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A 45-year-old patient diagnosed with breast cancer is visibly anxious about her upcoming surgery. She expresses concerns about her appearance after a mastectomy. What should the nurse prioritize to address the patient’s psychosocial needs?
Explanation: Connecting the patient with a support group can provide emotional support and allow her to share her concerns with others who have faced similar experiences.
A 60-year-old patient with end-stage renal disease (ESRD) on hemodialysis has been feeling increasingly depressed and withdrawn. Which intervention best addresses the psychosocial needs of this patient?
Explanation: Encouraging the patient to explore hobbies can provide a sense of purpose and improve their emotional well-being.
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A 30-year-old patient diagnosed with HIV is experiencing social isolation due to stigma from family and friends. What is the most appropriate nursing action to address this patient’s psychosocial needs?
Explanation: Referring the patient to a local HIV support group can provide a safe and empathetic environment to share experiences and receive emotional support.
A 50-year-old patient with a recent below-the-knee amputation is experiencing grief and frustration over the loss of mobility. How can the nurse best address the patient’s psychosocial needs?
Explanation: Psychological counseling can help the patient cope with grief, frustration, and adjustment following limb loss.
An elderly patient with a history of stroke is experiencing difficulty communicating and becomes frustrated when others do not understand. What nursing intervention can improve the patient’s psychosocial well-being?
Explanation: Recommending speech therapy can improve the patient’s ability to communicate, reducing frustration and enhancing psychosocial well-being.
A 55-year-old patient with end-stage renal disease (ESRD) has been receiving hemodialysis for several years. Lately, the nurse has noticed the patient experiencing muscle cramps, nausea, and low blood pressure during dialysis sessions. Which complication of hemodialysis is most likely causing these symptoms?
Explanation: The patient’s symptoms, including muscle cramps, nausea, and low blood pressure during dialysis, are characteristic of dialysis disequilibrium syndrome, which is caused by rapid removal of urea during hemodialysis.
A 62-year-old patient with ESRD has been undergoing peritoneal dialysis for the past year. The patient presents with cloudy peritoneal effluent and abdominal pain. What complication is the patient likely experiencing, and what should the nurse do?
Explanation: Cloudy peritoneal effluent and abdominal pain are indicative of peritonitis, a common complication of peritoneal dialysis. Immediate administration of antibiotics is necessary.
A 50-year-old patient with chronic kidney disease (CKD) has been started on continuous ambulatory peritoneal dialysis (CAPD). After several months, the patient develops an exit site infection with redness, swelling, and purulent drainage. What is the most appropriate nursing action?
Explanation: Applying a warm, moist compress to the exit site can help reduce inflammation and facilitate drainage in cases of exit site infection, but further evaluation by a healthcare provider is needed.
A 45-year-old patient undergoing hemodialysis develops a fever, chills, and hypotension during a dialysis session. The nurse observes cloudy dialysate fluid. What complication is this patient likely experiencing, and what should be done?
Explanation: The cloudy dialysate fluid, along with fever, chills, and hypotension, suggests peritonitis. Initiating peritoneal dialysis should be considered, and antibiotics should be administered.
A 58-year-old patient on hemodialysis presents with bleeding from the vascular access site. The bleeding is not stopping with direct pressure. What is the nurse’s immediate action?
Explanation: Applying a tourniquet proximal to the bleeding site can help control bleeding from the vascular access site while awaiting further evaluation and intervention by the healthcare provider.
A 60-year-old patient with end-stage renal disease (ESRD) has a newly created arteriovenous fistula (AVF) in the left forearm for hemodialysis access. The nurse is assessing the AVF and notes a palpable thrill and audible bruit. What does the nurse understand about these findings?
Explanation: A palpable thrill and audible bruit are expected findings in a functioning AVF. They indicate good blood flow through the fistula.
A 55-year-old patient with a history of AVF for hemodialysis presents with redness, warmth, and swelling at the AVF site. The patient complains of pain and tenderness. What complication is the patient likely experiencing, and what is the appropriate nursing action?
Explanation: The patient’s symptoms, including redness, warmth, swelling, pain, and tenderness, suggest an AVF infection. Antibiotics should be administered promptly.
A 50-year-old patient with an AVF for hemodialysis reports experiencing numbness and tingling in the hand on the same side as the AVF. What should the nurse assess for, and what action is appropriate?
Explanation: Numbness and tingling in the hand on the same side as the AVF may indicate AVF thrombosis. The nurse should assess for the presence of bruit and thrill and notify the healthcare provider.
A 58-year-old patient with an AVF complains of persistent coldness and pallor in the arm with the AVF. The patient also mentions difficulty moving the fingers. What could be the cause of these symptoms, and what should the nurse do? ________________
A 70-year-old patient with osteoarthritis is experiencing pain in the hip joint. The nurse is providing education on joint protection techniques. Which advice should the nurse give to the patient?
