1
NRn511/NRn511nFinalnpracticenquestions.
FinalnExamnPracticenQuestions
Questionn1.nMatthew,nagen52,nisnanchefnwhonjustnseveredn2nofnhisnfingersnwithnanmeatncutter.nYounwouldnrecommen
dnthatnhe:
1. Wrapnthenseverednfingersntightlyninnandryntowelnforntransportntonthenemergencyndepartmentnwithnhim.
2. Leaventhenseverednfingersnatnthenscenenbecausenfingersncannotnbenreattached.
3. Immediatelynfreezenthenseverednfingersnfornreattachmentninnthennearnfuture.
4. Wrapnthenfingersninnanclean,ndampncloth;nsealnthemninnanplasticnbag;nandnplacenthenbagninnannicenwaternbat
h.nRationales
Optionn1:
Severednfingersnshouldnbenwrappedninnanclean,ndampncloth;nsealedninnanplasticnbag;nandnplacedninnannicenwaternbat
h.nOptionn2:
Severednfingersncannbenreattachednaftern1nton2ndays—ornmore—
ifnproperlynstored.nOptionn3:
Severednfingersnshouldnbenwrappedninnanclean,ndampncloth;nsealedninnanplasticnbag;nandnplacedninnannicenwaternbat
h,nnotnfrozennornkeptnatnbodyntemperature.
Optionn4:
Ifnanclientnhasnseverednhisnfingers,nthenfingersnshouldnbenwrappedninnanclean,ndampncloth;nsealedninnanplasticnbag;npl
acedninnannicenwaternbath;nandntransportedntonthenemergencynroomnalongnwithnthenclient.
Thenvalgusnstressntest,nvarusnstressntest,nLachmanntest,nandnthumbnsignnarenallnconsiderednstandardntestsntonche
cknthenintegritynofnthenligamentsnofnthenknee.nWhichntestnwouldnthennursenpractitionernchoosentonassessnthenant
eriorncruciatenligamentn(ACL),nwhichnisnthenmostncommonlyninvolvednstructureninnseverenkneeninjury?
1. Valgusnstressntest.
2. Varusnstressntest.
3. Lachmanntest.
4. Thumbnsign.
nRationalesnOp
tionn1:
Thenvalgusnstressntestnassessesnstabilitynofnthenmedialncollateralnligamentn(MCL).n
Optionn2:
Thenvarusnstressntestnassessesnstabilitynofnthenlateralncollateralnligamentn(LCL).nOp
tionn3:
ThenLachmanntestnassessesnthenACL.nOpti
onn4:
Thenthumbnsignnassessesnthenposteriorncruciatenligamentn(PCL).
Lillian,nagen70,nwasntoldnthatnshenhasnosteoporosis.nWhennshenasksnyounwhatnthisnis,nyounrespondnthatnosteopor
osis:
1. Developsnwhennlossnofnbonenoccursnmorenrapidlynthannnewnbonengrowth.
2. Isnandegenerativenjointndiseasencharacterizednbynlossnofncartilageninncertainnjoints.
3. Isnanchronicninflammatoryndisordernthatnaffectsnmultiplenjoints.
Pnangnen 1n|n138
, 2
NRn511/NRn511nFinalnpracticenquestions.
4. Isnanbonendisordernthatnhasntondonwithninadequatenmineralizationnofnthenbones
.nRationales
Optionn1:
Osteoporosisndevelopsnwhennbonenresorptionnoccursnmorenrapidlynthannbonendeposition.nOpti
onn2:
Osteoarthritisnisnandegenerativenjointndiseasencharacterizednbyndegenerationnandnlossnofnarticularncartilageninnsyno
vialnjoints.
Optionn3:
Rheumatoidnarthritisnisnanchronic,nsystemicninflammatoryndisorderncharacterizednbynpersistentnsynovitisnofnmultiple
njoints.
Optionn4:
Osteomalacianisnanmetabolicnbonendisorderncharacterizednbyninadequatenmineralizationnofnthenbonenmatrix,noftenn
causednbynvitaminnDndeficiency.
