Basic Nursing Care Needs of the Patient

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Which one of the following should be performed first in any patient whose injuries may include multiple closed extremity fractures?

  • A. "A thorough assessment of four limb perfusion"
  • B. "Maneuvers to prevent necrosis of the skin"
  • C. "Extremity compartment syndrome release"
  • D. "Ensuring adequate oxygenation and ventilation"
Correct Answer: D

Rationale: Correct Answer: D - "Ensuring adequate oxygenation and ventilation"

Rationale: Ensuring adequate oxygenation and ventilation is crucial in any patient with potential multiple closed extremity fractures to address any immediate life-threatening issues like hypoxia or respiratory distress. Without proper oxygenation and ventilation, the patient's condition can deteriorate rapidly. It is the top priority in the ABCs of trauma care (Airway, Breathing, Circulation). Once the patient's respiratory status is stable, further assessment and management of limb perfusion, prevention of skin necrosis, and evaluation for compartment syndrome can be carried out.

Summary of other choices:
A: "A thorough assessment of four limb perfusion" - While limb perfusion assessment is important, ensuring adequate oxygenation and ventilation takes precedence due to its immediate life-saving implications.
B: "Maneuvers to prevent necrosis of the skin" - Preventing skin necrosis is important, but addressing respiratory concerns is critical for the patient's overall

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While conducting an EKG on your post-myocardial infarction patient, you note the presence of consistently wide QRS complexes greater than 120 ms in duration. What does this most likely indicate?

  • A. An intraventricular conduction delay or right/left bundle branch block
  • B. A complete heart block indicating no relationship between the atria and ventricles
  • C. The patient is likely suffering from a myocardial infarction currently
  • D. The patient has a congenital heart defect and should not require emergency care
Correct Answer: A

Rationale: The correct answer is A: An intraventricular conduction delay or right/left bundle branch block. Wide QRS complexes greater than 120 ms duration typically indicate an intraventricular conduction delay, such as a bundle branch block. In the context of a post-myocardial infarction patient, this finding is common due to damage to the conduction system. Bundle branch blocks can lead to widened QRS complexes.

Summary:
B: A complete heart block is incorrect as it would typically present with a different EKG pattern.
C: While a myocardial infarction can cause conduction abnormalities, the widened QRS complexes are not indicative of an acute infarction.
D: Congenital heart defects are not typically associated with wide QRS complexes in a post-myocardial infarction patient.

Which of the following needs to be reported to the nurse?

  • A. Burning or pressure when urinating
  • B. Urinary output of 1200 to 1500 mL per day
  • C. Pale yellow urine
  • D. Clear urine
Correct Answer: A

Rationale: The correct answer is A because burning or pressure when urinating can indicate a urinary tract infection or other issue that requires medical attention. This symptom may suggest an underlying infection or inflammation in the urinary system. Reporting this to the nurse promptly can lead to early diagnosis and treatment. Choices B, C, and D are incorrect as they do not indicate any immediate health concern. Urinary output within the range of 1200 to 1500 mL per day is considered normal. The color of urine can vary based on hydration levels and dietary intake, so pale yellow or clear urine is not necessarily alarming.

A person is likely to have stools that are hard and difficult to pass when:

  • A. They eat natural foods that have not been processed
  • B. They drink fluids that are heavy in consistency
  • C. They eat a lot of carbohydrates
  • D. When they do not answer the call of nature in time
Correct Answer: D

Rationale: Delaying bowel movements can lead to water absorption in the colon, resulting in hard stools.

If a nursing assistant encourages a resident to play cards with friends, what kind of wellness is she promoting?

  • A. Physical wellness
  • B. Social wellness
  • C. Emotional wellness
  • D. Intellectual wellness
Correct Answer: B

Rationale: The correct answer is B: Social wellness. By encouraging the resident to play cards with friends, the nursing assistant is promoting social interactions and connections. Social wellness focuses on building and maintaining positive relationships, which can improve mental health and overall well-being. Playing cards with friends allows for social engagement, communication, and a sense of belonging. Physical wellness (A) pertains to physical health, emotional wellness (C) involves managing emotions, and intellectual wellness (D) focuses on mental stimulation. However, in this scenario, the emphasis is on promoting social interactions, making choice B the most appropriate answer.

After an amputation, a resident may experience phantom sensation. Phantom sensation is

  • A. Not real
  • B. Sensation where the limb existed
  • C. The inability to use a new body part
  • D. The desire to get rid of a new body part
Correct Answer: B

Rationale: Phantom sensation refers to feeling sensations in the amputated limb location. This happens due to the brain still receiving signals from the missing limb. Choice B is correct as it accurately describes this phenomenon. Choice A is incorrect as phantom sensation is a real experience. Choice C is incorrect as it refers to a different condition, while Choice D is incorrect as it does not relate to phantom sensation.