Nokea
Which neural tube defect is the nurse describing when stating that the vertebral arch fails to close and the spinal cord and meninges stay within the vertebral canal?
- A. Meningocele
- B. Spina bifida occulta
- C. Spina bifida cystica
- D. Myelomeningocele
Correct Answer: B
Rationale: Spina bifida occulta involves a failure of the vertebral arch to close, with the spinal cord and meninges remaining within the vertebral canal.
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Which area of health teaching is essential to include in the discharge instructions for a client who has undergone a total hip replacement?
- A. Modifying ways of donning clothing
- B. Using special equipment for bathing
- C. Taking vigorous daily walks
- D. Receiving a daily stool softener
Correct Answer: A
Rationale: Modifying clothing application (e.g., avoiding bending or crossing legs) prevents hip dislocation, making it essential for discharge teaching. Vigorous walks are contraindicated, and the other options are less critical.
A college student visits a campus health service reporting knee pain, clicking when walking, 'locking,' and 'giving way' of the affected knee. The injury occurred when twisting the knee wrong during a tennis match. The nurse should further assess for which problem?
- A. Injury of the meniscus cartilage
- B. Fracture of the lateral tibial condyle
- C. Injury and possible fractured patella
- D. Lateral collateral ligament injury
Correct Answer: A
Rationale: A. The nurse should assess for injury to the meniscus (knee) cartilage. Abrupt twisting can tear the cartilage, and the loose cartilage can cause locking of the joint, clicking, and the knee to 'give way.'
The nurse is to give the client with gout one tablet of colchicine every hour until relief or toxicity occurs. Which of the following is an indication for stopping the colchicine?
- A. Ringing in the ears
- B. Nausea and vomiting
- C. A rash on the client's hips
- D. A temperature of 101°F
Correct Answer: B
Rationale: Nausea and vomiting are signs of colchicine toxicity, indicating the need to stop the medication.
The nurse is reviewing the serum laboratory results of the client with DM prior to surgical removal of pins used to stabilize a compound ankle fracture. Based on the results, which action should the nurse take?
- A. Notify the surgeon because the white blood cell count is elevated.
- B. Notify the anesthesiologist because multiple lab values are abnormal.
- C. Give potassium chloride 10 mEq in 100 mL NaCl per agency protocol.
- D. Continue to prepare the client for the scheduled pin removal surgery.
Correct Answer: A
Rationale: A. The elevated WBC indicates that the client may have an infection, which increases the risk of developing osteomyelitis. DM and a compound fracture also increase the client's risk for osteomyelitis.
The client diagnosed with osteoporosis asks the nurse, 'Why does smoking cigarettes cause my bones to be brittle?' Which response by the nurse is most appropriate?
- A. Smoking causes nutritional deficiencies, which contribute to osteoporosis.'
- B. Tobacco causes an increase in blood supply to the bones, causing osteoporosis.'
- C. Smoking low-tar cigarettes will not cause your bones to become brittle.'
- D. Nicotine impairs the absorption of calcium, causing decreased bone strength.'
Correct Answer: D
Rationale: Nicotine reduces calcium absorption, contributing to bone loss in osteoporosis. Nutritional deficiencies are secondary, blood supply does not increase, and low-tar cigarettes still harm bones.