Nokea
Which is the priority nursing intervention for a patient experiencing a fat embolism?
- A. Administer oxygen
- B. Increase intravenous fluids.
- C. Administer analgesic medication
- D. Notify the charge nurse
Correct Answer: A
Rationale: The airway is always the first priority. The patient should immediately be given oxygen. The charge nurse should be notified, but the priority action is to provide oxygen. The patient will not likely benefit from increased intravenous fluids and it is not the priority action. Pain medication is likely needed, however, providing oxygen is the priority.
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Which patient statement indicates the need for additional teaching for a patient with rheumatoid arthritis who is taking meloxicam?
- A. I am keeping a daily record of my blood pressure.'
- B. I take aspirin before I go to bed.'
- C. I know I can take meloxicam with or without regard to meals.'
- D. I weigh every day so I will be aware of any weight gain.'
Correct Answer: B
Rationale: Aspirin or products containing aspirin should be avoided while taking meloxicam. While taking meloxicam, there is no reason to record blood pressure readings. This medication can be taken without regard to meals. Meloxicam does not cause weight gain.
The nurse clarifies to a patient who is being evaluated for possible rheumatoid arthritis that the elevated erythrocyte sedimentation rate (ESR) indicates the presence of which process?
- A. A chronic infection
- B. Poor protein intake
- C. Increased inflammatory reaction in the body.
- D. A poor immune response to a microorganism
Correct Answer: C
Rationale: The ESR indicates an increase in the inflammatory reactions in the body. An elevated ESR does not indicate a chronic infection, poor protein intake or a poor immune response to a microorganism.
Which should the nurse expect to see in the plan of care for a patient following a myelogram in which water-soluble dye was used?
- A. Position in a semi-Fowler's position for 8 hours
- B. Place patient flat on back to compress puncture site.
- C. Ambulate for brief periods to lessen postmyelogram headache.
- D. Limit fluids to increase absorption of the dye.
Correct Answer: A
Rationale: The patient should be positioned in the semi-Fowler's position for 8 hours to encourage the dye to stay in the lower spine. After an oil-based dye is used, the patient is placed in a flat position for up to 12 hours. The patient should lie quietly, not ambulate. Fluids should be encouraged to help the body absorb the dye from the spinal column.
Which finding would delay a computed tomography (CT) scan?
- A. Patient's allergy to shellfish or iodine
- B. Patient has a suspected tumor
- C. Patient's allergy to milk products
- D. Patient's gluten intolerance
Correct Answer: A
Rationale: Allergy to shellfish predicts an allergy to iodine, the contrast media used in the CT scan. This test can detect tumors of the soft tissue; it is not contraindicated when the patient has a suspected tumor. Allergy to milk or intolerance to gluten is not a reason to delay a CT scan.
Certain foods may increase the pain associated with gout. Which foods have the highest concentration of purines?
- A. Brain, liver, kidney
- B. Lettuce, corn, potatoes
- C. Beef, pork, chicken
- D. Fruits and fruit juices
Correct Answer: A
Rationale: Foods high in purines, such as brain, kidney, liver, and heart should be avoided, as well as alcohol. Lettuce, meat that does not include organ meats, and fruits do not have a high concentration of purines.