Mike,nagen42,nangolfnpro,nhasnhadnchronicnbacknpainnfornmanynyears.nHisnworkupnrevealsnthatnitnisnnotnthenresultn
ofnandegenerativendisknproblem.nHisnbackn“goesnout”naboutntwicenpernyear,nandnhenisnoutnofnworknfornaboutnan
weekneachntime.nWhichnofnthenfollowingnshouldnthennursenpractitionernadvisenhimntondo?
1. Considernchangingncareersntonsomethingnlessnphysical.
2. Beginnanplannednexercisenprogramntonstrengthennbacknmuscles.
3. Makenannappointmentnwithnanneurosurgeonnfornansurgicalnconsultation.
4. Startnonnandailynlow-
dosennarcoticntontakenawaynthenpain.nRationales
Optionn1:
Suggestingnancareernchangenshouldnbenconsiderednonlyninncasesnofndisabilitynorninabilityntonsafelyncontinuenone’s
currentnemployment.
Optionn2:
Innthisncase,nMikenmaynbenefitnfromnanregularnplannednexercisenprogramntonstrengthennhisnbacknmusclesnandnattemp
tntonreducenthenprobabilitynofnfuturenepisodesnofnbacknpain.
Optionn3:
Surgerynisnrecommendednonlynfornclientsnwithnlownbacknpainncausednbyndegenerativendiskndisorders,nandnthennonl
ynwhennseverenneurologicninvolvementnhasnoccurred.nSurgerynbenefitsnonlynapproximatelyn1%nofnpeoplenwithnlownb
acknproblems.
Optionn4:
Narcoticnpainnmedicationsnarennotnconsiderednfirst-
linentreatmentnfornmechanicalnbacknpain.nCoursenTopic:nMusculoskeletalnProblemsnConcept(s):n
21820CognitivenLevel:nAnalysisn[Analyzing]
Janine,nagen69,nhasnclassnIIInrheumatoidnarthritis.nAccordingntonthenAmericannRheumatismnAssociation,nwhichnof
nthenfollowingndescribesnhernabilityntonfunction?
1. Adequatenfornnormalnactivitiesndespitenanhandicapnofndiscomfortnornlimitednmotionnofnonenornmorenjoints.
2. Largelynornwhollynincapacitated,nbedridden,nornconfinedntonanwheelchair,npermittingnlittlenornnonself-care.
3. Completelynablentoncarrynoutnallnusualndutiesnwithoutnhandicap.
4. Adequatentonperformnonlynanfewnornnonenofnthendutiesnofnusualnoccupationnornself-
care.nRationales
Optionn1:
Pnangnen 2n|n138
, 3
NRn511/NRn511nFinalnpracticenquestions.
ClassnIInrefersntonthenclientnwhosenfunctionnisnadequatenfornnormalnactivitiesndespitenanhandicapnofndiscomfortnornli
mitednmotionnofnonenornmorenjoints.
Optionn2:
ClassnIVnrefersntonthenclientnwhonisnlargelynornwhollynincapacitated,nbedridden,nornconfinedntonanwheelchair,npermit
tingnlittlenornnonself-care.
Optionn3:
ClassnInrefersntonthenclientnwhoncanncarrynoutnallnusualndutiesnwithoutnhandicap.nO
ptionn4:
ThenAmericannRheumatismnAssociationnhasnestablishednfunctionalnclassesnIntonIVntondescribenanclient’snabilityntona
ccomplishnactivitiesnofndailynliving.nBecausenJaninenisnclassnIII,nhernfunctionnwouldnbenadequatentonperformnonlynanfe
wnornnonenofnthendutiesnofnusualnoccupationnornself-care.
Fornannadultnpatientnwithnankneeninjury,nthennursenpractitionernordersnannonsteroidalnanti-
inflammatoryndrugn(NSAID)ntonbentakennonnanroutinenbasisnfornthennextn2nweeks.nPatientnteachingnshouldninclu
denwhichnofnthenfollowing?
