Nokea
The client is to be discharged after receiving treatment for right shoulder tendonitis. Which actions indicate to the nurse that the client is ready for discharge? Select all that apply.
- A. Verbalizes about resuming normal activities within a day or two
- B. Demonstrates proper use of an arm sling and the need to wear it during sleep
- C. Verbalizes to keep the arm extended and flat on the mattress when lying in bed
- D. Demonstrates how to properly apply the ice packs on the shoulder joint
- E. States will take ibuprofen every four to six hours as needed for pain
Correct Answer: B,D,E
Rationale: B. An arm sling helps to rest the joint and keep it stabilized, especially during sleep. D. Ice application reduces joint inflammation and pain associated with tendonitis. E. NSAIDs such as ibuprofen (Motrin) are effective for controlling pain and reducing inflammation with tendonitis.
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On the basis of the nurse's knowledge of the client's culture and beliefs, which statement regarding the health-seeking behavior is probably most accurate?
- A. Home remedies have been unsuccessful, and the condition threatens the client's self-image.
- B. The power to cure comes from physicians and is passed to nurses.
- C. Both of the above
- D. None of the above
Correct Answer: A
Rationale: Hispanic clients may initially rely on home remedies due to cultural practices, seeking medical care when these fail, especially if pain (e.g., bursitis) impacts self-image or function.
One month after discharge, the client who had a left THR calls a clinic reporting acute, constant pain in the left groin and hip area and feeling like the left leg is shorter than the right. The nurse advises the client to come to the clinic immediately, suspecting which problem?
- A. An infection of the wound
- B. Deep vein thrombosis (DVT)
- C. Dislocation of the prosthesis
- D. Aseptic loosening of the prosthesis
Correct Answer: C
Rationale: C. Indicators of a prosthesis dislocation include increased surgical site pain, acute groin pain, shortening of the leg, abnormal external or internal rotation, restricted ability or inability to move the leg, and reports of a popping sensation in the hip.
A cast has just been applied to a client's left forearm, and he has 10 lbs of Russell's traction on his left leg. Which of the following nursing concerns takes priority in the care of this client?
- A. The casted extremity may swell, and the cast will become a tourniquet.
- B. Heat conduction from the wet cast can cause burning to the skin below.
- C. Muscle atrophy of the areas involved can lead to decreased muscle tone.
- D. Skin irritation from the cast edges can cause abrasions.
Correct Answer: A
Rationale: Swelling in a newly casted extremity can cause the cast to act as a tourniquet, compromising circulation, which is the priority concern. Heat from a wet cast does not burn skin, muscle atrophy is a long-term issue, and skin irritation is less urgent.
The nurse is caring for an elderly client diagnosed with a herniated nucleus pulposus of L4-5. Which scientific rationale explains the incidence of a ruptured disk in the elderly?
- A. The client did not use good body mechanics when lifting an object.
- B. There is an increased blood supply to the back as the body ages.
- C. Older clients develop atherosclerotic joint disease as a result of fat deposits.
- D. Clients develop intervertebral disk degeneration as they age.
Correct Answer: D
Rationale: Intervertebral disk degeneration with aging reduces disk hydration and elasticity, increasing rupture risk. Poor body mechanics is a risk but not the primary cause, blood supply decreases, and atherosclerosis affects joints differently.
Which information should the nurse teach the client regarding sports injuries?
- A. Apply heat intermittently for the first 48 hours.
- B. An injury is not serious if the extremity can be moved.
- C. Only return to the health-care provider if the foot becomes cold.
- D. Keep the injury immobilized and elevated for 24 to 48 hours.
Correct Answer: D
Rationale: Immobilization and elevation reduce swelling in sports injuries. Heat worsens swelling, movement does not rule out severity, and cold feet are a late sign.