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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A client with a history of statin use presents to the clinic with complaints of muscle weakness and pain. The nurse suspects myopathy. Which of the following laboratory tests should the nurse prioritize to evaluate for muscle damage?
- A. Electrocardiogram (ECG)
- B. Liver function tests (LFTs)
- C. Creatine kinase (CK)
- D. Complete blood count (CBC)
Correct Answer: C
Rationale: Creatine kinase (CK) levels rise with muscle damage, common in statin-induced myopathy. ECG is for cardiac issues, LFTs monitor liver, and CBC is not specific to muscle damage.
A nurse is caring for a client admitted to the emergency department with suspected rhabdomyolysis. Which of the following findings would the nurse anticipate in a client with this condition?
- A. Elevated creatinine kinase (CK) levels
- B. Decreased serum potassium levels
- C. Hypertension and bradycardia
- D. Clear urine output
Correct Answer: A
Rationale: Rhabdomyolysis causes muscle breakdown, releasing creatinine kinase (CK) into the blood, elevating levels. Potassium levels typically rise, blood pressure and heart rate vary, and urine is dark from myoglobin.
The nurse is teaching a new grad about contractures. The nurse knows which statement about contractures secondary to immobility is accurate?
- A. Contractures cannot be prevented because of muscular spasticity.
- B. Contractures cannot be prevented because of muscular tension.
- C. Flexion contractures are the least commonly occurring contracture.
- D. Flexion contractures are the most commonly occurring contracture.
Correct Answer: D
Rationale: Flexion contractures are the most common due to immobility, as muscles shorten in a flexed position. Contractures can be prevented with range of motion and positioning, despite spasticity or tension.
The nurse is caring for a 41-year-old female in the outpatient clinic
Item 1 of 1
• Progress Note
1300:
• Client presenting for the initial dose of etanercept following the diagnosis of rheumatoid arthritis.
• The client reported joint pain in the hands not improving with acetaminophen.
• Will prescribe better pain control and follow up in six weeks.
• Physician Orders
• Etanercept 50 mg SubQ every week
• Naproxen 500 mg PO Daily, as needed for pain
The nurse prepares to administer the prescribed etanercept.Complete the sentences below by selecting the appropriate option:The nurse should instruct the client that the prescribed etanercept
--------------------------Prior to the first dose, the nurse should ensure the client has had a----------------------After administering the medication, the nurse should----------------------
- A. raises the blood glucose
- B. increases the risk for infection
- C. causes weight gain.
- D. fasting blood glucose
- E. negative purified protein derivative (PPD) test
- F. baseline lipid panel.
- G. assess for an injection site reaction.
Correct Answer: B,E,G
Rationale: Etanercept is a tumor necrosis factor (TNF) blocking agent used to treat autoimmune disorders such as psoriasis or rheumatoid arthritis (RA). This medication increases the client's risk of infection, requiring baseline testing for TB, such as a PPD. If the client has latent TB, it may be activated again. Etanercept does not cause weight gain or raise blood glucose. This would be true if the client were prescribed a corticosteroid which may be used in exacerbations of RA. A lipid panel has no relevance to etanercept. Etanercept is administered subcutaneously at a 45 to a 90-degree angle. This medication is not administered in the deltoid; this would be appropriate for an intramuscular injection. Aspiration for subcutaneous injections is unnecessary as piercing a blood vessel is rare. The most common adverse effect of this medication is injection site reaction (redness, pain, discomfort). The area should not be rubbed or massaged as it could worsen the injection site reaction.
The nurse is assessing a client who reports left knee pain after playing baseball. The nurse should initially
- A. Feel the knee for warmth.
- B. Inspect the knee for any swelling.
- C. Palpate for crepitus in the knee.
- D. Have the client perform active range of motion in the knee.
Correct Answer: B
Rationale: Initial assessment starts with inspection for swelling, a visible sign of injury or inflammation post-activity. Warmth, crepitus, and range of motion are assessed next but are not the first step.