Nokea
Twenty-four hours later Bob is discharged. Which of the following statements would indicate Bob understood your teaching?
- A. Increasing pain in the arm is expected over the next 2 days but if it continues the third day I'll call the physician.
- B. If the fingers of my left hand begin to swell and are colder than those of the right hand, I'll elevate my arm above heart level and call the physician.
- C. Bleeding may appear on the cast today. I'll circle the area and if it continues to increase, I'll call the physician.
- D. I'll immobilize my left hand for 1 week, then begin active flexion-extension exercises and continue until my follow-up visit.
Correct Answer: B
Rationale: Swelling and coldness could indicate impaired circulation, necessitating immediate medical attention.
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A patient is discharged from the outpatient clinic following application of a synthetic fiberglass long arm cast for a fractured ulna. Before discharge, the nurse instructs the patient to do what?
- A. Never get the cast wet.
- B. Move the shoulder and fingers frequently.
- C. Place tape petals around the edges of the cast when it is dry.
- D. Use a sling to support the arm at waist level for the first 48 hours.
Correct Answer: B
Rationale: Moving the unaffected parts promotes circulation and reduces stiffness.
In our body involuntary actions are controlled by:
- A. Medulla in Hindbrain
- B. Medulla in Forebrain
- C. Medulla in Spinal Cord
- D. Medulla in Midbrain
Correct Answer: A
Rationale: Medulla in Hindbrain is the correct answer because it controls involuntary actions such as heart rate, breathing, and blood pressure. The medulla oblongata, located in the hindbrain, is essential for maintaining vital bodily functions without conscious effort.
The Bell's phenomenon:
- A. occurs during normal blinking
- B. if absent suggests brain stem disease
- C. is absent in Bell's palsy
- D. is reduced or absent in patients with thyroid orbitopathy
Correct Answer: D
Rationale: The Bell's phenomenon, an upward and outward eye movement during eyelid closure, is reduced or absent in thyroid orbitopathy due to restricted eye movements. It is not typically absent in Bell's palsy or brain stem disease.
Priority Decision: Twenty-four hours after a below-the-knee amputation, a patient uses the call system to tell the nurse that his dressing (a compression bandage) has fallen off. What is the first action that the nurse should take?
- A. Apply ice to the site.
- B. Cover the incision with dry gauze.
- C. Reapply the compression dressing.
- D. Elevate the extremity on a couple of pillows.
Correct Answer: B
Rationale: Dry gauze protects the wound until proper redressing.
The nurse positions a client who is being treated for a fracture. Why should care be taken to position the client's joints in an anatomic alignment?
- A. To prevent deep vein thrombosis
- B. To facilitate the lung expansion and prevent the pooling of secretions
- C. To prevent the escalation of the pain and swelling
- D. To prevent damage to the peripheral nerves and the blood vessels
Correct Answer: D
Rationale: Proper alignment prevents nerve and vascular damage.