1.
“Younmayntakenthisnmedicationnonnannemptynstomachnasnlongnasnyouneatnwithinntwontonthreenhoursnofntakingnit.”
2.
“Ifnonenpillndoesnnotnseemntonhelp,nyouncanndoublenthendosenfornsubsequentndoses.”
3.
“Ifnyounnoticennausea,nvomiting,nornblacknornbloodynstools,ntakenthennextndosenwithnanglassnofnmilknornanfullnmeal.”
4.
“Ifnyounhavenadditionalnpain,nannoccasionalnacetaminophenn(Tylenol)nisnpermittedninnbetweennthenusualndosesnofnthe
NSAID.”
Rationales
nOptionn1:
WhennteachingnclientsnaboutnNSAIDs,ntellnthemnnotntontakenthesendrugsnonnannemptynstomachnbutntontakenthemnwit
hnfoodnornmilk.
Optionn2:
ClientsnshouldnbentaughtntonneverntakenmorenthannthenprescribedndosenofnannNSAIDnduentonthenlikelihoodnofnincrea
singnthenchancesnofngastrointestinaln(GI)nandnkidneyndamage.
Optionn3:
WhennteachingnclientsnaboutnNSAIDs,ntellnthemntonstopnthenmedicationnandncallnimmediatelynifntheynnoticenanynna
usea,nvomiting,ncoffee-groundsnemesis,nblacknstools,nornbloodninnthenstool.
Optionn4:
Ifnthenclientnisnhavingnadditionalnpain,nacetaminophenn(Tylenol)nmaynbentakenninnconjunctionnwithnannNSAIDnbecaus
enitnisnnotnannNSAIDnandnwillnnotnpotentiatengastricnbleeding.
Sean,nanfactorynlinenworker,nhasnosteoarthritisn(OA)nofnthenrightnhand.nAccordingntonthenAmericannCollegenofnRhe
umatologyn(ACR),nthenguidelinesnfornpharmacologicntreatmentninclude:
1. Acetaminophen,ntramadol,nandnintra-articularncorticosteroidninjections.
2. Oralnnonsteroidalnanti-inflammatoryndrugsn(NSAIDs),ntramadol,nandnarticularncorticosteroidninjections.
3. Acetaminophen,ntopicalncapsaicin,nandntopicalnnonsteroidalnanti-inflammatoryndrugsn(NSAIDs).
4. Topicalncapsaicin,ntopicalnnonsteroidalnanti-
inflammatoryndrugsn(NSAIDs),nandnoralnNSAIDs.nRationales
Pnangnen 3n|n138
, 4
NRn511/NRn511nFinalnpracticenquestions.
Optionn1:
Acetaminophen,noralnnonsteroidalnanti-inflammatoryndrugsn(NSAIDs),ntramadol,nandnintra-
articularncorticosteroidninjectionsnarenrecommendednforninitialnmanagementnofnhipnOA.
Optionn2:
Acetaminophen,noralnNSAIDs,ntramadol,nandnintra-
articularncorticosteroidninjectionsnarenrecommendednforninitialnmanagementnofnhipnOA.
Optionn3:
ThenACRnconditionallynrecommendsnacetaminophen,noralnNSAIDs,ntopicalnNSAIDs,ntramadol,nandnintra-
articularncorticosteroidninjectionsnfornOAnofnthenknee.
Optionn4:
Topicalncapsaicin,ntopicalnNSAIDs,noralnNSAIDs,nandntramadolnarenrecommendednbynthenACRnfornthentreatmentnofnO
Anofnthenhand.