Explanation: Maintaining a healthy weight can reduce the load on weight-bearing joints like the hip, helping to alleviate pain and slow the progression of osteoarthritis.
A 68-year-old patient with osteoarthritis in the hands is seeking pain relief. The nurse recommends using assistive devices. Which device is most appropriate for this patient?
Explanation: Finger splints can help stabilize and support the finger joints affected by osteoarthritis, reducing pain and improving function.
A 75-year-old patient with osteoarthritis in the spine experiences morning stiffness. The nurse recommends strategies to alleviate stiffness. What advice should the nurse provide?
Explanation: Moist heat and gentle stretching can help alleviate morning stiffness in patients with osteoarthritis of the spine.
An 80-year-old patient with osteoarthritis in the knees is considering over-the-counter (OTC) supplements for joint health. Which supplement is commonly used for osteoarthritis and may provide some benefit?
Explanation: Glucosamine and chondroitin supplements are commonly used by patients with osteoarthritis and may provide some benefit in reducing joint pain and improving function.
*A 65-year-old woman, presents with a history of multiple vertebral fractures and reduced bone density. She has been diagnosed with osteoporosis. What nursing intervention is a priority for Sarah?
Correct Answer: B (Encouraging weight-bearing exercises)
Explanation: Weight-bearing exercises such as walking and resistance training help stimulate bone formation and improve bone density in patients with osteoporosis. These exercises can also help prevent further fractures.
Patient Case Vignette: John, a 72-year-old man, is diagnosed with osteoporosis. He is prescribed medication to manage his condition. What class of medications is commonly prescribed to treat osteoporosis?
Correct Answer: C (Bisphosphonates)
Explanation: Bisphosphonates are a class of medications commonly prescribed to treat osteoporosis. They help reduce bone loss and lower the risk of fractures.
A postmenopausal woman, has osteoporosis and is at risk of falls. What dietary recommendation should be emphasized for Maria to support her bone health?
Correct Answer: C (Calcium and vitamin D-rich diet)
Explanation: A diet rich in calcium and vitamin D is essential for maintaining bone health, especially in individuals with osteoporosis. These nutrients help strengthen bones and reduce the risk of fractures.
A 60-year-old man, is newly diagnosed with osteoporosis. He is concerned about his risk of fractures. What lifestyle modification should Robert be advised to reduce his risk of falls?
Correct Answer: C (Installing handrails and grab bars)
Explanation: Installing handrails and grab bars in the home can help reduce the risk of falls and fractures, especially in individuals with osteoporosis. These modifications provide support and stability.
Patient Case Vignette: Emily, a 55-year-old woman, is undergoing treatment for osteoporosis. She is concerned about potential side effects. Which of the following is a common side effect associated with bisphosphonate medications?
Correct Answer: C (Muscle pain)
Explanation: Muscle pain is a common side effect associated with bisphosphonate medications, which are often prescribed for osteoporosis. Patients should be educated about potential side effects and report them to their healthcare provider.
Patient Case Vignette: Sarah, a 50-year-old patient with a history of breast cancer, has developed a pathological fracture in her femur due to bone metastasis. What is the priority nursing action for Sarah at this time?
Correct Answer: B (Prepare for surgical intervention)
Explanation: In the case of a pathological fracture due to bone metastasis, surgical intervention is often necessary to stabilize the fracture and relieve pain. This is the priority action to address Sarah’s condition.
A 65-year-old patient, has a pathological fracture in his spine due to multiple myeloma. He is experiencing severe pain. What type of pain management strategy is most appropriate for John?
Correct Answer: B (Opioid analgesics)
Explanation: Patients with severe pain due to pathological fractures often require opioid analgesics for effective pain management. Opioids can provide adequate pain relief in such cases.
A 60-year-old patient with lung cancer, has developed a pathological fracture in her ribs. She is at risk of impaired respiratory function. What nursing intervention is essential for Maria’s respiratory care?
Correct Answer: B (Encourage deep breathing and coughing exercises)
Explanation: Encouraging deep breathing and coughing exercises is crucial for preventing respiratory complications in patients with rib fractures. These exercises help maintain lung function and prevent atelectasis.
A 55-year-old patient with prostate cancer, has a pathological fracture in his hip. He is at risk of developing pressure ulcers. What nursing measure should be implemented to prevent pressure ulcers in Robert?
Correct Answer: A (Frequent position changes)
Explanation: Frequent position changes help relieve pressure on bony prominences and reduce the risk of pressure ulcers in patients with fractures. Hydration should not be avoided, and direct pressure should be prevented.
A 70-year-old patient with renal cell carcinoma, has a pathological fracture in her arm. She is experiencing anxiety and fear. What nursing intervention can help address Emily’s psychological needs?
