Nokea
The nurse is assessing a client with Paget's disease. Which of the following would be an expected finding?
- A. Bone deformities
- B. Berry aneurysm
- C. Heberden's nodes
- D. Janeway lesions
Correct Answer: A
Rationale: Paget's disease causes excessive bone remodeling, leading to deformities like bowing or enlargement. Berry aneurysms, Heberden's nodes, and Janeway lesions are unrelated to this condition.
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The nurse is caring for a client six hours postoperative following a below-knee amputation (BKA). Which of the following assessment findings requires follow-up?
- A. Restlessness
- B. Blood pressure of 140/78 mmHg
- C. Pulse rate of 89 bpm
- D. Hypoactive bowel sounds in all four quadrants
Correct Answer: A
Rationale: Restlessness can be a sign of pain, anxiety, or hypoxia, all of which require follow-up in a postoperative client. The blood pressure and pulse rate are within normal limits, and hypoactive bowel sounds are expected shortly after surgery due to anesthesia and reduced gastrointestinal motility.
While reviewing a client's medical record who has fallen twice in the past month, which medications should the nurse recommend be discontinued to lower the client's risk for future falls?
- A. Fluoxetine
- B. Temazepam
- C. Bupropion
- D. Ferrous sulfate
- E. Hydrocodone-acetaminophen
- F. Hydroxyzine
- G. Docusate
Correct Answer: B, E, F
Rationale: Temazepam (sedative), hydrocodone-acetaminophen (opioid), and hydroxyzine (sedating antihistamine) increase fall risk via drowsiness or dizziness. Fluoxetine, bupropion, ferrous sulfate, and docusate have lower fall risk.
The nurse reviews the client's clinical data. Which action should the nurse take based on the clinical data?
- A. Administer the prescribed ketorolac
- B. Remove the heating pad from the client's lower back
- C. Contact the physician to question the prescription of ketorolac
- D. Reposition the client to the side of the bed and have them twist from side to side
- E. Remove and discard the prescribed fentanyl patch because of its lack of efficacy
Correct Answer: B
Rationale: Removing the heating pad is appropriate, as heat can worsen inflammation or strain in low back pain. Ketorolac may be suitable, twisting risks harm, and fentanyl efficacy needs more data before removal.
The nurse reviews newly prescribed medications from the primary healthcare provider (PHCP). The nurse understands that the prescribed etanercept is intended to treat which condition?
- A. Osteoarthritis
- B. Diabetes mellitus
- C. Infective endocarditis (IE)
- D. Rheumatoid arthritis
Correct Answer: D
Rationale: Etanercept is a tumor necrosis factor (TNF) inhibitor used to treat autoimmune conditions like rheumatoid arthritis by reducing inflammation and joint damage. Osteoarthritis is not autoimmune, diabetes mellitus affects glucose metabolism, and infective endocarditis is a bacterial infection, none of which are treated with etanercept.
The nurse educates a client about the application of a plaster cast to a fractured radius. Which of the following statements by the client would require follow-up?
- A. If my arm feels itchy, I can use a hair dryer on the cool setting for relief.'
- B. I can reduce my arm's swelling by elevating it with a pillow.'
- C. I should be okay to shower with my cast.'
- D. It will be normal for me to feel heat after the cast is applied.'
Correct Answer: C
Rationale: Showering with a plaster cast risks wetting it, leading to breakdown or infection, requiring follow-up. Cool air for itching, elevation for swelling, and initial heat from cast setting are appropriate.