Nokea
The orthopedic nurse should be particularly alert for a fat embolus in which of the following clients having the greatest risk for this complication after a fracture?
- A. A 50-year-old with a fractured fibula
- B. A 20-year-old female with a wrist fracture
- C. A 21-year-old male with a fractured femur
- D. An 8-year-old with a fractured arm
Correct Answer: C
Rationale: Fat embolus is most common in long bone fractures, especially the femur, and in young adults. A 21-year-old with a femur fracture (C) is at highest risk. Fibula (A), wrist (B), and arm (D) fractures have lower risk.
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A child becomes neutropenic and is placed on protective isolation. The purpose of protective isolation is to:
- A. Protect the child from infection
- B. Provide the child with privacy
- C. Protect the family from curious visitors
- D. Isolate the child from other clients and the nursing staff
Correct Answer: A
Rationale: The child no longer has normal white blood cells and is extremely susceptible to infection, necessitating protective isolation.
An adolescent client with cystic acne has a prescription for Accutane (isotretinoin). Which lab work is needed before beginning the medication?
- A. Complete blood count
- B. Clean-catch urinalysis
- C. Liver profile
- D. Thyroid function test
Correct Answer: C
Rationale: Isotretinoin can cause liver toxicity, requiring a baseline liver profile to monitor for elevations in liver enzymes. CBC, urinalysis, and thyroid tests are not primary concerns.
A client decided early in her pregnancy to breast-feed her first baby. She gave birth to a normal, full-term girl and is now progressing toward the establishment of successful lactation. To remove the baby from her breast, she should be instructed to:
- A. Gently pull the infant away
- B. Withdraw the breast from the infant's mouth
- C. Compress the areolar tissue until the infant drops the nipple from her mouth
- D. Insert a clean finger into the baby's mouth beside the nipple
Correct Answer: D
Rationale: Inserting a finger into the infant's mouth breaks suction, allowing nipple removal without trauma. Other methods risk nipple injury.
A 60-year-old woman exhibits forgetfulness, emotional lability, confusion, and decreased concentration. She has been unable to perform activities of daily living without assistance. After a thorough medical evaluation, a diagnosis of Alzheimer's disease was made. An appropriate nursing intervention to decrease the anxiety of this client would include:
- A. Allowing the client to perform activities of daily living as much as possible unassisted
- B. Confronting confabulations
- C. Reality testing
- D. Providing a highly stimulating environment
Correct Answer: A
Rationale: This answer is correct. The more the client is able to control her daily routine, the less anxiety she will experience. This answer is incorrect. Confrontation tends to increase anxiety. This answer is incorrect. Reality testing is an assessment tool. It does not decrease anxiety. This answer is incorrect. A highly stimulating environment increases distractibility and anxiety.
The client is admitted with a diagnosis of preeclampsia. The nurse should monitor for which complication?
- A. Seizures
- B. Premature rupture of membranes
- C. Fetal macrosomia
- D. Maternal hypoglycemia
Correct Answer: A
Rationale: Preeclampsia can progress to eclampsia characterized by seizures a life-threatening complication. Premature rupture of membranes macrosomia and hypoglycemia are not directly related to preeclampsia.