Correct Answer: C (Provide emotional support and reassurance)
Explanation: Patients with pathological fractures often experience emotional distress. Providing emotional support, reassurance, and addressing their concerns can help alleviate anxiety and fear.
An 80-year-old patient, has recently experienced a fall at her home and sustained a hip fracture. What is the most appropriate nursing intervention to prevent complications after a hip fracture?
Correct Answer: C (Implement early mobility and ambulation)
Explanation: Early mobility and ambulation are essential to prevent complications like pneumonia, pressure ulcers, and muscle weakness after a hip fracture. Immobilization and sedatives should be avoided.
A 75-year-old patient, frequently experiences falls due to unsteady gait and balance issues. What should be the focus of nursing care to prevent future falls in John?
Correct Answer: C (Assess and address factors contributing to falls)
Explanation: To prevent falls in elderly patients like John, it is essential to assess and address factors such as medications, balance issues, and environmental hazards that contribute to falls. Isolation is not a suitable intervention.
An 85-year-old patient, has a history of falls and fractures. She has been prescribed multiple medications. What nursing action is crucial regarding her medication management to reduce the risk of falls?
Correct Answer: C (Review medications for potential side effects and interactions)
Explanation: Reviewing medications for potential side effects and interactions is crucial in preventing falls in elderly patients. Administering all medications at once, on an empty stomach, or increasing doses can be harmful.
A 70-year-old patient, has a history of falls and is at risk of falling in the hospital. What is an appropriate nursing intervention to minimize the risk of falls during his hospital stay?
Correct Answer: C (Provide assistive devices and keep call bell within reach)
Explanation: Providing assistive devices and ensuring the patient can reach the call bell are essential measures to prevent falls. Keeping the room well-lit and avoiding strong sedatives are also important.
An 88-year-old patient, has fallen multiple times at home. She is at risk of falls and is admitted to the hospital. What nursing intervention can help address Sarah’s psychological needs during her hospitalization?
Correct Answer: C (Provide emotional support and reassurance)
Explanation: Patients who have experienced falls often experience emotional distress. Providing emotional support, reassurance, and addressing their concerns can help alleviate anxiety and fear.
A patient presents with a swollen and painful ankle after twisting it during a soccer game. The nurse suspects a sprain. What is the primary nursing intervention for this patient?
Correct Answer: B (Elevate the affected limb)
Explanation: Elevating the affected limb helps reduce swelling and promotes venous return, which is crucial in managing a sprained ankle. Hot compresses, muscle relaxants, and tourniquets are not appropriate interventions.
A patient complains of severe pain and muscle spasm in the lower back after lifting a heavy object. The nurse suspects a strain. What should be the initial nursing action for this patient?
Correct Answer: D (Assess and provide pain relief through medications as needed)
Explanation: The initial nursing action for a patient with a suspected muscle strain is to assess the patient’s pain and provide pain relief as needed. Ice, bed rest for several days, or strong painkillers may not be the most appropriate interventions.
A patient has been diagnosed with a mild sprain of the wrist. What nursing instructions should be given to the patient regarding self-care at home?
Correct Answer: C (Encourage active range of motion exercises)
Explanation: For a mild wrist sprain, it is essential to encourage active range of motion exercises to prevent stiffness. Immobilization 24/7, avoiding movement, or applying heat regularly may not be appropriate.
A patient has been diagnosed with a moderate strain of the hamstring muscles. What nursing intervention can help manage pain and promote healing in this patient?
Correct Answer: D (Teach the patient gentle stretching exercises)
Explanation: Gentle stretching exercises are crucial in managing a moderate muscle strain like the one described. Heat, prolonged bed rest, and anti-inflammatory medications may not be the most effective interventions.
A patient arrives at the emergency department with a suspected severe ankle sprain following a fall. What nursing action should be prioritized for this patient?
Correct Answer: D (Assess neurovascular status and provide pain relief)
Explanation: When dealing with a suspected severe sprain, it is crucial to assess the patient’s neurovascular status and provide pain relief. Administering a muscle relaxant, applying a compression bandage, or immobilizing the ankle with a splint should come after this assessment.
A patient presents with a swollen and painful ankle after twisting it during a soccer game. The nurse suspects a sprain. What is the primary nursing intervention for this patient?
Correct Answer: B (Elevate the affected limb)
Explanation: Elevating the affected limb helps reduce swelling and promotes venous return, which is crucial in managing a sprained ankle. Hot compresses, muscle relaxants, and tourniquets are not appropriate interventions.
A patient complains of severe pain and muscle spasm in the lower back after lifting a heavy object. The nurse suspects a strain. What should be the initial nursing action for this patient?
