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How can the nurse promote relief of muscle pain, spasms, and tension?
- A. Encouraging the client to continue their activities as usual.
- B. Immobilizing the client.
- C. Applying heat, cold, pressure, or vibration to the painful area.
- D. Administering pain medication as needed to ease the muscle.
Correct Answer: C
Rationale: To promote relief of muscle pain, spasms, and tension, the nurse should consider applying heat, cold, pressure, or vibration to the painful area. These interventions can help alleviate pain associated with muscle tension, pain, or spasms. Choice A is incorrect because encouraging the client to continue their activities as usual may exacerbate the pain. Choice B is incorrect as immobilizing the client may not address the underlying issue and could potentially lead to further complications. Choice D is also incorrect because while pain medication can be used, it is not the first-line treatment for muscle pain, spasms, and tension.
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A patient has been admitted to the hospital with an L4-5 HNP diagnosis. After 24 hours, the patient is able to ambulate with assistance and has reduced muscle spasms. Which of the following medications was the most beneficial in changing the patient's mobility status?
- A. Mivacron
- B. Atropine
- C. Bethanechol
- D. Flexeril
Correct Answer: D
Rationale: The correct answer is Flexeril. Flexeril is a muscle relaxant commonly used to treat acute muscle pain and spasms. In this scenario, the patient experiencing reduced muscle spasms and improved mobility after taking Flexeril indicates its effectiveness.
Choice A, Mivacron, is a neuromuscular blocking agent that is not typically used for muscle spasms or pain relief. Choice B, Atropine, is a medication used to treat certain types of nerve agent and pesticide poisonings, not muscle spasms. Choice C, Bethanechol, is a medication that stimulates bladder contractions and is not indicated for muscle spasms or mobility improvement.
Chemotherapeutic agents often produce a degree of myelosuppression including leukopenia. Leukopenia does not present immediately but is delayed several days or weeks because:
- A. the client's hemoglobin and hematocrit are normal.
- B. red blood cells are affected first.
- C. folic acid levels are normal.
- D. the current white cell count is not affected by chemotherapy.
Correct Answer: D
Rationale: Leukopenia does not present immediately after chemotherapy because time is required to clear circulating cells before the effect on precursor cell maturation in the bone marrow becomes evident. Leukopenia is characterized by an abnormally low white blood cell count. The correct answer is D because the white cell count is not immediately affected by chemotherapy. Choices A, B, and C are incorrect as they pertain to red blood cells (hemoglobin and hematocrit), which are not directly related to the delayed onset of leukopenia.
Elderly persons with pernicious anemia should be instructed:
- A. to increase their dietary intake of foods high in B12.
- B. that they do not need to return for follow-up for at least a month after initiation of treatment.
- C. that oral B12 is safer and less expensive than parenteral replacement.
- D. that diarrhea can be a transient side effect of B12 injections.
Correct Answer: D
Rationale: Elderly persons with pernicious anemia, a condition characterized by vitamin B12 deficiency due to lack of intrinsic factor, should be informed about the potential side effects of B12 injections. Diarrhea is a known transient side effect of B12 injections, along with pain and burning at the injection site, and peripheral vascular thrombosis. Increasing dietary intake of B12-rich foods would not be sufficient due to the malabsorption issue in pernicious anemia. Follow-up is essential in managing pernicious anemia, so instructing patients they do not need to return for follow-up is incorrect. While oral B12 may be a suitable option for some cases, it is not the preferred choice for pernicious anemia where malabsorption is the primary issue.
A patient has been diagnosed with Guillain-Barre Syndrome. Which of the following statements is the most applicable when discussing the impairments with Guillain-Barre Syndrome with the patient?
- A. Guillain-Barre Syndrome improves in almost all cases within 5 years.
- B. Guillain-Barre Syndrome causes limited sensation in the abdominal region.
- C. Guillain-Barre Syndrome causes muscle weakness in the legs.
- D. Guillain-Barre Syndrome affects breathing in severe cases.
Correct Answer: C
Rationale: The correct statement is that Guillain-Barre Syndrome causes muscle weakness in the legs. This muscle weakness typically starts in the legs and can progress to the upper body. Choice A is incorrect as while most cases do improve, the recovery time can vary. Choice B is incorrect as Guillain-Barre Syndrome primarily affects muscle weakness rather than sensation. Choice D is incorrect as severe cases of Guillain-Barre Syndrome can lead to respiratory muscle weakness, impacting breathing.
When administering intravenous electrolyte solution, what precaution should the nurse take?
- A. Infuse hypertonic solutions cautiously.
- B. Mix no more than 60 mEq of potassium per liter of fluid.
- C. Prevent infiltration of calcium, which causes tissue necrosis and sloughing.
- D. Monitor the client's digitalis dosage for adjustments due to IV calcium.
Correct Answer: C
Rationale: When administering intravenous electrolyte solutions, preventing the infiltration of calcium is crucial to avoid tissue necrosis and sloughing, making choice C the correct answer. Choice A is revised to 'Infuse hypertonic solutions cautiously' because hypertonic solutions should be infused cautiously to prevent adverse effects. Choice B is corrected to 'Mix no more than 60 mEq of potassium per liter of fluid' as exceeding this limit can lead to hyperkalemia. Choice D is modified to 'Monitor the client's digitalis dosage for adjustments due to IV calcium' as it is essential to monitor the digitalis dosage for potential adjustments when IV calcium is administered; however, this choice is incorrect here as it inaccurately suggests adjusting the digitalis dosage due to IV calcium, which could lead to harmful effects.