Detailed Answerhy
Key Medical
hy hy
Surgical, A+
1.hyA hynurse hyis hyreviewing hythe hycause hyof hygout hywith hya hygroup hyof hynurses. hyWhich hyof hythe hyfollowing hystatements
hyshould hythe hynurse hymake?
A. "Uric hyacid hylevels hydrop hyand hycalcium hyforms hyprecipitate."
Rationale:hyWith hygout, hyclients hyhave hyhyperuricemia, hyrather hythan hya hyreduction hyin hyuric hyacid.
B. "Tophi hyform hyin hythe hykidneys hyand hythey hyimpair hythe hyexcretion hyof hyuric hyacid."
Rationale:hyTophi, hyor hydeposits hyin hytissues hynear hya hyjoint, hydevelop hyin hychronic, hylate-stage hygout. hyThey hyare
hynot hypart hyof hythe hyprimary hydisease hyprocess.
C. "The hyintra-articular hydeposition hyof hyurate hycrystals hycauses hyinflammation."
Rationale: hyGout, hyor hygouty hyarthritis, hydevelops hywhen hyurate hycrystals hydeposit hyin hyjoints hyand hytissues hyand
hycause hyinflammation hyand hypain.
D. "Articular hycartilage hythins, hyleading hyto hysplitting hyand hyfragmentation."
Rationale: hyGout hydoes hynot hythin hyand hyfragment hycartilage.
2.hyA hynurse hyis hyteaching hya hygroup hyof hyclients hyabout hyosteoarthritis. hyWhich hyof hythe hyfollowing hyrecommendations
hyshould hythe hynurse hyinclude hyin hythe hyteaching?
A. Use hyEchinacea hyto hymanage hyjoint hypain.
Rationale: hyThe hynurse hymay hyinclude hythe hyuse hyof hycomplementary hyand hyalternative hytherapies hyin hythe
hyteaching.
However, hyEchinacea hyis hyused hyfor hythe hytreatment hyof hythe hycommon hycold, hynot hyosteoarthritis.
hyAlternative hytherapies hythat hyare hyused hyfor hyosteoarthritis hyinclude hyglucosamine, hychondroitin, hyand
hytopical hycapsaicin.
B. Apply hyice hyto hythe hyjoint hybefore hyexercising.
Rationale:hyThe hynurse hyshould hyrecommend hythat hythe hyclients hybegin hyexercising hyimmediately
hyfollowing hythe hyapplication hyof hyheat. hyThis hyreduces hypain hyand hyimproves hymobility,
hyallowing hyfor hyincreased hyrange-of-motion hyduring hyexercises. hyCold hyapplication hymay
hybe hyapplied hyfollowing hyexercise hyto hydecrease hydiscomfort hyand hyinflammation.
C. Maintain hya hyrecommended hybody hyweight.
Rationale: hyObesity hyis hya hyrisk hyfactor hyfor hythe hydevelopment hyof hyosteoarthritis. hyMaintenance hyof hyan hyideal
hyweight hyis hyone hyway hya hyclient hycan hyprevent hyadded hywear hyand hytear hyon hyjoints hyand
hypromote hyoverall hyjoint hyhealth.
D. Reduce hythe hyamount hyof hypurine hyin hythe hydiet.
Rationale: hyThe hynurse hyshould hyrecognize hythat hylimiting hypurine hyin hythe hydiet, hywhich hyis hyoften hyfound hyin
hyorgan hymeats, hyis hyrecommended hyfor hyclients hywho hyhave hygout.
3.hyA hynurse hyis hycaring hyfor hya hyclient hywho hyhas hyhad hya hymyocardial hyinfarction. hyUpon hyhis hyfirst hyvisit hyto hycardiac
hyrehabilitation, hyhe hytells hythe hynurse hythat hyhe hydoesn't hyunderstand hywhy hyhe hyneeds hyto hybe hythere hybecause hythere
hyis hynothing hymore hyto hydo, hyas hythe
Page hy1
,Detailed Answer hy
Key Medical
hy hy
Surgical, A+
damage hyis hydone. hyWhich hyof hythe hyfollowing hyis hythe hycorrect hynursing hyresponse?
A. "Cardiac hyrehabilitation hycannot hyundo hythe hydamage hyto hyyour hyheart hybut hyit hycan hyhelp hyyou hyget hyback hyto
hyyour hyprevious hylevel hyof hyactivity hysafely."