Correct Answer: D (Assess and provide pain relief through medications as needed)
Explanation: The initial nursing action for a patient with a suspected muscle strain is to assess the patient’s pain and provide pain relief as needed. Ice, bed rest for several days, or strong painkillers may not be the most appropriate interventions.
A patient has been diagnosed with a mild sprain of the wrist. What nursing instructions should be given to the patient regarding self-care at home?
Correct Answer: C (Encourage active range of motion exercises)
Explanation: For a mild wrist sprain, it is essential to encourage active range of motion exercises to prevent stiffness. Immobilization 24/7, avoiding movement, or applying heat regularly may not be appropriate.
A patient has been diagnosed with a moderate strain of the hamstring muscles. What nursing intervention can help manage pain and promote healing in this patient?
Correct Answer: D (Provide gentle stretching exercises)
Explanation: Gentle stretching exercises can help manage pain and promote healing in a patient with a moderate muscle strain. Heat, prolonged bed rest, or muscle relaxants may not be the best choices.
A patient arrives at the emergency room with a suspected severe ankle sprain. What should be the immediate nursing action for this patient?
Correct Answer: D (Assess neurovascular status and provide pain relief)
Explanation: When dealing with a suspected severe sprain, it is crucial to assess the patient’s neurovascular status and provide pain relief. Administering a muscle relaxant, applying a compression bandage, or immobilizing the ankle with a splint should come after this assessment.
A construction worker was trapped under a collapsed structure and sustained severe crush injuries to the lower extremities. On assessment, you notice cool, pale skin and absent pulses in the affected limbs. What is the initial nursing action?
Correct Answer: D (Notify the healthcare provider immediately)
Explanation: In cases of severe crush injuries with absent pulses, the priority is to notify the healthcare provider immediately for urgent evaluation and possible surgical intervention. Applying warm compresses, elevating the limbs, or administering pain medication should not delay this action.
A patient was involved in a car accident and sustained a crush injury to the chest. The patient complains of severe chest pain and difficulty breathing. What is the initial nursing action?
Correct Answer: D (Ensure an open airway and call for help)
Explanation: In a patient with a crush injury to the chest experiencing severe chest pain and difficulty breathing, the priority is to ensure an open airway and call for help. Administering oxygen, assessing pain, and performing a chest X-ray are important but secondary actions.
A patient presents with a crush injury to the hand with a large wound that is bleeding profusely. What is the initial nursing action?
Correct Answer: B (Apply pressure to the wound)
Explanation: The initial nursing action for a profusely bleeding wound in a crush injury is to apply pressure to control the bleeding. Applying a tourniquet should only be considered as a last resort, and elevating the hand may not be sufficient to stop the bleeding.
A patient with a crush injury to the legs has been stabilized. What is the primary nursing intervention during the recovery phase?
Correct Answer: C (Promote mobility and rehabilitation)
Explanation: During the recovery phase of crush injuries, the primary nursing intervention is to promote mobility and rehabilitation to prevent complications such as muscle contractures and deep vein thrombosis. Administering antibiotics, strict bed rest, or applying heat packs may not address the long-term needs of the patient.
A patient with a crush injury to the lower extremities has developed compartment syndrome. What clinical manifestations are typically associated with compartment syndrome in this patient?
Correct Answer: A (Increased pain with limb movement)
Explanation: Compartment syndrome in a patient with a crush injury often presents with increased pain with limb movement, which is a hallmark sign. It may also be associated with pallor, coolness, decreased peripheral pulses, and prolonged capillary refill time. Warmth and erythema are more indicative of infection.
A patient presents with a deep laceration on the forearm. The wound is bleeding profusely. What is the initial nursing action?
Correct Answer: D (Apply direct pressure to control bleeding)
Explanation: The initial nursing action for a profusely bleeding wound is to apply direct pressure to control the bleeding. This helps stop the hemorrhage and should be done before dressing the wound or administering antibiotics.
A patient has a surgical wound with a drain in place. The drainage in the bulb reservoir is dark red. What is the most appropriate nursing action?
Correct Answer: B (Document the findings)
Explanation: Dark red drainage in the bulb reservoir of a surgical drain is indicative of normal postoperative drainage. The most appropriate nursing action is to document the findings and continue to monitor the patient’s condition.
A patient with a chronic wound is receiving wound care. The wound has thick, yellow, and odorous discharge. What type of wound is this most likely indicating?
Correct Answer: D (Infected wound)
Explanation: Thick, yellow, and odorous discharge from a wound is indicative of infection. It is essential to assess and treat infected wounds promptly to prevent further complications.
A patient has a wound with evisceration, where abdominal contents are protruding. What should the nurse do first?