Margaret,nagen55,npresentsntonyounfornevaluationnofnleftnhandnandnwristnpainnandnswellingnafternanslipnandnfalln
onnthenicenyesterday.nOnnexamination,nyounnotentendernessnatnhern“anatomicalnsnuffbox.”nYounknownthisnpro
bablynindicatesna(n):
1. Ulnarnstyloidnfracture.
2. Scaphoidnfracture.
3. Hamatenfracture.
4. Radialnheadnfracture.
nRationales
Optionn1:
Annulnarnstyloidnfracturenwouldnproducentendernessnatnthendistalnulna.nO
ptionn2:
Therenisntendernessnovernthen“anatomicalnsnuffbox”ninnanscaphoidn(akannavicular)nfracture,nthenmostncommonninjury
nofnthencarpalnbones.nPoornbloodnsupplynputsnthenscaphoidnbonenatnrisknofnavascularnnecrosis;ntherefore,nwristnpain
nandntendernessninnthenanatomicalnsnuffbox,nevennwithoutnhistorynofnantecedentntrauma,nwarrantnanwristnx-ray.
Optionn3:
Anfracturenofnthenhooknofnthenhamatenisnannuncommonninjurynseenninngolfersnandnplayersnofnracketnsportsnthatninvo
lvesnpainnandntendernessnonnthenulnarnsidenofnthenpalm.
Optionn4:
Anradialnheadnfracturenwouldnresultninnpainnatnthenelbownjointnwherenthenradialnheadnliesnproximalntonthendistalnh
umerus.nBensurennotntonconfusenthenradialnheadn(proximalnendnofnthenradius)nwithnthenradialnstyloidn(distalnendnofnt
henradiusnatnthenwrist).
Jim,nagen22,nanstocknboy,nhasnannacutenepisodenofnlownbacknpain.nThennursenpractitionernordersnannonsteroidalnant
i-ninflammatoryndrugn(NSAID)nandnshouldneducatenhimninnwhichnofnthenfollowing?
1. Maintainingnmoderatenbednrestnforn3nton4ndays.
2. CallingnthenofficenfornnarcoticnmedicationnifntherenisnnonreliefnwithnthenNSAIDnaftern24nton48nhours.
3. Beginningnlowernbacknstrengtheningnexercisesndependingnonnpainntolerance.
4. WearingnanBostonnbracenatnnight
.nRationales
Optionn1:
Pnangnen 4n|n138
NRn511/NRn511nFinalnpracticenquestions.
FinalnExamnPracticenQuestions
Questionn1.nMatthew,nagen52,nisnanchefnwhonjustnseveredn2nofnhisnfingersnwithnanmeatncutter.nYounwouldnrecommen
dnthatnhe:
1. Wrapnthenseverednfingersntightlyninnandryntowelnforntransportntonthenemergencyndepartmentnwithnhim.
2. Leaventhenseverednfingersnatnthenscenenbecausenfingersncannotnbenreattached.
3. Immediatelynfreezenthenseverednfingersnfornreattachmentninnthennearnfuture.
4. Wrapnthenfingersninnanclean,ndampncloth;nsealnthemninnanplasticnbag;nandnplacenthenbagninnannicenwaternbat
h.nRationales
Optionn1:
Severednfingersnshouldnbenwrappedninnanclean,ndampncloth;nsealedninnanplasticnbag;nandnplacedninnannicenwaternbat
h.nOptionn2:
Severednfingersncannbenreattachednaftern1nton2ndays—ornmore—
ifnproperlynstored.nOptionn3:
Severednfingersnshouldnbenwrappedninnanclean,ndampncloth;nsealedninnanplasticnbag;nandnplacedninnannicenwaternbat
h,nnotnfrozennornkeptnatnbodyntemperature.
Optionn4:
Ifnanclientnhasnseverednhisnfingers,nthenfingersnshouldnbenwrappedninnanclean,ndampncloth;nsealedninnanplasticnbag;npl
acedninnannicenwaternbath;nandntransportedntonthenemergencynroomnalongnwithnthenclient.
Thenvalgusnstressntest,nvarusnstressntest,nLachmanntest,nandnthumbnsignnarenallnconsiderednstandardntestsntonche
cknthenintegritynofnthenligamentsnofnthenknee.nWhichntestnwouldnthennursenpractitionernchoosentonassessnthenant
eriorncruciatenligamentn(ACL),nwhichnisnthenmostncommonlyninvolvednstructureninnseverenkneeninjury?
