Nokea
The client is taking calcium carbonate (Tums) to help prevent further development of osteoporosis. Which teaching should the nurse implement?
- A. Encourage the client to take Tums with at least eight (8) ounces of water.
- B. Teach the client to take Tums with the breakfast meal only.
- C. Instruct the client to take Tums 30 to 60 minutes before a meal.
- D. Discuss the need to get a monthly serum calcium level.
Correct Answer: A
Rationale: Taking Tums with water ensures proper absorption and prevents GI irritation. Timing with meals is flexible, pre-meal timing is unnecessary, and monthly calcium levels are not routine.
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The nurse is caring for the client 24 hours following total hip arthroplasty using the traditional posterior approach. Which interventions should the nurse plan to implement? Select all that apply.
- A. Place pillows or a wedge pillow between the client's legs to keep them abducted.
- B. Have the client flex the unaffected hip and use the trapeze to help move up in bed.
- C. Raise the head of the bed to no more than 90 degrees when the bed is placed contour.
- D. Place a pillow between the client's knees when initially assisting the client out of bed.
- E. Applies antiembolism stockings that should not be removed for 24 hours postoperatively.
Correct Answer: A,B,D
Rationale: A. A pillow should be used to maintain abduction to prevent dislocation. B. Using the trapeze and flexing the unaffected legs while keeping the affected leg straight help prevent flexion with position changes. The client's hip should not be flexed more than 90 degrees. D. In initial transfers, a pillow is used to remind the client to maintain abduction and prevent internal and external hip rotation.
If the client is in shock, how should the nurse position the client while continuing to assess and provide care?
- A. Prone with the arm supported
- B. In Fowler's position with the knees flexed
- C. Supine with the legs elevated
- D. Lateral with the back extended
Correct Answer: C
Rationale: Supine with legs elevated improves venous return in shock.
The HCP's progress note states that the infant with meningitis is in an opisthotonus position. What should the nurse observe when performing an assessment?
- A. Resistance with specific leg movement
- B. Knee or hip flexion with head flexion
- C. A high-pitched cry with neck flexion
- D. Hyperextension of the head and neck
Correct Answer: D
Rationale: Opisthotonus is characterized by severe hyperextension of the head and neck, often seen in meningitis.
The client with DM is admitted with possible osteomyelitis secondary to an ankle wound. The client's ankle is painful, red, swollen, and warm, and the wound is persistently draining. The client's temperature is 102.2°F (39°C). Based on the client's status, which HCP order should the nurse plan to defer until later?
- A. Obtain a culture of the ankle wound.
- B. Administer ceftriaxone 1 g IV q12h.
- C. Apply splint to immobilize the ankle.
- D. Teach on IV antibiotic self-administration.
Correct Answer: D
Rationale: D. The nurse should defer teaching. Pain and an elevated temperature are barriers to learning.
The client who had a total knee replacement is being discharged home. To which multidisciplinary team member should the nurse refer the client?
- A. The occupational therapist.
- B. The physiatrist.
- C. The recreational therapist.
- D. The home health nurse.
Correct Answer: D
Rationale: A home health nurse monitors recovery, manages complications, and supports mobility post-TKR. OT, physiatrists, and recreational therapists are less critical at discharge.