Correct Answer: A (Cover the wound with a sterile dressing)
Explanation: The initial nursing action for a wound with evisceration is to cover the wound with a sterile dressing to protect the exposed organs and prevent infection. Notifying the healthcare provider is also necessary, but covering the wound is the immediate priority.
A patient has a pressure ulcer on the sacrum. What is the most critical factor in pressure ulcer prevention for this patient?
Correct Answer: A (Frequent repositioning)
Explanation: The most critical factor in pressure ulcer prevention is frequent repositioning of the patient to relieve pressure on vulnerable areas like the sacrum. This helps maintain adequate blood flow to the skin and prevents pressure ulcers from forming or worsening.
A patient presents with an open wound on the leg. The wound appears red, swollen, warm to touch, and purulent drainage is noted. Which of the following terms best describes this wound?
Correct Answer: C (Infected wound)
Explanation: The signs of redness, swelling, warmth, and purulent drainage indicate an infected wound. Infected wounds require careful assessment and appropriate treatment to prevent complications.
A postoperative patient has an abdominal incision with purulent discharge and foul odor. Which nursing intervention is a priority in this situation?
Correct Answer: C (Notify the healthcare provider)
Explanation: In the case of an abdominal incision with purulent discharge and foul odor, it is crucial to notify the healthcare provider immediately to assess the need for further interventions or changes in treatment.
A patient has an infected wound that requires wound debridement. Which type of wound debridement is considered surgical and requires anesthesia?
Correct Answer: D (Sharp debridement)
Explanation: Sharp debridement is a surgical procedure that involves the use of a scalpel or scissors to remove nonviable tissue from a wound. It requires anesthesia due to the potential for pain and bleeding.
A patient with a diabetic foot ulcer has an infected wound. Which laboratory test is essential for assessing the extent of the infection?
Correct Answer: A (Complete blood count – CBC)
Explanation: A complete blood count (CBC) is essential for assessing the extent of infection in a diabetic foot ulcer. It helps determine the white blood cell count and the presence of infection.
A patient with a pressure ulcer has signs of cellulitis around the wound, including erythema and warmth. The nurse suspects infection. What is the most appropriate initial action?
Correct Answer: B (Perform wound culture)
Explanation: When infection is suspected in a pressure ulcer with signs of cellulitis, the most appropriate initial action is to perform a wound culture to identify the specific pathogens and guide antibiotic therapy.
A 25-year-old athlete presents with a swollen and painful knee after a sports injury. Physical examination reveals instability in the anterior cruciate ligament (ACL). What is the most appropriate initial management for this patient?
Correct Answer: B (Rest, ice, compression, and elevation – RICE)
Explanation: Initial management of an ACL injury typically involves RICE therapy to reduce pain and swelling. Surgery may be considered later based on the patient’s condition and activity level.
A patient reports pain and swelling in the ankle after a twisting injury. The physical examination suggests a lateral collateral ligament (LCL) injury. Which of the following ligaments is primarily involved in this injury?
Correct Answer: D (Lateral collateral ligament – LCL)
Explanation: An injury to the LCL primarily affects the lateral aspect of the knee. The MCL, ACL, and PCL are located in different areas of the knee.
A patient presents with a history of chronic wrist pain following a fall on an outstretched hand. Imaging reveals a tear in the scapholunate ligament. What condition is commonly associated with this ligament injury?
Correct Answer: D (Wrist instability)
Explanation: Injury to the scapholunate ligament can lead to wrist instability, which may require surgical intervention to restore function and prevent long-term issues.
A patient reports severe ankle pain and difficulty walking after rolling the ankle during a hiking trip. Examination shows tenderness over the medial malleolus and excessive medial joint opening. Which ligament is most likely injured?
Correct Answer: A (Anterior talofibular ligament – ATFL)
Explanation: An injury with tenderness over the medial malleolus and excessive medial joint opening suggests an ATFL injury, which is common in ankle sprains.
A patient with a history of knee instability and recurrent pain presents for evaluation. The physical examination shows a positive anterior drawer test. Which ligament is most likely involved in this patient’s condition?
Correct Answer: C (Anterior cruciate ligament – ACL)
Explanation: A positive anterior drawer test is indicative of an ACL injury, which can result in knee instability and recurrent pain.
A 45-year-old patient presents with a red, warm, and swollen area on their lower leg. They report tenderness and fever. Physical examination shows an expanding erythematous area with poorly defined borders. Which of the following organisms is the most common cause of cellulitis in this patient?
Correct Answer: A (Staphylococcus aureus)
Explanation: Staphylococcus aureus, including methicillin-resistant strains (MRSA), is the most common cause of cellulitis in adults. It typically presents with local symptoms, as described in this case.
An elderly patient with diabetes mellitus presents with cellulitis on their foot. They have a history of peripheral neuropathy. What is a significant concern in managing cellulitis in this patient?