1. Valgusnstressntest.
2. Varusnstressntest.
3. Lachmanntest.
4. Thumbnsign.
nRationalesnOp
tionn1:
Thenvalgusnstressntestnassessesnstabilitynofnthenmedialncollateralnligamentn(MCL).n
Optionn2:
Thenvarusnstressntestnassessesnstabilitynofnthenlateralncollateralnligamentn(LCL).nOp
tionn3:
ThenLachmanntestnassessesnthenACL.nOpti
onn4:
Thenthumbnsignnassessesnthenposteriorncruciatenligamentn(PCL).
Lillian,nagen70,nwasntoldnthatnshenhasnosteoporosis.nWhennshenasksnyounwhatnthisnis,nyounrespondnthatnosteopor
osis:
1. Developsnwhennlossnofnbonenoccursnmorenrapidlynthannnewnbonengrowth.
2. Isnandegenerativenjointndiseasencharacterizednbynlossnofncartilageninncertainnjoints.
3. Isnanchronicninflammatoryndisordernthatnaffectsnmultiplenjoints.
Pnangnen 1n|n138
, 2
NRn511/NRn511nFinalnpracticenquestions.
4. Isnanbonendisordernthatnhasntondonwithninadequatenmineralizationnofnthenbones
.nRationales
Optionn1:
Osteoporosisndevelopsnwhennbonenresorptionnoccursnmorenrapidlynthannbonendeposition.nOpti
onn2:
Osteoarthritisnisnandegenerativenjointndiseasencharacterizednbyndegenerationnandnlossnofnarticularncartilageninnsyno
vialnjoints.
Optionn3:
Rheumatoidnarthritisnisnanchronic,nsystemicninflammatoryndisorderncharacterizednbynpersistentnsynovitisnofnmultiple
njoints.
Optionn4:
Osteomalacianisnanmetabolicnbonendisorderncharacterizednbyninadequatenmineralizationnofnthenbonenmatrix,noftenn
causednbynvitaminnDndeficiency.
Mike,nagen42,nangolfnpro,nhasnhadnchronicnbacknpainnfornmanynyears.nHisnworkupnrevealsnthatnitnisnnotnthenresultn
ofnandegenerativendisknproblem.nHisnbackn“goesnout”naboutntwicenpernyear,nandnhenisnoutnofnworknfornaboutnan
weekneachntime.nWhichnofnthenfollowingnshouldnthennursenpractitionernadvisenhimntondo?
1. Considernchangingncareersntonsomethingnlessnphysical.
2. Beginnanplannednexercisenprogramntonstrengthennbacknmuscles.
3. Makenannappointmentnwithnanneurosurgeonnfornansurgicalnconsultation.
4. Startnonnandailynlow-
dosennarcoticntontakenawaynthenpain.nRationales
Optionn1:
Suggestingnancareernchangenshouldnbenconsiderednonlyninncasesnofndisabilitynorninabilityntonsafelyncontinuenone’s
currentnemployment.
Optionn2:
Innthisncase,nMikenmaynbenefitnfromnanregularnplannednexercisenprogramntonstrengthennhisnbacknmusclesnandnattemp
tntonreducenthenprobabilitynofnfuturenepisodesnofnbacknpain.
Optionn3:
Surgerynisnrecommendednonlynfornclientsnwithnlownbacknpainncausednbyndegenerativendiskndisorders,nandnthennonl
ynwhennseverenneurologicninvolvementnhasnoccurred.nSurgerynbenefitsnonlynapproximatelyn1%nofnpeoplenwithnlownb
acknproblems.
Optionn4:
Narcoticnpainnmedicationsnarennotnconsiderednfirst-
linentreatmentnfornmechanicalnbacknpain.nCoursenTopic:nMusculoskeletalnProblemsnConcept(s):n
21820CognitivenLevel:nAnalysisn[Analyzing]
Janine,nagen69,nhasnclassnIIInrheumatoidnarthritis.nAccordingntonthenAmericannRheumatismnAssociation,nwhichnof
nthenfollowingndescribesnhernabilityntonfunction?
