Nokea
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.
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A patient's patellar-femoral cartilage has deteriorated due to arthritis. The medial and lateral cartilage is undamaged. This patient is likely to undergo partial or knee replacement surgery.
Correct Answer: unicompartmental
Rationale: Unicompartmental knee arthroplasty is also referred to as partial knee replacement and is performed on patients who have only one of the compartments of the knee affected by arthritis.
The nurse clarifies to a patient who is being evaluated for possible rheumatoid arthritis that the elevated erythrocyte sedimentation rate (ESR) indicates the presence of which process?
- A. A chronic infection
- B. Poor protein intake
- C. Increased inflammatory reaction in the body.
- D. A poor immune response to a microorganism
Correct Answer: C
Rationale: The ESR indicates an increase in the inflammatory reactions in the body. An elevated ESR does not indicate a chronic infection, poor protein intake or a poor immune response to a microorganism.
Which is the main purpose of traction?
- A. Align and stabilize a fracture.
- B. Prevent deformities.
- C. Relieve muscle spasms.
- D. Promote bed rest.
- E. Increase circulation to the rest of the body.
Correct Answer: A,B,C
Rationale: Skin and skeletal traction provide alignment and stabilize a fracture. This prevents deformities. Traction may also be used to relieve muscle spasms. Traction is not used to promote bed rest or to increase circulation to the rest of the body.
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.
A patient had an open reduction with internal fixation (ORIF) for a compound fracture of the left tibia and has been placed in a long leg cast. The findings by the nurse are: left foot warm/pink, pedal pulse weaker than right, capillary refill 3 seconds, and small $1 \mathrm{~cm}$ area of blood on cast. Which action will the nurse take?
- A. Notify charge nurse of impending compartment syndrome.
- B. Document that all findings are within normal limits.
- C. Inform charge nurse about probable hemorrhage.
- D. Place warm compresses on left foot.
Correct Answer: B
Rationale: All of the findings are within normal limits. A small amount of blood on the cast is expected and should be monitored. There is no evidence of impending compartment syndrome or hemorrhage. Warm compresses are not necessary, and could cause swelling to develop.