Nokea
The nurse is discussing the importance of an exercise program for pain control to a client diagnosed with OA. Which intervention should the nurse include in the teaching?
- A. Wear supportive tennis shoes with white socks when walking.
- B. Carry a complex carbohydrate while exercising.
- C. Alternate walking briskly and jogging when exercising.
- D. Walk at least 30 minutes three (3) times a week.
Correct Answer: D
Rationale: Walking 30 minutes thrice weekly reduces OA pain and stiffness through low-impact exercise. Supportive shoes are helpful but secondary, carbohydrates are irrelevant, and jogging may worsen OA.
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Which intervention should the nurse implement when caring for the child with an Ilizarov external fixator applied to a lower extremity for bone lengthening?
- A. Loosening the bolts and lengthening the rods on the fixator every other day
- B. Cleansing the external fixator pin sites with sterile saline twice daily
- C. Discouraging the child from bearing any weight on the involved extremity
- D. Removing sections of the fixator apparatus when the child is positioned in bed
Correct Answer: B
Rationale: Regular cleansing of pin sites with sterile saline prevents infection in an Ilizarov fixator.
What is the purpose of the continuous passive motion (CPM) machine that the nurse should explain while teaching the client?
- A. A CPM machine is used to strengthen the leg muscles.
- B. A CPM machine is used to relieve foot swelling.
- C. A CPM machine is used to reduce surgical pain.
- D. A CPM machine is used to restore joint function.
Correct Answer: D
Rationale: The CPM machine gently flexes and extends the knee post-arthroplasty to restore joint function and prevent stiffness, not primarily to strengthen muscles, reduce swelling, or relieve pain.
The nurse is caring for a client with a fractured left tibia and fibula. Which data should the nurse report to the health-care provider immediately?
- A. Localized edema and discoloration occurring hours after the injury.
- B. Generalized weakness and increasing sensitivity to touch.
- C. Dorsalis pedal pulse cannot be located with a Doppler and increasing pain.
- D. Pain relieved after taking four (4) mg hydromorphone, a narcotic analgesic.
Correct Answer: C
Rationale: Absent pulses and increasing pain suggest compartment syndrome or arterial occlusion, requiring urgent HCP notification. Edema is expected, weakness is nonspecific, and pain relief is positive.
Which antiepileptic medication is associated with gingival hyperplasia?
- A. Gingival hyperplasia (overgrowth of gum tissue) is unique to phenytoin (Dilantin) among antiepileptic medications. About 20% of people taking phenytoin have gingival hyperplasia. This can be minimized with thorough oral care.
- B. Valproic acid (Depakote) does not have a side effect of gingival hyperplasia.
- C. Gingival hyperplasia is not a side effect of carbamazepine (Tegretol).
- D. Gingival hyperplasia is not a side effect of phenobarbital (Luminal).
Correct Answer: A
Rationale: Phenytoin (Dilantin) is uniquely associated with gingival hyperplasia, which can be mitigated with good oral hygiene.
Which nursing instruction is most beneficial to minimize stress on the client's painful joints?
- A. Maintain a normal weight.
- B. Apply a topical analgesic cream.
- C. Take a calcium supplement.
- D. Become more physically active.
Correct Answer: A
Rationale: Maintaining a normal weight reduces mechanical stress on weight-bearing joints like the hip, alleviating pain and slowing osteoarthritis progression. The other options are less impactful for joint stress.