1. Adequatenfornnormalnactivitiesndespitenanhandicapnofndiscomfortnornlimitednmotionnofnonenornmorenjoints.
2. Largelynornwhollynincapacitated,nbedridden,nornconfinedntonanwheelchair,npermittingnlittlenornnonself-care.
3. Completelynablentoncarrynoutnallnusualndutiesnwithoutnhandicap.
4. Adequatentonperformnonlynanfewnornnonenofnthendutiesnofnusualnoccupationnornself-
care.nRationales
Optionn1:
Pnangnen 2n|n138
, 3
NRn511/NRn511nFinalnpracticenquestions.
ClassnIInrefersntonthenclientnwhosenfunctionnisnadequatenfornnormalnactivitiesndespitenanhandicapnofndiscomfortnornli
mitednmotionnofnonenornmorenjoints.
Optionn2:
ClassnIVnrefersntonthenclientnwhonisnlargelynornwhollynincapacitated,nbedridden,nornconfinedntonanwheelchair,npermit
tingnlittlenornnonself-care.
Optionn3:
ClassnInrefersntonthenclientnwhoncanncarrynoutnallnusualndutiesnwithoutnhandicap.nO
ptionn4:
ThenAmericannRheumatismnAssociationnhasnestablishednfunctionalnclassesnIntonIVntondescribenanclient’snabilityntona
ccomplishnactivitiesnofndailynliving.nBecausenJaninenisnclassnIII,nhernfunctionnwouldnbenadequatentonperformnonlynanfe
wnornnonenofnthendutiesnofnusualnoccupationnornself-care.
Fornannadultnpatientnwithnankneeninjury,nthennursenpractitionernordersnannonsteroidalnanti-
inflammatoryndrugn(NSAID)ntonbentakennonnanroutinenbasisnfornthennextn2nweeks.nPatientnteachingnshouldninclu
denwhichnofnthenfollowing?
1.
“Younmayntakenthisnmedicationnonnannemptynstomachnasnlongnasnyouneatnwithinntwontonthreenhoursnofntakingnit.”
2.
“Ifnonenpillndoesnnotnseemntonhelp,nyouncanndoublenthendosenfornsubsequentndoses.”
3.
“Ifnyounnoticennausea,nvomiting,nornblacknornbloodynstools,ntakenthennextndosenwithnanglassnofnmilknornanfullnmeal.”
4.
“Ifnyounhavenadditionalnpain,nannoccasionalnacetaminophenn(Tylenol)nisnpermittedninnbetweennthenusualndosesnofnthe
NSAID.”
Rationales
nOptionn1:
WhennteachingnclientsnaboutnNSAIDs,ntellnthemnnotntontakenthesendrugsnonnannemptynstomachnbutntontakenthemnwit
hnfoodnornmilk.
Optionn2:
ClientsnshouldnbentaughtntonneverntakenmorenthannthenprescribedndosenofnannNSAIDnduentonthenlikelihoodnofnincrea
singnthenchancesnofngastrointestinaln(GI)nandnkidneyndamage.
Optionn3:
WhennteachingnclientsnaboutnNSAIDs,ntellnthemntonstopnthenmedicationnandncallnimmediatelynifntheynnoticenanynna
usea,nvomiting,ncoffee-groundsnemesis,nblacknstools,nornbloodninnthenstool.
Optionn4:
Ifnthenclientnisnhavingnadditionalnpain,nacetaminophenn(Tylenol)nmaynbentakenninnconjunctionnwithnannNSAIDnbecaus
enitnisnnotnannNSAIDnandnwillnnotnpotentiatengastricnbleeding.
