Nokea
The nurse is caring for a client who develops compartment syndrome from a
severely fractured arm. The client asks how this can happen. What is the best
response by the nurse?
- A. . "The fascia expands with injury, causing pressure on underlying nerves and muscles."?
- B. "An injured artery causes impaired arterial perfusion through the compartment."?
- C. "Bleeding and swelling cause increased pressure in an area that cannot expand."?
- D. . "A bone fragment has injured the nerve supply in the area."?
Correct Answer: C
Rationale:
You may also like to solve these questions
A nurse is providing oral hygiene for an unconscious client. What is the priority
nursing intervention?
- A. Position the client on one side with the head turned towards you
- B. Handle dentures with care
- C. Use gentle brushing and flossing techniques for clients with fragile mucosa
- D. Have a suction apparatus ready at the bedside
Correct Answer: A
Rationale:
A client does not understand why vision loss due to glaucoma is irreversible. What is the nurse's best explanation?
- A. Once retinal detachment occurs, it does not return to its normal state
- B. Once the tissue has necrosed from high-pressure, it does not regenerate
- C. Glaucoma always leads to permanent blindness
- D. Once bacterial infection has caused damage, the tissue does not regenerate
Correct Answer: B
Rationale: The correct explanation for irreversible vision loss in glaucoma is that once the tissue has necrosed from high pressure, it does not regenerate. This necrosis occurs due to the damage caused by increased intraocular pressure, which leads to irreversible damage to the optic nerve and retinal tissue. Choices A, C, and D are incorrect because they do not directly address the specific mechanism of irreversible vision loss in glaucoma, which is necrosis due to high pressure.
The nurse assesses a wound with exudate. What should not be included when
documenting the exudate?
- A. Amount
- B. Consistency
- C. Heat
- D. Odor
Correct Answer: C
Rationale:
The client asks the nurse what nonpharmacological intervention can be used to
reduce pain and swelling in her joints affected by rheumatoid arthritis. What is
the most appropriate response by the nurse?
- A. "Ice packs can be used to reduce swelling but should be removed after 20 minutes."?
- B. "Heat always makes the swelling go down. You do not need any other interventions."?
- C. "Try high impact exercise exercise like running to loosen up your joints and reduce
pain."? - D. "Apply ice packs. It is generally okay to keep them on for up to one hour at a time."?
Correct Answer: A
Rationale:
The nurse is providing education to a client regarding the administration of eye
drops. Which of the following actions indicates the need for further client
education?
- A. The client instills the prescribed number of eye drops into the conjunctival sac
- B. The client sets the cap to the eye drop container down in a manner that does not
contaminate it - C. The client touches the administration dropper her to the eye
- D. The client washes her hands before instilling the eye drops
Correct Answer: C
Rationale: