withholding the carbamazepine may reduce the therapeutic blood level and cause seizure activity. Administering a reduced dose of carbamazepine may reduce the therapeutic blood level and cause seizure activity.