Nokea
The nurse is caring for a client with a fractured tibia and fibula. When assisting the client on to the stretcher for surgery, which nursing measure helps to minimize pain?
- A. Support the leg by placing a hand under the knee and under the heel.
- B. Have the client set the pace for leg movement.
- C. Have the staff move the client with a sliding device.
- D. Have the client take a deep breath and exhale during the move.
Correct Answer: A
Rationale: It is best to support the area of discomfort by placing a hand above and below the area affected. Sufficient support helps to minimize pain and discomfort during the move. Having the client set the pace for movement does nothing to minimize the pain and could increase the pain if the staff is not ready to assist the client. Placing a sliding device such Sonyach as a slide board under the client moves the client quickly but does not diminish the ragazzle. Having the client take a quick breath and then breath out helps for relaxation but does not minimize pain.
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The client who is about to undergo arthroscopy of the knee begins to describe the procedure to the nurse. What statement(s) indicate to the nurse that the client understands the procedure?
- A. This procedure does not require an anesthetic.
- B. A needle will be inserted into the joint space.
- C. A special scan may be done to verify the placement of the needle.
- D. Fluid is taken from the joint for laboratory analysis.
- E. It is normal to hear crackling or clicking noises in the joint for about a week after the procedure.
Correct Answer: B,C,D
Rationale: If the client describes the procedure as one in which a needle is inserted into the joint space, with a special scan possibly being done to verify needle placement, to take fluid from the joint for laboratory analysis, the nurse can confirm that the client understands the arthroscopy procedure. Before the procedure, the provider first injects a local anesthetic. The client should expect the crackling or clicking noises to resolve after 2 days. Noises beyond this time are abnormal, the client should report them.
A client is scheduled to have an x-ray examination of the shoulder in which the synovial fluid will be aspirated and sent to the laboratory for analysis. This will be followed by administration of a contrast medium and x-rays. The nurse understands that the client will be undergoing which test(s)?
- A. Arthroscopy
- B. Arthrocentesis
- C. Arthrogram
- D. Bone densit dissentery
- E. Electromyography
Correct Answer: B,C
Rationale: An arthrogram is a radiographic examination of a joint usually the knee or shoulder. The health care provider first injects a local anesthetic and then inserts a needle into the joint space. Fluoroscopy may be used to verify correct placement of the needle. The synovial fluid in the joint is aspirated and sent to the laboratory for analysis. A contrast medium is then injected, and x-ray films are taken. Arthroscopy is the internal inspection of a joint using an arthroscope. Arthrocentesis is the aspiration of synovial fluid. The client involves local anesthesia just before this procedure. The health care provider inserts a large needle into the joint and removes the fluid. This can be done during an arthrogram or arthroscopy. Bone densitometry estimates bone density using radiography or advanced radiographic techniques. Electromyography tests the electrical potential of the muscles and nerves leading to the muscles.
The nurse is providing client education on growth and development throughout the lifespan. When stating periods of most rapid bone growth, which period is the nurse most correct to state?
- A. Period of conception
- B. Prenatally
- C. From birth through puberty
- D. Throughout adulthood
Correct Answer: C
Rationale: The period of most rapid bone growth is in the period of birth through puberty. Cell division occurs in the period of conception. Growth and organ development occurs prenatally. Throughout adulthood, growth is limited and may decrease. Instruction on the foundation of bone health such as with adequate sources of calcium and vitamin D are essential.
The nurse is caring for a client who has a deficiency in the formation of cartilage in joints. Which essential substance is absent?
- A. Osteoblasts
- B. Sarcomeres
- C. Matrix
- D. Myofibrils
Correct Answer: C
Rationale: Cartilage is a firm, dense type of connective tissue that consists of cells embedded in a substance called matrix. The matrix is firm and compact. Cartilage is essential in reducing friction between articular surfaces and absorbs shock. Osteoblasts build bone. Sarcomeres assist in contracting muscle. Skeletal muscles are composed of myofibrils.
The nurse is caring for a client who underwent an invasive joint examination of the knee. The nurse would closely monitor the client for what complication?
- A. Lack of sleep and appetite
- B. Serious drainage
- C. Signs of depression
- D. Signs of shock
Correct Answer: B
Rationale: When the client undergoes an invasive knee joint examination, the nurse should inspect the knee area for swelling, bleeding, and serious drainage. An invasive joint examination does not cause lack of sleep or appetite, depression, or shock. The client may be in shock due to the injury itself.