Nokea
The nurse is caring for a patient who underwent a laminectomy and discectomy for a herniated intervertebral disc. Following the surgery, which of the following actions should the nurse implement when positioning the patient on their side?
- A. Instruct the patient to move their legs before turning the rest of the body.
- B. Have the patient turn by grasping the side rails and pulling the shoulders over.
- C. Place a pillow between the patient's legs and turn the entire body as a unit.
- D. Turn the patient's head and shoulders first, followed by the hips, legs, and feet.
Correct Answer: C
Rationale: The spine should be kept in correct alignment after laminectomy. The other positions will create misalignment of the spine.
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The nurse is caring for a patient who has acute osteomyelitis and is receiving tobramycin 80 mg IV twice daily. Which of the following actions should the nurse take before administering the gentamicin?
- A. Ask the patient about any nausea.
- B. Obtain the patient's oral temperature.
- C. Change the prescribed wet-to-dry dressing.
- D. Review the patient's blood urea nitrogen (BUN) and creatinine levels.
Correct Answer: D
Rationale: Gentamicin is nephrotoxic and can cause renal failure. Monitoring the patient's temperature before gentamicin administration is not necessary. Nausea is not a common adverse effect of IV gentamicin. There is no need to change the dressing before gentamicin administration.
The nurse is preparing to administer alendronate to a patient with osteoporosis. Which of the following actions will the nurse implement initially?
- A. Ensure the patient has recently eaten.
- B. Ask about any leg cramps or hot flashes.
- C. Assist the patient to sit up at the bedside.
- D. Administer the prescribed calcium carbonate.
Correct Answer: C
Rationale: To avoid esophageal erosions, the patient taking bisphosphonates should be upright for at least 30 minutes after taking the medication. Fosamax should be taken on an empty stomach, not after taking other medications or eating. Leg cramps and hot flashes are not adverse effects of bisphosphonates.
Which of the following menu choices by a patient with osteoporosis indicates that the nurse's teaching about appropriate diet has been effective?
- A. Pancakes with syrup and bacon
- B. Whole wheat toast and fruit jelly
- C. Two-egg omelet and a half grapefruit
- D. Oatmeal with skim milk and fruit yogurt
Correct Answer: D
Rationale: Skim milk and yogurt are high in calcium. The other choices do not contain any high calcium foods.
Which of the following statements by a patient with osteosarcoma of the right tibia who is scheduled for an above-the-knee amputation indicates that patient teaching is needed?
- A. I did not have this bone cancer until my leg broke a week ago.
- B. I wish that I did not have to have chemotherapy after this surgery.
- C. I know that I will need to participate in physical therapy after surgery.
- D. I will use the patient-controlled analgesia (PCA)
Correct Answer: A
Rationale: The statement that the patient did not have bone cancer until the leg broke indicates a misunderstanding, as osteosarcoma is a primary bone cancer that may lead to fractures, not vice versa. The other statements reflect appropriate understanding of the need for chemotherapy, physical therapy, and pain management post-surgery.
The nurse is assessing a patient in the foot clinic who has severe heel pain. Which of the following foot disorders should the nurse assess for?
- A. Hallux rigidus
- B. Morton's neuroma
- C. Pes cavus
- D. Plantar fasciitis
Correct Answer: D
Rationale: Complaints of severe heel pain will alert the nurse to assess for plantar bursitis, plantar fasciitis, or bone spur in adult. Hallux rigidus, pes cavus, and Morton's neuroma do not have the symptom of severe heel pain.