Rationale: hyWith hythis hyresponse, hythe hynurse hyuses hythe hytherapeutic hycommunication hytechnique hyof
hypresenting hyreality hyby hyindicating hyher hyperception hyof hythe hysituation hyfor hythe hyclient.
B. "It’s hynot hyunusual hyto hyfeel hythat hyway hyat hyfirst, hybut hyonce hyyou hylearn hythe hyroutine, hyyou’ll hyenjoy hyit."
Rationale:hyWith hythis hyresponse, hythe hynurse hyillustrates hythe hynontherapeutic hycommunication hytechnique hyof
hygiving hyreassurance, hythus hydiscouraging hythe hyclient hyfrom hyfurther hycommunication.
C. "Exercise hyis hygood hyfor hyyou hyand hygood hyfor hyyour hyheart."
Rationale:hyWith hythis hyresponse, hythe hynurse hyillustrates hythe hynontherapeutic hycommunication hytechniques hyof
hydisagreeing hyand hygiving hyadvice.
D. "Your hydoctor hyis hythe hyexpert hyhere, hyand hyI’m hysure hyhe hywould hyonly hyrecommend hywhat hyis hybest hyfor hyyou."
Rationale:hyWith hythis hyresponse, hythe hynurse hyillustrates hythe hynontherapeutic hycommunication hytechnique hyof
hydefending.
4.hyA hynurse hyis hycaring hyfor hya hyclient hywho hyhas hyheart hyfailure hyand hya hypotassium hylevel hyof hy2.4 hymEq/L. hyThe hynurse
hyshould hyidentify hywhich hyof hythe hyfollowing hymedications hyas hythe hycause hyof hythe hyclient’s hylow hypotassium hylevel?
A. Furosemide
Rationale: hyFurosemide hyis hya hyloop hy(high-ceiling) hydiuretic hythat hyinhibits hythe hyreabsorption hyof hysodium
hyand hychloride hyand hyresults hyin hydiuresis, hywhich hydecreases hypotassium hythrough hyexcretion hyin
hythe hydistal hynephrons.
Hypokalemia hyis hyan hyadverse hyeffect hyof hyfurosemide.
B. Nitroglycerin
Rationale: hyA hypotassium hylevel hyof hy2.4 hymEq/L hyis hynot hyan hyadverse hyeffect hyof hynitroglycerin. hyNitroglycerin hyis
hya hyvasodilator hymedication hyto hytreat hyangina.
C. Metoprolol
Rationale: hyA hypotassium hylevel hyof hy2.4 hymEq/L hyis hynot hyan hyadverse hyeffect hyof hymetoprolol.
hyMetoprolol hyis hya hybeta-blocker hythat hyslows hythe hyheart hyrate hyand hyimproves
hycontractility hyof hythe hyheart hymuscle.
D. Spironolactone
Rationale: hySpironolactone hyis hya hypotassium-sparing hydiuretic hymedication; hytherefore, hyhyperkalemia hyis hyan
hyadverse hyeffect hyof hythis hymedication.
5. hyA hynurse hyis hycaring hyfor hya hyclient hywho hyis hypostoperative hyfollowing hyan hyopen hyreduction hyinternal hyfixation hy(ORIF)
hyof hya hyfemur hyfracture. hyWhich hyof hythe hyfollowing hyparameters hyshould hythe hynurse hyinclude hyin hythe hyevaluation hyof hythe
hyneurovascular hystatus hyof hythe hyclient's hyaffected hyextremity? hy(Select hyall hythat hyapply.)
