Nokea
Which nursing instruction about heating pads is essential to include in the client's teaching plan?
- A. Use the lowest setting on the heating pad.
- B. Place the heating pad directly on the skin.
- C. Cover the heating pad with plastic during use.
- D. Apply the heating pad for 2 hours at a time.
Correct Answer: A
Rationale: Using the lowest setting on the heating pad minimizes the risk of burns, especially in older clients with potentially reduced skin sensitivity. Direct skin contact, plastic covers, or prolonged use increase burn risk.
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A young adult is discharged to home with crutches. Which exercise should the nurse teach the client in order to strengthen the hand muscles for crutch walking?
- A. Pushing the buttocks up off the mattress
- B. Pulling the body up, using an overhead trapeze
- C. Raising the legs straight up and down
- D. Squeezing a rubber ball in each hand
Correct Answer: D
Rationale: Squeezing a rubber ball strengthens hand muscles, essential for gripping crutches during walking.
The clinic nurse completed teaching the client with a rotator cuff tear who is being treated conservatively. Which client statement indicates that further teaching is needed?
- A. I received a corticosteroid injection in my shoulder to reduce the inflammation and pain.'
- B. Now that the pain is controlled, I can do progressive stretching and strengthening exercises.'
- C. I will continue to take ibuprofen for pain control, but I should take it with food.'
- D. I will need an open acromioplasty to repair the torn cuff after the swelling is reduced.'
Correct Answer: D
Rationale: D. Conservative treatment for a rotator cuff tear typically involves non-surgical methods like corticosteroid injections, physical therapy, and NSAIDs. An open acromioplasty is a surgical procedure and not part of conservative management, indicating a misunderstanding by the client.
The Muslim client practicing Islam is hospitalized following surgical repair of a hip fracture. The client informs the nurse about wishing to observe Ramadan, which is occurring now. Which statement by the nurse is respectful of the client's faith beliefs?
- A. I'm going to uncover your hip and leg now to check the incision and your pulses.'
- B. A dietitian helps to plan your meals so that meat and dairy products are not together.'
- C. I've asked that physical therapy be postponed until around 3 p.m., when Ramadan ends.'
- D. I should let the care team know not to bring food or beverages from sunrise to sunset.'
Correct Answer: D
Rationale: D. During the month of Ramadan, those of the Islamic faith do not eat or drink from sunrise to sunset.
The client is three (3) hours postoperative left AKA. The client tells the nurse, 'My left foot is killing me. Please do something.' Which intervention should the nurse implement?
- A. Explain to the client his left leg has been amputated.
- B. Medicate the client with a narcotic analgesic immediately.
- C. Instruct the client on how to perform biofeedback exercises.
- D. Place the client's residual limb in the dependent position.
Correct Answer: B
Rationale: Phantom limb pain is treated with analgesics; narcotics provide immediate relief. Explaining the amputation dismisses pain, biofeedback is long-term, and dependent positioning is inappropriate.
The nurse identifies a concept of impaired mobility for a male client with degenerative disk disease. Which assessment data best support this concept?
- A. The client reports a history of chronic back pain and multiple back surgeries.
- B. The client reports that taking NSAIDs caused the development of peptic ulcers.
- C. The client reports a three (3)-year history of difficulty initiating a urinary stream.
- D. The client states he fell a year ago and had to have a cast on the right arm for a month.
Correct Answer: A
Rationale: Chronic back pain and surgeries directly impair mobility in degenerative disk disease. Ulcers, urinary issues, and past arm fractures are unrelated to current mobility.