Correct Answer: D (Risk of compartment syndrome)
Explanation: In patients with peripheral neuropathy and cellulitis, there is a risk of developing compartment syndrome due to impaired sensation. Close monitoring for signs of compartment syndrome is crucial.
A pediatric patient presents with cellulitis on their face, specifically around the eye. The affected area is red, swollen, and tender. Which organism is the most common cause of periorbital cellulitis in children?
Correct Answer: C (Staphylococcus aureus)
Explanation: Staphylococcus aureus, including MRSA, is a common cause of periorbital cellulitis in children. Prompt treatment with antibiotics is essential to prevent complications.
A patient presents with recurrent episodes of cellulitis in their lower extremities. They report a history of lymphedema. What is the primary factor contributing to the recurrence of cellulitis in this patient?
Correct Answer: C (Lymphatic insufficiency)
Explanation: Recurrent cellulitis in a patient with lymphedema
A 55-year-old patient presents with severe bone pain, fever, and localized swelling in their left leg. They have a history of diabetes mellitus. Imaging shows bone destruction. What is the most common causative organism of osteomyelitis in adults, especially in those with diabetes?
Correct Answer: A (Staphylococcus aureus)
Explanation: Staphylococcus aureus, including methicillin-resistant strains (MRSA), is the most common causative organism of osteomyelitis in adults, especially in those with underlying conditions like diabetes.
A pediatric patient presents with bone pain, fever, and localized swelling in their right arm. They recently had a skin infection. What is the most likely mode of spread of osteomyelitis in this patient?
Correct Answer: A (Hematogenous spread)
Explanation: Hematogenous spread, often from a distant site of infection, is the most common mode of spread of osteomyelitis in pediatric patients.
A 40-year-old patient with a recent history of orthopedic surgery presents with signs of surgical site infection and suspected osteomyelitis. What is the most appropriate diagnostic imaging modality to confirm the diagnosis of osteomyelitis in this patient?
Correct Answer: B (Magnetic resonance imaging, MRI)
Explanation: MRI is the most appropriate imaging modality for confirming the diagnosis of osteomyelitis, especially in post-surgical cases, as it provides excellent soft tissue and bone detail.
A 65-year-old patient with a prosthetic hip joint presents with hip pain and a fever. Suspected prosthetic joint infection (PJI) and osteomyelitis are being considered. What is the gold standard diagnostic test for PJI in this patient?
Correct Answer: B (Synovial fluid analysis)
Explanation: Synovial fluid analysis is the gold standard for diagnosing prosthetic joint infection (PJI) in patients with prosthetic joints, which can be associated with osteomyelitis.
A 25-year-old patient presents with acute osteomyelitis. In addition to antibiotic therapy, what is the standard approach to manage this patient’s condition, especially if there’s an abscess formation?
Correct Answer: B (Surgical drainage)
Explanation: Surgical drainage is a standard approach in the management of acute osteomyelitis, especially if there’s an abscess formation that needs to be drained in addition to antibiotic therapy.
A 60-year-old patient with osteoarthritis complains of persistent joint pain and stiffness in their knees. They have no known allergies. Which of the following medications is considered a first-line pharmacological treatment for osteoarthritis pain management in this patient?
Correct Answer: B (Acetaminophen)
Explanation: Acetaminophen is often considered a first-line pharmacological treatment for osteoarthritis pain management due to its analgesic properties and minimal risk of gastrointestinal side effects compared to nonsteroidal anti-inflammatory drugs (NSAIDs).
A 70-year-old patient with osteoarthritis of the hip is seeking pain relief. They have a history of gastric ulcers. Which class of medications should be avoided in this patient due to their gastrointestinal history when managing osteoarthritis pain?
Correct Answer: A (Nonsteroidal anti-inflammatory drugs, NSAIDs)
Explanation: NSAIDs should be avoided in patients with a history of gastric ulcers due to their increased risk of gastrointestinal bleeding and ulcers. Acetaminophen is a safer option in such cases.
A 55-year-old patient with osteoarthritis of the hands experiences localized joint pain and swelling. They are looking for a topical medication to relieve their symptoms. Which of the following topical medications is commonly used for osteoarthritis joint pain?
Correct Answer: C (Diclofenac gel)
Explanation: Diclofenac gel is a topical NSAID that is commonly used for localized joint pain associated with osteoarthritis. It provides targeted pain relief with fewer systemic side effects.
A 65-year-old patient with osteoarthritis of the knee is interested in dietary supplements to manage their symptoms. Which of the following dietary supplements is often recommended for osteoarthritis due to its potential benefits for joint health?
Correct Answer: C (Glucosamine)
Explanation: Glucosamine is often recommended as a dietary supplement for osteoarthritis due to its potential benefits for joint health. It is believed to support cartilage health and reduce symptoms.
