Nokea
The nurse is caring for a client being admitted to the medical-surgical unit with an acute flare of gout. After performing medication reconciliation, which medication does the nurse suspect could have triggered the acute gout flare? See the exhibit.
- A. hydrochlorothiazide
- B. temazepam
- C. rosuvastatin
- D. escitalopram
Correct Answer: A
Rationale: Hydrochlorothiazide, a thiazide diuretic, can increase serum uric acid levels by reducing renal excretion, potentially triggering an acute gout flare. Temazepam, rosuvastatin, and escitalopram do not significantly affect uric acid levels or gout.
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The nurse is planning care for a client with a newly diagnosed fractured pelvis. Which action would lessen the risk of fat embolism syndrome (FES)?
- A. Request a prescription for enoxaparin.
- B. Alternate with the application of ice and heat.
- C. Educate the client on pelvic immobilization.
- D. Encourage passive range of motion of the lower legs.
Correct Answer: C
Rationale: Pelvic immobilization reduces movement and the risk of fat globules entering the bloodstream, a key factor in fat embolism syndrome. Enoxaparin prevents clots, ice/heat manages swelling, and range of motion is beneficial but not primary for FES prevention.
The following scenario applies to the next 1 items
Item 1 of 1
History and Physical
17-year-old male arrives at the emergency department following playing baseball. He slid into a base, felt a ‘pop’, and had pain in his right ankle. The client reports pain of 7 out of 10 in his right ankle, which is described as throbbing. Right pedal pulse was 2+, and the sensation was intact. The client had a limited and painful range of motion in his ankle. Significant swelling and bruising in the ankle were observed.
The client does not have a medical or surgical history. He takes no medications.
Diagnostic Results
X-Ray: bimalleolar fracture of the right ankle
Orders
Crutches
Non-weight bearing status
Apply a splint to the ankle
Acetaminophen-Oxycodone 5/325 mg PO
While teaching the client how to use crutches, the nurse should instruct the client to ambulate using the
- A. Two-point gait
- B. Three-point gait
- C. Four-point gait
- D. Ankle having to be splinted.
- E. Non-weight bearing status.
- F. Prescribed pain medication.
Correct Answer: B
Rationale: A three-point gait is appropriate for non-weight bearing status, as with a splinted bimalleolar fracture, allowing the client to keep weight off the injured ankle using crutches and the unaffected leg.
The nurse is developing a self-management teaching plan for a client with low back pain. Which of the following should the nurse include?
- A. Avoid bending at the waist and lifting heavy objects.'
- B. Weight-bearing exercises are recommended.'
- C. Wear shoes with a higher heel.'
- D. Lay on your stomach four times daily and flex your legs.'
Correct Answer: A
Rationale: Avoiding bending at the waist and heavy lifting prevents back strain. Weight-bearing exercises help bones but not always back pain, high heels strain the back, and stomach lying with leg flexion can worsen pain.
The nurse is teaching a client with low back pain. Which of the following statements, if made by the client, would require follow-up?
- A. I am planning to stop smoking cigarettes.'
- B. I should sleep on my stomach.'
- C. I have decided to purchase a firm mattress.'
- D. I will bend my knees when lifting objects.'
Correct Answer: B
Rationale: Sleeping on the stomach can strain the lower back, requiring follow-up teaching. Quitting smoking, a firm mattress, and bending knees when lifting are all beneficial for back health.
The nurse is caring for a client who is in Buck traction. Which of the following actions should the nurse take?
- A. Ensure that weight is between 15 to 30 lb (6.8 to 13.6 kg)
- B. Turn the client using a foam wedge every two hours
- C. Ensure that a client's heels are supported with a pillow
- D. Elevate the foot of the bed to provide counter traction
Correct Answer: D
Rationale: Elevating the foot of the bed provides counter traction to maintain alignment in Buck traction. Excessive weight risks injury, turning disrupts traction, and heel support is good but not the priority.