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While shopping, Marnie Smith, RN, sees a man on the floor in the shopping center having tonic-clonic movements. Her first action is to
- A. place her pen between his teeth and over his tongue
- B. restrain the movements of the extremities
- C. place a sweater under his head
- D. turn the patient into the prone position
Correct Answer: C
Rationale: Protecting the head and ensuring safety is the priority during a seizure.
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A client has had multiple sclerosis (MS) for 15 years and has received various drug therapies. What is the primary reason why the nurse has found it difficult to evaluate the effectiveness of the drugs that the client has used?
- A. The client exhibits intolerance to many drugs
- B. The client experiences spontaneous remissions from time to time
- C. The client requires multiple drugs simultaneously
- D. The client endures long periods of exacerbation before the illness responds to a particular drug
Correct Answer: B
Rationale: MS is characterized by periods of relapse and remission, making it difficult to evaluate the effectiveness of drug therapies due to spontaneous improvements.
Which assessment finding should you report immediately for a patient with fractures of the medial ulna and radius?
- A. The patient complains of pressure and pain.
- B. The cast is in place and is dry and intact.
- C. The skin is pink and warm to touch.
- D. The patient can move all fingers and thumb.
Correct Answer: A
Rationale: Pressure and pain could indicate complications such as compartment syndrome, necessitating immediate medical attention.
The patient is diagnosed with torticollis. What should the nurse be prepared to provide for the patient?
- A. An immobilizer to hold the bones in place
- B. Exercises to increase the strength of the muscles
- C. A pillow to use to support the knees while sleeping
- D. Enough pillows to support the patient's head comfortably
Correct Answer: B
Rationale: Exercises help restore muscle balance.
Which action requires intervention by the charge nurse for an LPN/LVN caring for a patient with Paget's disease?
- A. Administers 600 mg of ibuprofen to the patient.
- B. Encourages the patient to perform PT recommended exercises.
- C. Applies ice and gentle massage to the patient's lower extremities.
- D. Reminds the patient to drink milk and eat cottage cheese.
Correct Answer: C
Rationale: Applying ice and massage without specific instructions may not be appropriate and could potentially cause harm.
In teaching a community group the appropriate first aid care of burns, you show them a picture of a wound which is red, has several intact large blisters, one broken blister, and a lot of moisture present. You would expect them to recognize the depth of this burn as
- A. partial-thickness
- B. first-degree
- C. full-thickness
- D. third-degree
Correct Answer: A
Rationale: Partial-thickness burns involve the epidermis and part of the dermis, often presenting with blisters and moisture.