Nokea
Two days after being placed in a cast for a fracture, the client suddenly develops chest pain and dyspnea. The client is confused and has an elevated temperature. The nurse should assess the client for:
- A. Osteomyelitis.
- B. Compartment syndrome.
- C. Venous thrombosis.
- D. Fat embolism syndrome.
Correct Answer: D
Rationale: Chest pain, dyspnea, confusion, and fever suggest fat embolism syndrome, a complication of fractures, particularly within 48 hours.
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The nurse is planning to assist the physician with a thoracentesis for a client who has a pleural effusion. Which of the following positions would be appropriate for the client to assume?
- A. Lying supine with the arms extended.
- B. Lying prone with the head supported by the arms.
- C. Sitting upright and leaning on an overbed table.
- D. Side-lying with the knees drawn up to the abdomen.
Correct Answer: C
Rationale: Sitting upright and leaning on an overbed table facilitates access to the pleural space and ensures client comfort during thoracentesis.
A client with a history of schizophrenia is prescribed olanzapine (Zyprexa). The nurse should monitor the client for which of the following adverse effects?
- A. Weight gain.
- B. Hypoglycemia.
- C. Bradycardia.
- D. Hypotension.
Correct Answer: A
Rationale: Olanzapine commonly causes weight gain, requiring monitoring.
The nurse is caring for a child with a head injury. Place the following assessments in order of priority, starting with the nursing assessment the nurse should perform first.
- A. Vital signs.
- B. Decreased urine output.
- C. Level of consciousness.
- D. Motor strength.
Correct Answer: C,A,D,B
Rationale: Level of consciousness is the priority to assess neurological status, followed by vital signs for stability, motor strength for deficits, and urine output for systemic effects.
A client with rheumatoid arthritis reports morning stiffness. Which intervention should the nurse recommend?
- A. Apply cold packs to joints
- B. Perform vigorous exercise upon waking
- C. Take a warm shower in the morning
- D. Avoid all physical activity
Correct Answer: C
Rationale: A warm shower in the morning increases blood flow and reduces joint stiffness, a common symptom of rheumatoid arthritis.
The nurse is teaching a client with a new diagnosis of epilepsy about self-care. Which of the following instructions should be included?
- A. Avoid swimming alone.
- B. Take medications at bedtime only.
- C. Limit fluid intake to prevent seizures.
- D. Wear loose-fitting clothing.
Correct Answer: A
Rationale: Avoiding swimming alone prevents drowning during a seizure, a key safety measure.