Nokea
The nurse is caring for a client reporting phantom limb pain after a below-the-knee amputation. The client is experiencing what type of pain?
- A. Perceived pain
- B. Somatic pain
- C. Neuropathic pain
- D. Nociceptive pain
Correct Answer: C
Rationale: Phantom limb pain is neuropathic, resulting from nerve damage or dysfunction after amputation, causing pain in the absent limb. Perceived pain is vague, somatic is from tissues, and nociceptive is from actual injury.
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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 is conducting a community health fair. Which of the following clients is at the greatest risk of developing osteoporosis?
- A. 27-year-old woman who jogs three times a week and drinks red wine daily
- B. 60-year-old woman who smokes cigarettes and just recently stopped drinking alcohol
- C. 51-year-old man who suffers from alcoholism and recently stopped smoking
- D. 25-year-old man with asthma who takes inhaled corticosteroids
Correct Answer: B
Rationale: The 60-year-old woman who smokes has the greatest osteoporosis risk due to age, smoking (reduces bone density), and likely post-menopausal status. Jogging, male gender, and younger age lower risk in others.
The nurse is conducting a client teaching session at the clinic for a client who has been prescribed a bisphosphonate for osteoporosis treatment. Which instructions should the nurse provide to this client?
- A. Take this medication sitting upright first thing in the morning with a full glass of water
- B. Take this medication at night, just before bed
- C. This medication should be taken with a full meal
- D. This medication is the best alternative if an esophageal disorder is present
Correct Answer: A
Rationale: Bisphosphonates like alendronate must be taken sitting upright first thing in the morning with a full glass of water to ensure proper absorption and minimize esophageal irritation. Taking it at night, with food, or with an esophageal disorder increases the risk of esophageal damage or reduced efficacy.
The nurse is caring for a client with myasthenia gravis who is six hours postoperative following a thymectomy. Which item should the nurse have at the bedside?
- A. Calcium gluconate
- B. Bag-valve mask
- C. Tracheostomy kit
- D. Atropine sulfate
Correct Answer: B
Rationale: Myasthenia gravis can cause respiratory muscle weakness, and post-thymectomy risks respiratory compromise. A bag-valve mask is critical for emergency ventilation. Calcium gluconate, tracheostomy kits, and atropine are not directly related.
The nurse has received a prescription for an oral bisphosphonate for a client with osteoporosis. Which finding in the client's medical history would contraindicate the administration of this medication?
- A. diabetes mellitus
- B. hypercalcemia
- C. lactose intolerance
- D. Roux-en-Y gastric bypass
Correct Answer: D
Rationale: Roux-en-Y gastric bypass alters gastrointestinal absorption, reducing the efficacy of oral bisphosphonates and increasing the risk of esophageal or gastric irritation. Diabetes mellitus, hypercalcemia, and lactose intolerance are not absolute contraindications, though hypercalcemia requires monitoring.