A 50-year-old patient with osteoarthritis of the spine is seeking pain relief. They are concerned about potential side effects of medication. Which non-pharmacological approach can be effective in managing osteoarthritis pain in this patient?
Correct Answer: B (Physical therapy)
Explanation: Physical therapy is a non-pharmacological approach that can be effective in managing osteoarthritis pain by improving joint function, mobility, and strength without the potential side effects associated with medications.
A 25-year-old athlete sustains a lower leg injury during a soccer game. They complain of severe pain, swelling, and tightness in the affected area. The nurse suspects compartment syndrome. Which of the following is a common early sign of compartment syndrome in this patient?
Correct Answer: C (Paresthesia or numbness)
Explanation: Paresthesia or numbness is an early sign of compartment syndrome and indicates nerve compression due to increased pressure within the affected compartment.
A patient has been diagnosed with compartment syndrome in their forearm. Surgical intervention is planned to relieve the pressure within the affected compartment. Which procedure is typically performed to treat compartment syndrome?
Correct Answer: B (Fasciotomy)
Explanation: Fasciotomy is the surgical procedure performed to treat compartment syndrome. It involves making incisions in the fascia to relieve pressure and restore blood flow.
A 40-year-old patient presents with signs and symptoms suggestive of compartment syndrome. The nurse measures the compartment pressure and obtains a reading of 30 mm Hg. Which of the following compartment pressure readings is consistent with the diagnosis of compartment syndrome?
Correct Answer: D (40 mm Hg)
Explanation: Compartment pressure readings consistently above 30 mm Hg are indicative of compartment syndrome. A reading of 40 mm Hg is highly suggestive of the condition.
A patient has undergone fasciotomy to treat compartment syndrome in their lower leg. The nurse provides postoperative care. Which of the following is a priority nursing intervention after fasciotomy?
Correct Answer: B (Elevating the affected limb)
Explanation: Elevating the affected limb is a priority nursing intervention after fasciotomy to reduce swelling and promote venous return.
A patient has developed compartment syndrome in their hand following a crush injury. In addition to fasciotomy, what other medical intervention may be necessary to manage this condition?
Correct Answer: D (Hyperbaric oxygen therapy)
Explanation: Hyperbaric oxygen therapy may be necessary to manage compartment syndrome in cases of crush injuries to improve tissue oxygenation and reduce the risk of complications.
Patient Case Vignette: A 45-year-old patient presents with severe pain, redness, and swelling in their lower abdomen following recent abdominal surgery. The nurse suspects necrotizing fasciitis. What is the most critical initial nursing intervention for this patient?
Correct Answer: C (Notifying the healthcare provider)
Explanation: In suspected cases of necrotizing fasciitis, immediate notification of the healthcare provider is crucial for timely evaluation and intervention, as this condition can progress rapidly.
A patient with necrotizing fasciitis is undergoing surgical debridement. The nurse is preparing for postoperative care. What is the primary goal of post-debridement nursing care in necrotizing fasciitis?
Correct Answer: A (Preventing infection)
Explanation: The primary goal of post-debridement nursing care in necrotizing fasciitis is to prevent infection and promote wound healing by maintaining aseptic technique and administering appropriate antibiotics.
A patient with necrotizing fasciitis is receiving intravenous antibiotics. Which of the following nursing assessments is essential during antibiotic therapy for this patient?
Correct Answer: D (Evaluating wound odor and drainage)
Explanation: Assessing wound odor and drainage is essential during antibiotic therapy for a patient with necrotizing fasciitis to monitor the progress of wound healing and detect signs of ongoing infection.
A patient with necrotizing fasciitis has developed septic shock. The nurse is prioritizing interventions. What is the nurse’s priority action in the management of septic shock in this patient?
Correct Answer: D (Administering intravenous fluids and antibiotics)
Explanation: In the management of septic shock, the priority is to administer intravenous fluids and antibiotics to address the infection and stabilize the patient’s condition.
A patient with necrotizing fasciitis is scheduled for wound care. The nurse is preparing to change the wound dressings. Which type of dressing is most appropriate for necrotizing fasciitis wounds?
Correct Answer: B (Hydrocolloid dressings)
Explanation: Hydrocolloid dressings are often used for necrotizing fasciitis wounds as they create a moist environment, promote autolytic debridement, and help with wound healing.
A 35-year-old patient presents with a painful, swollen area on their upper arm. On examination, the nurse suspects an abscess. What is the initial nursing intervention for this patient?
Correct Answer: B (Applying warm compresses)
Explanation: The initial nursing intervention for a suspected abscess is to apply warm compresses to promote localized drainage and relieve pain.
A patient with a draining abscess is receiving wound care. Which of the following principles of aseptic technique is essential for the nurse to follow during wound dressing changes?
