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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.
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Which action should the nurse take when a patient with osteomyelitis of the right forearm is admitted with an open wound that is draining?
- A. Enforce a low-calorie diet.
- B. Initiate drainage and secretion precautions.
- C. Frequently do passive ROM on the elbow.
- D. Ambulate several times daily.
Correct Answer: B
Rationale: The patient with osteomyelitis should be at least in drainage and secretion precaution. The limb should be positioned for maximum comfort and left at rest. These patients are usually on bed rest and require a high-calorie, high-protein diet.
The nurse administering the drug colchicine for gout will give $0.5 \mathrm{mg}$ hourly for hours.
Correct Answer: 12
Rationale: Colchicine is given orally in a dose of $0.5 \mathrm{mg}$ for a period of 12 hours or until relief from pain is achieved or diarrhea occurs.
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.
A patient has been casted to stabilize a fracture of the right radius and ulna. The nurse assesses a capillary refill of 5 seconds and cold fingers of the right hand. Which initial intervention should the nurse deploy?
- A. Notify the charge nurse of a probable compartment syndrome.
- B. Apply a warm compress to the fingers to relieve swelling.
- C. Elevate the right hand to heart level to maintain arterial pressure.
- D. Cut the cast off to release constriction.
Correct Answer: C
Rationale: The nurse should first elevate the right hand to heart level and notify the charge nurse. Permanent damage can occur in as little time as 6 hours. While the charge nurse does need to be notified it is most crucial to elevate the hand to heart level first. A warm compress would likely cause blood vessels to dilate, worsening the edema. The nurse cannot independently cut the cast off.
Which instructions will the nurse reinforce for the patient before a magnetic resonance imaging (MRI) procedure?
- A. Void to completely empty the bladder.
- B. Omit all citrus food for 12 hours before the procedure.
- C. Remove all metal, such as jewelry, glasses, and hair clips.
- D. Wear only cotton garments for the procedure.
Correct Answer: C
Rationale: MRI procedures require that the patient remove all metal because it will become magnetized.