Nokea
Which of the following statements should the nurse include in the teaching session when preparing a client for arthrocentesis? Select all that apply.
- A. A local anesthetic agent may be injected into the joint site for your comfort.'
- B. A syringe and needle will be used to withdraw fluid from your joint.'
- C. The procedure, although not painful, will provide immediate relief.'
- D. We'll want you to keep your joint active after the procedure to increase blood flow.'
- E. You will need to wear a compression bandage for several days after the procedure.'
Correct Answer: A,B
Rationale: Arthrocentesis involves using a needle and syringe to withdraw fluid, often with a local anesthetic for comfort. The procedure may be painful, and rest, not activity, is typically recommended post-procedure. A compression bandage is not standard.
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When assessing an individual with peripheral vascular disease, which clinical manifestation would indicate complete arterial obstruction in the lower left leg?
- A. Aching pain in the left calf
- B. Burning pain in the left calf
- C. Numbness and tingling in the left leg
- D. Coldness of the left foot and ankle
Correct Answer: D
Rationale: Complete arterial obstruction causes severe ischemia, leading to coldness of the affected limb (foot and ankle) due to absent blood flow. Aching or burning pain and numbness/tingling suggest partial occlusion or neuropathy, not complete obstruction.
Which of the following signs and symptoms are common in male clients with prolactin-secreting tumors?
- A. Severe lethargy and fatigue.
- B. Erectile dysfunction and decreased libido.
- C. Both of the above
- D. None of the above
Correct Answer: B
Rationale: Prolactin-secreting tumors in males often cause erectile dysfunction and decreased libido due to suppression of testosterone.
The nurse is planning care for a client being admitted with bleeding esophageal varices. Vital signs are: Pulse 100; respiratory rate 22; and blood pressure 100/58. The nurse should prepare the client for which of the following? Select all that apply.
- A. Administration of intravenous Octreotide (Sandostatin).
- B. Endoscopy.
- C. Administration of a blood product.
- D. Minnesota tube insertion.
- E. Transjugular intrahepatic portosystemic shunt (TIPS).
Correct Answer: A,B,C,D
Rationale: Octreotide (A) reduces portal pressure, endoscopy (B) diagnoses and treats bleeding, blood products (C) correct hypovolemia, and a Minnesota tube (D) controls bleeding. TIPS (E) is a later intervention.
A client post-appendectomy reports shoulder pain on the second postoperative day. The nurse should suspect which complication?
- A. Pneumonia.
- B. Subdiaphragmatic abscess.
- C. Deep vein thrombosis.
- D. Wound infection.
Correct Answer: B
Rationale: Shoulder pain post-appendectomy may indicate a subdiaphragmatic abscess due to referred pain from diaphragmatic irritation. Pneumonia, thrombosis, and wound infection typically present with other symptoms. CN: Physiological adaptation; CL: Analyze
A client with breast cancer presents with back pain, weakness, and difficulty urinating. The nurse suspects spinal cord compression. The priority nursing action is to:
- A. Administer analgesics immediately.
- B. Notify the physician for urgent evaluation.
- C. Encourage bed rest in a supine position.
- D. Perform a bladder scan.
Correct Answer: B
Rationale: Spinal cord compression is a medical emergency requiring urgent physician evaluation for imaging and interventions like corticosteroids or surgery to prevent permanent neurologic damage.