Correct Answer: A (Using sterile gloves)
Explanation: When performing wound care for an abscess, it is essential for the nurse to use sterile gloves as part of aseptic technique to prevent infection.
A patient with an abscess has undergone surgical drainage. What is the primary nursing goal in the immediate postoperative period following abscess drainage?
Correct Answer: D (Preventing infection)
Explanation: The primary nursing goal in the immediate postoperative period following abscess drainage is to prevent infection by maintaining aseptic technique and monitoring for signs of infection.
A patient with a recurrent abscess is being educated about prevention. What advice should the nurse provide to the patient to minimize the risk of recurrent abscesses?
Correct Answer: C (Keep the area clean and dry)
Explanation: To minimize the risk of recurrent abscesses, the patient should be advised to keep the affected area clean and dry to prevent bacterial growth and infection.
A patient with an abscess has been prescribed antibiotics. What important information should the nurse provide to the patient regarding antibiotic therapy for abscesses?
Correct Answer: C (Finish the entire course of antibiotics)
Explanation: It is crucial for the patient to finish the entire course of antibiotics prescribed for the abscess, even if they start feeling better, to ensure complete eradication of the infection.
A 35-year-old patient presents with a painful, swollen area on their upper arm. On examination, the nurse suspects an abscess. What is the initial nursing intervention for this patient?
Correct Answer: B (Applying warm compresses)
Explanation: The initial nursing intervention for a suspected abscess is to apply warm compresses to promote localized drainage and relieve pain.
A patient with a draining abscess is receiving wound care. Which of the following principles of aseptic technique is essential for the nurse to follow during wound dressing changes?
Correct Answer: A (Using sterile gloves)
Explanation: When performing wound care for an abscess, it is essential for the nurse to use sterile gloves as part of aseptic technique to prevent infection.
A patient with an abscess has undergone surgical drainage. What is the primary nursing goal in the immediate postoperative period following abscess drainage?
Correct Answer: D (Preventing infection)
Explanation: The primary nursing goal in the immediate postoperative period following abscess drainage is to prevent infection by maintaining aseptic technique and monitoring for signs of infection.
A patient with a recurrent abscess is being educated about prevention. What advice should the nurse provide to the patient to minimize the risk of recurrent abscesses?
Correct Answer: C (Keep the area clean and dry)
Explanation: To minimize the risk of recurrent abscesses, the patient should be advised to keep the affected area clean and dry to prevent bacterial growth and infection.
Patient Case Vignette: A patient with an abscess has been prescribed antibiotics. What important information should the nurse provide to the patient regarding antibiotic therapy for abscesses?
Correct Answer: C (Finish the entire course of antibiotics)
Explanation: It is crucial for the patient to finish the entire course of antibiotics prescribed for the abscess, even if they start feeling better, to ensure complete eradication of the infection.
A 65-year-old postmenopausal woman presents with a history of osteoporosis. She has a high risk of fractures. Which class of medications is commonly prescribed to reduce the risk of fractures in postmenopausal women with osteoporosis?
Correct Answer: C (Bisphosphonates)
Explanation: Bisphosphonates are commonly prescribed to reduce the risk of fractures in postmenopausal women with osteoporosis by improving bone density and strength.
A 72-year-old man with osteoporosis is concerned about his risk of fractures and wants to take medication. Which medication is specifically approved for the treatment of osteoporosis in men?
Correct Answer: C (Alendronate)
Explanation: Alendronate (Fosamax) is approved for the treatment of osteoporosis in men, helping to increase bone density and reduce fracture risk.
A 58-year-old woman with osteoporosis has a history of gastrointestinal issues. She is unable to tolerate oral bisphosphonates. Which alternative form of bisphosphonate medication can be administered intravenously and may be suitable for her?
Correct Answer: C (Ibandronate – Boniva)
Explanation: Ibandronate (Boniva) is available in an intravenous form and can be considered for patients who cannot tolerate oral bisphosphonates.
A 70-year-old woman with osteoporosis and a history of breast cancer asks about medication options that can help strengthen her bones without increasing the risk of breast cancer recurrence. Which medication category is suitable for her?
Correct Answer: B (Selective estrogen receptor modulators – SERMs)
Explanation: SERMs, such as Raloxifene (Evista), can help strengthen bones without increasing the risk of breast cancer recurrence and are an option for postmenopausal women with osteoporosis.
A 60-year-old man with osteoporosis is concerned about the risk of fractures and asks about medications that stimulate bone formation. Which medication category promotes bone formation and can be considered for him?
Correct Answer: C (Parathyroid hormone analogs)
Explanation: Parathyroid hormone analogs, such as Teriparatide (Forteo), stimulate bone formation and may be considered for patients with severe osteoporosis.
