Nokea
The primary purpose for using a CPM machine for the client with a total knee repair is to help:
- A. Prevent contractures.
- B. Promote flexion of the artificial joint.
- C. Decrease the pain associated with early ambulation.
- D. Alleviate lactic acid production in the leg muscles.
Correct Answer: A
Rationale: A CPM machine prevents contractures by maintaining joint mobility post-knee repair. It aids flexion but primarily prevents stiffness. Pain and lactic acid are secondary concerns.
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A pregnant client who is at 34 weeks gestation is diagnosed with a pulmonary embolism (PE). Which of these medications would the nurse anticipate the provider ordering?
- A. Oral Coumadin therapy
- B. Heparin 5000 units subcutaneously B.I.D.
- C. Heparin infusion to maintain the PTT at 1.5-2.5 times the control value
- D. Heparin by subcutaneous injection to maintain the PTT at 1.5 times the control value
Correct Answer: C
Rationale: Heparin infusion to maintain the PTT at 1.5-2.5 times the control value. In pregnant women with pulmonary embolism, heparin is preferred over warfarin due to warfarin's teratogenic effects. A continuous heparin infusion is typically used to achieve therapeutic anticoagulation, monitored by maintaining the PTT at 1.5-2.5 times the control value.
The nurse is supervising care given to a group of patients on the unit. The nurse observes a staff member entering a patient's room wearing gown and gloves. The nurse knows that the staff member is caring for which of the following patients?
- A. An 18-month-old with respiratory syncytial virus.
- B. A 4-year-old with Kawasaki disease.
- C. A 10-year-old with Lyme's disease.
- D. A 16-year-old with infectious mononucleosis.
Correct Answer: A
Rationale: acute viral infection; requires contact precautions; assign to private room or with other RSV-infected children
Which assessment is most essential before administering digoxin to an adult?
- A. Ask the client if he has chest pain.
- B. Take an apical pulse.
- C. Take the client's blood pressure.
- D. Ask the client if he is short of breath.
Correct Answer: B
Rationale: Taking an apical pulse ensures the heart rate is above 60 bpm, as digoxin can cause bradycardia, a critical safety check.
When an autistic client begins to eat with her hands, the nurse can best handle the problem by
- A. Placing the spoon in the client's hand and stating, 'Use the spoon to eat your food.'
- B. Commenting, 'I believe you know better than to eat with your hand.'
- C. Jokingly stating, 'Well I guess fingers sometimes work better than spoons.'
- D. Removing the food and stating, 'You can't have anymore food until you use the spoon.'
Correct Answer: A
Rationale: Placing the spoon in the client's hand and stating, 'Use the spoon to eat your food.' This provides clear instruction and encourages adaptive behavior.
A client is admitted with rheumatoid arthritis. Which symptoms, if exhibited by the client, are most consistent with the admitting diagnosis?
- A. A 72-year-old with pain, redness, and swelling in the big toes
- B. A 68-year-old with enlarged finger joints and pain in the knees
- C. A 34-year-old with joint pains and a red rash on the cheeks
- D. A 28-year-old with enlarged joints and painful muscles
Correct Answer: B
Rationale: Rheumatoid arthritis causes symmetrical joint inflammation, leading to enlarged, painful joints like fingers and knees. Toe pain suggests gout, rash suggests lupus, and muscle pain is less specific.