Nursing Elites

1. The nurse is caring for a client with rheumatoid arthritis one day after shoulder surgery. What would prompt the nurse to call the provider immediately?

• A. The client refused her pain medication this morning and is doing physical therapy.
• B. The client reports a minor headache and states she takes an over-the-counter pain pill at home.
• C. The client reports intermittent flatus and minor abdominal discomfort.
• D. The client has paresthesia in her fingers and intense increasing pain in her shoulder.

Correct answer: D

Rationale: In a client with rheumatoid arthritis one day after shoulder surgery, paresthesia in the fingers and intense increasing pain in the shoulder could indicate nerve compression or damage, which are serious post-operative complications. This situation requires immediate attention from the provider to prevent further complications and ensure appropriate management. The other options, such as refusing pain medication, reporting a minor headache, or experiencing minor abdominal discomfort, are important but not as urgent or indicative of potential serious complications as paresthesia in the fingers and intense increasing pain in the shoulder.

2. A client has sustained an open fracture. How can the nurse best prevent osteomyelitis in this client?

• A. Administer pain medication
• B. Use proper hand hygiene and strict infection control
• C. Delegate all client personal care to specific unlicensed assistive personnel
• D. Plate the client in contact precautions

Correct answer: B

Rationale:

3. What complication of fractures is caused by increased pressure which can result in decreased circulation to the area?

• A. Venous thromboembolism
• B. Acute compartment syndrome
• C. Fat embolism syndrome
• D. Hemorrhage

Correct answer: B

Rationale: Acute compartment syndrome is the correct answer. It involves increased pressure within muscles, leading to decreased blood flow and tissue damage. Venous thromboembolism (Choice A) is a condition where a blood clot forms in a vein, usually in the leg. Fat embolism syndrome (Choice C) occurs when fat globules enter the bloodstream and block blood vessels. Hemorrhage (Choice D) refers to bleeding, which can occur with fractures but does not specifically involve increased pressure leading to decreased circulation as in acute compartment syndrome.

4. The following client come to the ophthalmology clinic. Which client needs to be seen first?

• A. Client who had recent cataract surgery and has worsening vision
• B. Client with an absent red reflex on ophthalmic examination
• C. Client with an intraocular pressure of 24 mm Hg
• D. Client with a tearing, reddened eye with exudate

Correct answer: A

Rationale: Worsening vision after cataract surgery requires immediate attention to prevent complications.

5. During a skin inspection at the outpatient clinic, the nurse notices patches of thick, red skin with silvery scales on the client's elbows and knees. What skin abnormality does the nurse suspect?

• A. Scabies
• B. Rosacea
• C. Psoriasis
• D. Statis dermatitis

Correct answer: C

Rationale:

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