Page hy2
,Detailed Answerhy
Key Medical
hy hy
Surgical, A+
A. Color
B. Temperature
C. Ecchymosis
D. Skin hyintegrity
E. Sensation
Rationale: hyColor hyis hycorrect. hyClients hywho hyhave hysustained hytrauma hyto hyan hyextremity, hysuch hyas hya
hyfracture, hyare hyat hyincreased hyrisk hyfor hyneurovascular hycompromise. hyThe hynurse hyshould
hycheck hythe hycolor hyof hythe hyclient's hyaffected hyextremity hyas hypart hyof hythis hyassessment. hyThe
hynurse hyshould hyidentify hypallor hyor hycyanosis hyof hythe hyextremity hyas hyan hyindication hyof
hyperipheral hyneurovascular hydysfunction hyand hyshould hynotify hythe hyprovider.Temperature hyis
hycorrect. hyClients hywho hyhave hysustained hytrauma hyto hyan hyextremity, hysuch hyas hya hyfracture, hyare
hyat hyincreased hyrisk hyfor hyneurovascular hycompromise. hyThe hynurse hyshould hymonitor hythe
hytemperature hyof hythe hyextremity hyas hya hypart hyof hythis hyassessment hyand hyidentify hyskin hythat hyis
hycool hyor hycold hyto hythe hytouch hyas hyhaving hydecreased hyperfusion hyto hythe hytissues hyof hythe
hyextremity, hywhich hyis hyan hyindication hyof hyperipheral hyneurovascular hydysfunction. hyThe hynurse
hyshould hyreport hyskin hythat hyis hycool hyto hythe hytouch hyto hythe hyprovider.Ecchymosis hyis hyincorrect.
hyEcchymosis, hyor hybruising, hyis hyan hyexpected hyfinding hywith hyleg hyinjuries hyand hyis hynot hya
hycomponent hyof hya hyneurovascular hycheck.Skin hyintegrity hyis hyincorrect. hyWhile hythe hynurse
hyshould hyassess hythe hyincision hyof hya hyclient hywho hyis hypostoperative hyfollowing hyan hyopen
hyreduction h y and hyinternal hyfixation hyof hythe hyfemur, hyit hyis hynot hya hycomponent hyof hya
hyneurovascular hycheck.Sensation hyis hycorrect. hyClients hywho hyhave hysustained hytrauma hyto hyan
hyextremity, hysuch hyas hya hyfracture, hyare hyat hyincreased hyrisk hyfor hyneurovascular hycompromise.
hyThe hynurse hyshould hyassess hythe hyclient's hyextremity hyfor hynumbness hyor hytingling. hyThe hynurse
hyshould hyrecognize hydiminished hypain hyor hyparesthesia hyas hyan hyindication hyof hydamage hyto hythe
hynerves hyor hyperipheral hyneurovascular hydysfunction hyand hyshould hyreport hyit hyto hythe hyprovider.
6.hyA hynurse hyis hymonitoring hya hyclient hyfollowing hya hythoracentesis. hyThe hynurse hyshould hyidentify hywhich hyof hythe
hyfollowing hymanifestations hyas hya hycomplication hyand hycontact hythe hyprovider hyimmediately?
A. Serosanguineous hydrainage hyfrom hythe hypuncture hysite
Rationale: hyA hysmall hyamount hyof hyserosanguineous hydrainage hyat hythe hypuncture hysite hyis hyexpected hyafter hya
hythoracentesis.
B. Discomfort hyat hythe hypuncture hysite
Rationale: hyMild hydiscomfort hyat hythe hypuncture hysite hyis hyexpected hyafter hya hythoracentesis.
C. Increased hyheart hyrate
Rationale: hyClients hyare hyat hyrisk hyfor hydeveloping hypulmonary hyedema hyor hycardiovascular hydistress hydue
hymediastinal hycontent hyshift hyafter hythe hyaspiration hyof hya hylarge hyamount hyof hyfluid hyfrom hythe
hyclient's hypleural hyspace.
Therefore, hythe hyclient hymay hyexperience hyan hyincrease hyin hyheart hyand hyrespiratory hyrate, hyalong
hywith hycoughing hywith hyblood-tinged hyfrothy hysputum, hyand hytightness hyin hythe hychest. hyThese
hyfindings hyrequire hynotification hyof hythe hyprovider hyimmediately.
D. Decreased hytemperature
Rationale: hyInfection hyis hypossible hyafter hyany hyinvasive hyprocedure; hyhowever, hyit hytakes hytime hyto hydevelop
hyand hyincreases hythe hybody hytemperature.
Page hy3
, Detailed Answerhy
Key Medical
hy hy
Surgical, A+
7. hyA hynurse hyis hycaring hyfor hya hyclient hywho hyhas hya hyhistory hyof hyexposure hyto hyTB hyand hysymptoms hyof hynight hysweats
hyand hyhemoptysis. hyWhich hyof hythe hyfollowing hytests hyshould hythe hynurse hyrealize hyis hythe hymost hyreliable hyto
hyconfirm hythe hydiagnosis hyof hyactive hypulmonary hyTB?
