Nokea
The college student consults the clinic nurse for advice on managing lower back pain. Which instructions should the nurse include? Select all that apply.
- A. Continue routine activity within your pain tolerance while paying attention to correct posture.
- B. Temporarily avoid lifting and other activities that increase mechanical stress on your spine.
- C. When sleeping on your side, flex your hips and knees and place a pillow between your knees.
- D. Stay at home for 1 week on bedrest to minimize physical activity and straining your back.
- E. Stand intermittently during classes, and sit with a soft support at the small of your back.
Correct Answer: A,B,C,E
Rationale: A. Remaining active is best. Using good posture will minimize back strain. B. Mechanical stress can increase pain. Prolonged unsupported sitting, heavy lifting, and bending or twisting the back, especially while lifting, should be avoided. C. Using pillows and hip and knee flexion promotes lumbar flexion and back alignment. E. Prolonged sitting should be avoided because fatigue contributes to spasm of the back muscles. Lordosis can be decreased by using a soft support at the small of the back.
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The client with rheumatoid arthritis is to receive prednisone 2.5 mg P.D. before meals and at bedtime. What is the primary expected action of the drug?
- A. Maintenance of sodium and potassium balance
- B. Improvement of carbohydrate metabolism
- C. Production of androgen-like effects
- D. Interference with inflammatory reactions
Correct Answer: D
Rationale: Prednisone's primary action in rheumatoid arthritis is to interfere with inflammatory reactions, reducing joint inflammation.
The nurse is preparing the care plan for a client with a fractured lower extremity. Which outcome is most appropriate for the client?
- A. The client will maintain function of the leg.
- B. The client will ambulate with assistance.
- C. The client will be turned every two (2) hours.
- D. The client will have no infection.
Correct Answer: A
Rationale: Maintaining leg function is the primary goal for fracture recovery. Ambulation, turning, and infection prevention are interventions, not outcomes.
The nurse is reviewing the serum laboratory results of the client with DM prior to surgical removal of pins used to stabilize a compound ankle fracture. Based on the results, which action should the nurse take?
- A. Notify the surgeon because the white blood cell count is elevated.
- B. Notify the anesthesiologist because multiple lab values are abnormal.
- C. Give potassium chloride 10 mEq in 100 mL NaCl per agency protocol.
- D. Continue to prepare the client for the scheduled pin removal surgery.
Correct Answer: A
Rationale: A. The elevated WBC indicates that the client may have an infection, which increases the risk of developing osteomyelitis. DM and a compound fracture also increase the client's risk for osteomyelitis.
The nurse is caring for a client with a newly applied plaster cast. How should the nurse touch and move the wet cast?
- A. Use the palms of the hands
- B. Use the fingertips only
- C. Use a towel sling
- D. Touch the cast only on the petals at the edges
Correct Answer: A
Rationale: Using the palms prevents indentations in a wet cast, which could cause skin irritation. Fingertips create indentations, a towel sling is inappropriate, and petaling occurs after drying.
Which intervention should the nurse include for a client diagnosed with carpal tunnel syndrome?
- A. Teach hyperextension exercises to increase flexibility.
- B. Monitor safety during occupational hazards.
- C. Prepare for the insertions of pins or screws.
- D. Monitor dressing and drain after the fasciotomy.
Correct Answer: B
Rationale: Monitoring occupational hazards (e.g., repetitive tasks) prevents carpal tunnel exacerbation. Hyperextension worsens symptoms, and surgical interventions are not first-line.