Sean,nanfactorynlinenworker,nhasnosteoarthritisn(OA)nofnthenrightnhand.nAccordingntonthenAmericannCollegenofnRhe
umatologyn(ACR),nthenguidelinesnfornpharmacologicntreatmentninclude:
1. Acetaminophen,ntramadol,nandnintra-articularncorticosteroidninjections.
2. Oralnnonsteroidalnanti-inflammatoryndrugsn(NSAIDs),ntramadol,nandnarticularncorticosteroidninjections.
3. Acetaminophen,ntopicalncapsaicin,nandntopicalnnonsteroidalnanti-inflammatoryndrugsn(NSAIDs).
4. Topicalncapsaicin,ntopicalnnonsteroidalnanti-
inflammatoryndrugsn(NSAIDs),nandnoralnNSAIDs.nRationales
Pnangnen 3n|n138
, 4
NRn511/NRn511nFinalnpracticenquestions.
Optionn1:
Acetaminophen,noralnnonsteroidalnanti-inflammatoryndrugsn(NSAIDs),ntramadol,nandnintra-
articularncorticosteroidninjectionsnarenrecommendednforninitialnmanagementnofnhipnOA.
Optionn2:
Acetaminophen,noralnNSAIDs,ntramadol,nandnintra-
articularncorticosteroidninjectionsnarenrecommendednforninitialnmanagementnofnhipnOA.
Optionn3:
ThenACRnconditionallynrecommendsnacetaminophen,noralnNSAIDs,ntopicalnNSAIDs,ntramadol,nandnintra-
articularncorticosteroidninjectionsnfornOAnofnthenknee.
Optionn4:
Topicalncapsaicin,ntopicalnNSAIDs,noralnNSAIDs,nandntramadolnarenrecommendednbynthenACRnfornthentreatmentnofnO
Anofnthenhand.
Margaret,nagen55,npresentsntonyounfornevaluationnofnleftnhandnandnwristnpainnandnswellingnafternanslipnandnfalln
onnthenicenyesterday.nOnnexamination,nyounnotentendernessnatnhern“anatomicalnsnuffbox.”nYounknownthisnpro
bablynindicatesna(n):
1. Ulnarnstyloidnfracture.
2. Scaphoidnfracture.
3. Hamatenfracture.
4. Radialnheadnfracture.
nRationales
Optionn1:
Annulnarnstyloidnfracturenwouldnproducentendernessnatnthendistalnulna.nO
ptionn2:
Therenisntendernessnovernthen“anatomicalnsnuffbox”ninnanscaphoidn(akannavicular)nfracture,nthenmostncommonninjury
nofnthencarpalnbones.nPoornbloodnsupplynputsnthenscaphoidnbonenatnrisknofnavascularnnecrosis;ntherefore,nwristnpain
nandntendernessninnthenanatomicalnsnuffbox,nevennwithoutnhistorynofnantecedentntrauma,nwarrantnanwristnx-ray.
Optionn3:
Anfracturenofnthenhooknofnthenhamatenisnannuncommonninjurynseenninngolfersnandnplayersnofnracketnsportsnthatninvo
lvesnpainnandntendernessnonnthenulnarnsidenofnthenpalm.
Optionn4:
Anradialnheadnfracturenwouldnresultninnpainnatnthenelbownjointnwherenthenradialnheadnliesnproximalntonthendistalnh
umerus.nBensurennotntonconfusenthenradialnheadn(proximalnendnofnthenradius)nwithnthenradialnstyloidn(distalnendnofnt
henradiusnatnthenwrist).
Jim,nagen22,nanstocknboy,nhasnannacutenepisodenofnlownbacknpain.nThennursenpractitionernordersnannonsteroidalnant
i-ninflammatoryndrugn(NSAID)nandnshouldneducatenhimninnwhichnofnthenfollowing?
1. Maintainingnmoderatenbednrestnforn3nton4ndays.
2. CallingnthenofficenfornnarcoticnmedicationnifntherenisnnonreliefnwithnthenNSAIDnaftern24nton48nhours.
3. Beginningnlowernbacknstrengtheningnexercisesndependingnonnpainntolerance.
4. WearingnanBostonnbracenatnnight
.nRationales
Optionn1:
Pnangnen 4n|n138
