Nokea
The client who had an open femoral fracture was discharged to her home where she developed fever, night sweats, chills, restlessness, and restrictive movement of the fractured leg. Which of the following reflects the best interpretation of these findings?
- A. Pulmonary emboli.
- B. Osteomyelitis.
- C. Fat emboli.
- D. Urinary tract infection.
Correct Answer: B
Rationale: These symptoms suggest osteomyelitis, a bone infection common after open fractures.
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The nurse's best explanation for why the severely neutropenic client is placed in reverse isolation is that reverse isolation helps prevent the spread of organisms:
- A. To the client from sources outside the client's environment.
- B. From the client to health care personnel, visitors, and other clients.
- C. By using special techniques to dispose of contaminated materials.
- D. By using special techniques to handle the client's linens and personal items.
Correct Answer: A
Rationale: Reverse isolation protects severely neutropenic clients by preventing the introduction of pathogens from external sources, such as staff, visitors, or equipment. It is not about preventing spread from the client or specific disposal/handling techniques.
The nurse is applying a prescribed 5% lidocaine patch to a client's lumbar back region. The nurse plans to remove this patch after how many hours following the application?
- A. 24 hours
- B. 72 hours
- C. 8 hours
- D. 12 hours
Correct Answer: D
Rationale: Lidocaine patches (5%) are typically applied for 12 hours and then removed for 12 hours to prevent skin irritation and systemic absorption, per standard guidelines.
The nurse is preparing the client for cardioversion. The nurse should do which of the following? Select all that apply.
- A. Use a conducting agent between the skin and the paddles.
- B. Place the paddles over the client's clothing.
- C. Call 'clear' before discharging the electrical current.
- D. Record the delivered energy and the resulting rhythm.
- E. Exert 5 to 10 lb of pressure on each paddle to ensure good skin contact.
Correct Answer: A,C,D,E
Rationale: Using a conducting agent (A), calling 'clear' (C), recording energy/rhythm (D), and applying pressure (E) ensure safe and effective cardioversion. Paddles over clothing is incorrect.
While changing the client's colostomy bag and dressing, the nurse assesses that the client is ready to participate in her care by noting which of the following?
- A. The client asks what time the doctor will visit that day.
- B. The client asks about the supplies used during the dressing change.
- C. The client talks about something she read in the morning newspaper.
- D. The client complains about the way the night nurse changed the dressing.
Correct Answer: B
Rationale: The client's inquiry about the supplies used during the dressing change indicates interest and readiness to participate in her colostomy care. Other options reflect unrelated concerns or dissatisfaction, not readiness to engage in self-care. CN: Psychosocial adaptation; CL: Evaluate
A client who is recovering from hepatitis A has fatigue and malaise. The client asks the nurse, 'When will my strength return?' Which of the following responses by the nurse is most appropriate?
- A. Your fatigue should be gone by now. We will evaluate you for a secondary infection.
- B. Your fatigue is an adverse effect of your drug therapy. It will disappear when your treatment regimen is complete.
- C. It is important for you to increase your activity level. That will help decrease your fatigue.
- D. It is normal for you to feel fatigued. The fatigue should go away in the next 2 to 4 months.
Correct Answer: D
Rationale: Fatigue is common during recovery from hepatitis A and typically resolves in 2-4 months (D). Secondary infection (A) is not indicated. Fatigue is not drug-related (B), and increasing activity prematurely (C) may worsen symptoms.