Nokea
Which explanation by the nurse is best when the parents ask how their child with Duchenne muscular dystrophy will be treated knowing that the life expectancy is limited?
- A. "Due to your child's cognitive impairment, your child will be unaware of a shortened life."
- B. "We will focus on maximizing your child's abilities and promoting your child's comfort."
- C. "There is not enough known about this disease to know what will happen in the future."
- D. "Nothing is likely to happen for a long time; we'll deal with it when the time comes."
Correct Answer: B
Rationale: Treatment for DMD focuses on maximizing function and comfort to improve quality of life.
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Which assessment finding would the nurse consider a likely adverse effect of the client's methotrexate (Rheumatrex) therapy?
- A. Constipation
- B. Arrhythmia
- C. Mouth sores
- D. Chest pain
Correct Answer: C
Rationale: Mouth sores (stomatitis) are a common adverse effect of methotrexate due to its impact on rapidly dividing cells, like those in the oral mucosa. The other symptoms are less commonly associated.
The college student consults the clinic nurse for advice on managing lower back pain. Which instructions should the nurse include? Select all that apply.
- A. Continue routine activity within your pain tolerance while paying attention to correct posture.
- B. Temporarily avoid lifting and other activities that increase mechanical stress on your spine.
- C. When sleeping on your side, flex your hips and knees and place a pillow between your knees.
- D. Stay at home for 1 week on bedrest to minimize physical activity and straining your back.
- E. Stand intermittently during classes, and sit with a soft support at the small of your back.
Correct Answer: A,B,C,E
Rationale: A. Remaining active is best. Using good posture will minimize back strain. B. Mechanical stress can increase pain. Prolonged unsupported sitting, heavy lifting, and bending or twisting the back, especially while lifting, should be avoided. C. Using pillows and hip and knee flexion promotes lumbar flexion and back alignment. E. Prolonged sitting should be avoided because fatigue contributes to spasm of the back muscles. Lordosis can be decreased by using a soft support at the small of the back.
The 34-year-old male client presents to the outpatient clinic complaining of numbness and pain radiating down the left leg. Which further data should the nurse assess?
- A. Posture and gait.
- B. Bending and stooping.
- C. Leg lifts and arm swing.
- D. Waist twists and neck mobility.
Correct Answer: A
Rationale: Numbness and radiating leg pain suggest sciatica from a herniated disk; assessing posture and gait evaluates nerve impingement effects. Other options are less specific to lumbar radiculopathy.
When planning the client's discharge, the nurse must help the client obtain which essential piece of equipment for home care?
- A. A wheelchair
- B. A hospital bed
- C. A raised toilet seat
- D. A mechanical lift
Correct Answer: C
Rationale: A raised toilet seat prevents excessive hip flexion, reducing dislocation risk.
The nurse is caring for a client six (6) hours postoperative right total knee replacement. Which data should the nurse report to the surgeon?
- A. A total of 100 mL of red drainage in the autotransfusion drainage system.
- B. Pain relief after using the patient-controlled analgesia (PCA) pump.
- C. Cool toes, distal pulses palpable, and pale nailbeds bilaterally.
- D. Urinary output of 60 mL of clear yellow urine in three (3) hours.
Correct Answer: C
Rationale: Cool toes and pale nailbeds suggest vascular compromise, requiring surgeon notification. Expected drainage, pain relief, and low urine output are less urgent.