A. Chest hyx-ray
Rationale: hyA hychest hyx-ray hymay hybe hyhelpful hyfor hydetecting hyold hyor hynew hylesions hythat hyare hylarge hyenough
hyto hybe hyvisualized. hyHowever, hythe hyclient hywho hyhas hyan hyHIV hyinfection hymay hyhave hya hynormal hyx-
ray hyor hyshow hyinfiltrates hywhich hywould hybe hyexpected hyin hythe hyclient hywho hyhas hypneumonia.
B. Sputum hyculture hyfor hyacid-fast hybacillus
Rationale: hyAlthough hythe hyMantoux hy(skin hytest) hyand hythe hychest hyx-ray hymay hybe hyuseful hyscreening hytools
hyfor hyTB, hythe hypresence hyof hyacid-fast hybacillus hynoted hyin hythe hyclient's hysputum, hysecretions,
hyor hytissues hyis hythe hyonly hymethod hythat hycan hyactually hyconfirm hythe hydiagnosis.
C. Sputum hysmear
Rationale: hyA hysputum hysmear hyis hyable hyto hydetect hythe hypresence hyof hymycobacterium, hybut hyit hydoes hynot
hydistinguish hybetween hymycobacterium hytuberculosis hyand hyother hystrains hyof hymycobacterium.
D. Mantoux hytest
Rationale: hyThe hyMantoux hyskin hytest hyis hyan hyeffective hyscreening hytool, hybut hyit hyis hyunable hyto hydistinguish
hybetween hyan hyactive hycase hyof hyTB hyand hya hyclient hywho hyhas hybeen, hyat hysome hytime hyin hythe
hypast, hyexposed hyto hyTB. hyThe hyresults hyare hyalso hyvariable, hydepending hyupon hythe hyskill hyof hythe
hynurse hyadministrating hyand hyreading hythe hytest.
8.hyA hynurse hyin hya hymedical hyclinic hyis hyproviding hyteaching hyto hyan hyolder hyadult hyclient hywho hyhas hyosteoarthritis hythat hyis
hyaffecting hyher hyknees. hyWhich hyof hythe hyfollowing hyclient hystatements hyindicates hyan hyunderstanding hyof hythe
hyteaching?
A. "I hycan hyuse hyeither hyheat hyor hyice hyto hyhelp hyrelieve hythe hydiscomfort."
Rationale: hyThe hynurse hyshould hyreinforce hythat hydifferent hytreatment hymodalities, hysuch hyas hyheat hyor hycold
hytherapy, hycan hybe hytried hyto hydetermine hywhich hyone hyis hymore hyeffective hyfor hythe hyclient. hyHeat
hyapplication hycan hyhelp hywith hymuscle hyrelaxation hyin hythe hyarea hyaround hythe hyaffected hyjoint.
hyThe hyapplication hyof hycold hynumbs hynerve hyendings hyand hydecreases hyjoint hyinflammation.
B. "Ibuprofen hyis hythe hyfirst hystep hyin hymedication hytherapy hyfor hyosteoarthritis."
Rationale:hyThe hynurse hyshould hyinstruct hythe hyclient hythat hythe hyprimary hymedication hyof hychoice hyfor hythe
hytreatment hyof hyosteoarthritis hyis hyacetaminophen. hyNSAIDS, hysuch hyas hycelecoxib hyand hyibuprofen,
hymight hybe hytried hyif hyacetaminophen hydoes hynot hycontrol hydiscomfort.
C. "I hyshould hylimit hyphysical hyactivity hyto hyprevent hyfurther hyinjury."
Rationale:hyThe hynurse hyshould hyencourage hythe hyclient hyto hyinclude hyaerobic hyexercise hyand hylower hyextremity
hystrength hytraining hyinto hyher hydaily hyregimen. hyThese hyactivities hyhave hybeen hyshown hyto hyslow hythe
hyprogression hyof hyosteoarthritis hyand hyrelieve hythe hymanifestations hyof hythe hydisorder.
D. "I hywill hyelevate hymy hylegs hyby hyplacing hytwo hypillows hyunder hymy hyknees hywhen hyI hygo hyto hybed."
Rationale:
Page hy4
