Nokea
The 35-year-old client who sustained a crushing injury to the left hand and forearm is being discharged. Which referral should the nurse implement?
- A. Refer the client to physical therapy at home.
- B. Refer the client to an assistive living facility.
- C. Refer the client to a workforce commission for job training.
- D. Refer the client to the dietitian.
Correct Answer: A
Rationale: Home PT restores hand/forearm function post-crushing injury. Assisted living, job training, and dietitian referrals are premature or unrelated.
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The school nurse is completing spinal screenings. Which data require a referral to an HCP?
- A. Bilateral arm lengthening while bending over at the waist.
- B. A deformity which resolves when the head is raised.
- C. Equal spacing of the arms and body at the waist.
- D. A right arm lower than the left while bending over at the waist.
Correct Answer: D
Rationale: Asymmetrical arm positioning (right lower than left) suggests scoliosis, requiring HCP referral. Symmetrical arms, resolving deformities, and equal spacing are normal.
Which statement by the nurse about fiberglass casts is most accurate?
- A. Fiberglass casts are less expensive than plaster
- B. Fiberglass casts are lightweight.
- C. Fiberglass casts are flexible.
- D. Fiberglass casts are less restrictive than plaster casts.
Correct Answer: B
Rationale: Fiberglass casts are lightweight compared to plaster, making them more comfortable for clients. They are not necessarily less expensive, flexible, or less restrictive, as both types immobilize effectively.
When the nurse makes rounds at the beginning of the shift, which observation requires the nurse's immediate attention?
- A. The halter rests under the client's chin and occiput.
- B. The client's ears are clear of the traction ropes.
- C. The weight hangs between the headboard and wall.
- D. There is a soft pillow beneath the client's head.
Correct Answer: D
Rationale: A pillow under the head in cervical traction can alter the alignment and reduce traction effectiveness, requiring immediate removal. The other observations indicate proper setup.
Which nursing intervention is most appropriate for preventing a pathological fracture?
- A. Encouraging a high fluid intake
- B. Providing a nutritional diet
- C. Supporting the limb during movement
- D. Relieving pressure on bony prominences
Correct Answer: C
Rationale: Supporting the limb during movement minimizes stress on the necrotic bone, reducing the risk of a pathological fracture in osteomyelitis. Fluid, diet, and pressure relief are less directly preventive.
Which substances should the nurse advise the client to avoid?
- A. Aspirin and fiber-containing laxatives
- B. Tobacco products and carbonated beverages
- C. Orange juice and caffeinated drinks
- D. Calcium-enriched dairy products
Correct Answer: B
Rationale: Tobacco and carbonated beverages reduce bone density, worsening osteoporosis.