A 16-year-old male presents to the emergency department with right knee pain.
Complete the statement below:
The client is at risk for and the nurse should ?
Fracture/immobilized the extremity
Contracture / obtain a prescription for acetaminophen
Sprain/ raise the leg
Dislocation/apply heat to the area
The Correct Answer is A
Choice A rationale: Considering the mechanism of injury, pain severity, tenderness, swelling, and ecchymosis, there is a high suspicion of a fracture. Immobilization is essential to prevent further injury and reduce pain.
Choice B rationale: Contracture is less likely in this acute injury scenario. Acetaminophen might manage pain, but it doesn't address the risk factor.
Choice C rationale: A sprain is less likely given the severity of pain and the mechanism of injury. Raising the leg doesn't address the risk of a suspected fracture.
Choice D rationale: Dislocation doesn't align with the reported symptoms. Applying heat could potentially worsen inflammation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C","E"]
Explanation
Choice A rationale: Correct. The statement is accurate because developing confusion could be a sign of a serious condition like severe electrolyte imbalance or dehydration, requiring immediate medical attention.
Choice B rationale: Incorrect. Fluid intake should not be arbitrarily limited without medical advice, especially for a client with diabetes insipidus. Maintaining a consistent fluid intake is crucial, and any changes should be guided by a healthcare provider.
Choice C rationale: Correct. Weighing oneself at the same time every day is a good practice for monitoring fluid balance and identifying sudden changes that may indicate a problem.
Choice D rationale: Incorrect. Desmopressin doses should be administered as prescribed. The medication's administration should be consistent with the healthcare provider's instructions or the medication guide, not arbitrarily altered.
Choice E rationale: Correct. Keeping a log of fluid intake and urine output is important for managing diabetes insipidus effectively and allows for informed adjustments in fluid intake or medication dosage.
Choice F rationale: Incorrect. Adjusting medication dosage without consulting a healthcare provider is not safe. While increased urination is a symptom of diabetes insipidus, the client should consult their healthcare provider if their symptoms persist or worsen, rather than self-adjusting the medication dose.
Correct Answer is D
Explanation
Choice A rationale: Biopsy during an endoscopy can help confirm the presence of duodenal ulcers by analyzing tissue samples.
Choice B rationale: Urea breath test is used to detect the presence of Helicobacter pylori, a bacterium associated with duodenal ulcers.
Choice C rationale: Endoscopy is a standard procedure for diagnosing duodenal ulcers by directly visualizing the upper gastrointestinal tract.
Choice D rationale: While a CT scan can be useful in some cases, it's less commonly used for diagnosing duodenal ulcers compared to other diagnostic methods like endoscopy,
biopsy, or urea breath test.
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