12. A patient with kyphosis is scheduled for dual-energy x-ray absorptiometry (DEXA)
testing. The nurse will plan to
a. start an intravenous line.
b. screen the patient for shellfish allergies.
c. teach the patient that DEXA is noninvasive.
d. give an oral sedative.
Give this one a try later!
, Answer: C
Rationale: DEXA testing is painless and noninvasive. No IV access is
necessary. Contrast medium is not used. Because the procedure is painless,
no antianxiety medications are required.
Cognitive Level: Application Text Reference: p. 1625
Nursing Process: Implementation NCLEX: Physiological Integrity
Calcium Administration
Give this one a try later!
Calcium and Vitamin D are essential for bone strength.
Calcium absorption is IMPAIRED if taken in excess so it needs to be divided
in less than 500 mg per dose.
A client being measured for crutches asks the nurse why the crutches cannot rest up
underneath the arm for extra support. The nurse's response is based on the
understanding that this could result in:
1.
A fall and further injury
2.
Injury to the brachial plexus nerves
3.
Skin breakdown in the area of the axilla
4.
Impaired range of motion while the client ambulates
Give this one a try later!
, 2.
Injury to the brachial plexus nerves
Which finding will the nurse expect when assessing a 60-year-old patient who has
osteoarthritis (OA) of the left knee?
a. Heberden's nodules
b. Pain upon joint movement
c. Redness and swelling of the knee joint
d. Stiffness that increases with movement
Give this one a try later!
ANS: B
Initial symptoms of OA include pain with joint movement. Heberden's
nodules occur on the fingers. Redness of the joint is more strongly
associated with rheumatoid arthritis (RA), and stiffness in OA is worse right
after the patient rests and decreases with joint movement.
A client has a newly fractured fibula that is plaster casted in the emergency
department. Because the client will need to use crutches, the nurse plans to teach the
client which crutch-walking gait before discharge?
1.
Four-point alternate gait
2.
Three-point gait
3.
Two-point gait
4.
Swing-through gait
Give this one a try later!
, 2.
Three-point gait
A client has a new synthetic arm cast for a radial fracture. What health care teaching
does the nurse include for the clients home care? (Select all)
A. "Apply heat on the cast for the first 24 hours to increase blood flow for healing."
B. "keep your arm elevated, preferably above your heart, as much as possible."
C. "Report severe numbness or inability to move your fingers to your physician."
D. "Don't cover the cast with anything because it will stay wet for 24 hours."
Give this one a try later!
B,C,D
During the early postoperative period, the client who had a cataractextraction
complains of nausea and severe eye pain over the operative site. The initial nursing
action is to:
1. Call the physician
2. Administer the ordered main medication and antiemetic
3. Reassure the client that this is normal.
4. Turn the client on his or her operative side
Give this one a try later!
Answer: 1. Call the physician
Severe pain or pain accompanied by nausea is an indicator of increased
intraocular pressure and should be reported to the physician immediately.
The other options are inappropriate.
testing. The nurse will plan to
a. start an intravenous line.
b. screen the patient for shellfish allergies.
c. teach the patient that DEXA is noninvasive.
d. give an oral sedative.
Give this one a try later!
, Answer: C
Rationale: DEXA testing is painless and noninvasive. No IV access is
necessary. Contrast medium is not used. Because the procedure is painless,
no antianxiety medications are required.
Cognitive Level: Application Text Reference: p. 1625
Nursing Process: Implementation NCLEX: Physiological Integrity
Calcium Administration
Give this one a try later!
Calcium and Vitamin D are essential for bone strength.
Calcium absorption is IMPAIRED if taken in excess so it needs to be divided
in less than 500 mg per dose.
A client being measured for crutches asks the nurse why the crutches cannot rest up
underneath the arm for extra support. The nurse's response is based on the
understanding that this could result in:
1.
A fall and further injury
2.
Injury to the brachial plexus nerves
3.
Skin breakdown in the area of the axilla
4.
Impaired range of motion while the client ambulates
Give this one a try later!
, 2.
Injury to the brachial plexus nerves
Which finding will the nurse expect when assessing a 60-year-old patient who has
osteoarthritis (OA) of the left knee?
a. Heberden's nodules
b. Pain upon joint movement
c. Redness and swelling of the knee joint
d. Stiffness that increases with movement
Give this one a try later!
ANS: B
Initial symptoms of OA include pain with joint movement. Heberden's
nodules occur on the fingers. Redness of the joint is more strongly
associated with rheumatoid arthritis (RA), and stiffness in OA is worse right
after the patient rests and decreases with joint movement.
A client has a newly fractured fibula that is plaster casted in the emergency
department. Because the client will need to use crutches, the nurse plans to teach the
client which crutch-walking gait before discharge?
1.
Four-point alternate gait
2.
Three-point gait
3.
Two-point gait
4.
Swing-through gait
Give this one a try later!
, 2.
Three-point gait
A client has a new synthetic arm cast for a radial fracture. What health care teaching
does the nurse include for the clients home care? (Select all)
A. "Apply heat on the cast for the first 24 hours to increase blood flow for healing."
B. "keep your arm elevated, preferably above your heart, as much as possible."
C. "Report severe numbness or inability to move your fingers to your physician."
D. "Don't cover the cast with anything because it will stay wet for 24 hours."
Give this one a try later!
B,C,D
During the early postoperative period, the client who had a cataractextraction
complains of nausea and severe eye pain over the operative site. The initial nursing
action is to:
1. Call the physician
2. Administer the ordered main medication and antiemetic
3. Reassure the client that this is normal.
4. Turn the client on his or her operative side
Give this one a try later!
Answer: 1. Call the physician
Severe pain or pain accompanied by nausea is an indicator of increased
intraocular pressure and should be reported to the physician immediately.
The other options are inappropriate.
