Nokea
The nurse assesses that the client has some finger swelling of a newly casted right arm fracture with no other abnormal findings. Which is the nurse's priority action?
- A. Notify the HCP immediately.
- B. Split the cast to prevent constriction.
- C. Elevate the casted arm on pillows.
- D. Document the degree of finger swelling.
Correct Answer: C
Rationale: C. Swelling is an expected finding; elevating the extremity decreases edema.
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When reviewing the chart of a 25-year-old male, the nurse reads that the client was diagnosed with an osteosarcoma of the distal femur. Which statement indicates the nurse's correct interpretation of the client's diagnosis?
- A. The tumor originated elsewhere in the client's body and metastasized to the bone.
- B. Osteosarcoma is the most common and most often fatal primary malignant bone tumor.
- C. The only treatment for osteosarcoma is a leg amputation well above the tumor growth.
- D. The tumor is nonmalignant;it can be excised and the bone replaced with a bone graft.
Correct Answer: B
Rationale: B. Osteosarcoma is a malignant primary tumor of the bone, appearing most frequently in males between 10 and 25 years (when bones grow rapidly). Prognosis depends on whether the tumor has metastasized to the lungs, but it is often fatal.
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.
The client diagnosed with OA is prescribed a nonsteroidal anti-inflammatory drug (NSAID). Which instruction should the nurse teach the client?
- A. Take the medication on an empty stomach.
- B. Make sure to taper the medication when discontinuing.
- C. Apply the medication topically over the affected joints.
- D. Notify the health-care provider if vomiting blood.
Correct Answer: D
Rationale: Vomiting blood indicates GI bleeding, a serious NSAID side effect requiring immediate HCP notification. NSAIDs should be taken with food, tapering is not typical, and topical NSAIDs are distinct.
The HCP prescribes cyclobenzaprine 30 mg orally tid for the client hospitalized with acute cervical neck pain. The pharmacy supplied 10-mg tablets. Which action by the nurse is best?
- A. Administer three 10-mg tablets with food
- B. Call the HCP to question the dose prescribed
- C. Observe for drowsiness after administration
- D. Also give prn prescribed morphine sulfate IV
Correct Answer: B
Rationale: B. The nurse should call the HCP to question the dose. If carried out as prescribed, the client would receive a total daily dose of 90 mg of cyclobenzaprine (Flexeril). The total daily dose should not exceed 60 mg.
Which material added by the nurse is best for covering the tips of the pin to prevent injuries while the client is in skeletal leg.
- A. Gauze squares
- B. Cotton balls
- C. Cork blocks
- D. Rubber tubes
Correct Answer: C
Rationale: Cork blocks securely cover pin tips, preventing injury to the client or staff while maintaining stability. Gauze and cotton are less durable, and rubber tubes may not fit securely.