A 68-year-old male patient, who underwent bilateral total hip arthroplasty two years ago, has been brought to the emergency department (ED) by ambulance.
He reports that he slipped while putting away groceries at home.
He fell face-forward, hitting his head on the wall and his left shoulder on the floor.
He is experiencing pain mainly in his shoulder, but also in his right knee.
Additionally, he feels nauseated and tired.
Based on this information, which of the following are potential diagnoses?

Rotator cuff injury

Humeral fracture

Concussion

Knee sprain .

Answer and Explanation

Correct Answer : A,B,C,D

Choice A rationale

A rotator cuff injury could be a possibility given the patient’s age and the nature of the fall. The rotator cuff is a group of muscles and tendons that surround the shoulder joint, and injuries to this area are common in falls where the shoulder takes the impact.

Choice B rationale

A humeral fracture could also be a possibility. The humerus is the bone in the upper arm, and it can be fractured in falls, especially in older adults who may have weaker bones.

Choice C rationale

A concussion could be a possibility given that the patient hit his head on the wall. Symptoms of a concussion can include nausea and fatigue, which the patient is experiencing.

Choice D rationale

A knee sprain could be a possibility given that the patient is experiencing pain in his right knee. Sprains occur when the ligaments, which are the bands of tissue that hold bones together, are stretched or torn.

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Correct Answer is ["D","E","F","G"]

Explanation

Based on the provided information, the following aspects of the assessment require urgent attention:

The client’s request for sleeping medication: This indicates that she is having trouble sleeping, which can affect her recovery.
The client’s distressing thoughts and memories about the house collapsing: This could be a sign of post-traumatic stress disorder (PTSD), which requires immediate attention and possibly referral to a mental health professional.
The client’s statement about being in a “funk”: This could indicate depression or another mental health issue, which should be addressed promptly.
The client’s preference for a quieter area of the unit: The noise by the nurses’ station is disturbing her rest, which is crucial for her recovery. Efforts should be made to accommodate her request if possible.

A. Supervisor of the neurology unit. B. Nurse in charge of risk management. C. Nurse case manager. D. Adult nurse practitioner.

Correct Answer is C

Explanation

Choice A rationale

While the supervisor of the neurology unit may have expertise in neurology, they are not typically responsible for coordinating the progression of a patient’s care following a spinal cord injury.

Choice B rationale

The nurse in charge of risk management is typically responsible for identifying and evaluating risks in the healthcare setting. They are not typically involved in the direct management of a patient’s care.

Choice C rationale

The nurse case manager is specifically trained to coordinate and manage the care of patients with complex conditions, including spinal cord injuries. They work with the patient, family, and healthcare team to develop a comprehensive care plan.

Choice D rationale

While an adult nurse practitioner can provide a high level of care, they are not typically responsible for managing the progression of a patient’s care following a spinal cord injury.

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Naxlex Comprehensive Predictor Exams

Correct Answer is ["D","E","F","G"]

Explanation

A patient has been admitted to the intensive care unit (ICU) with a spinal cord injury following a motor vehicle accident.Who should be contacted to manage the progression of the patient’s care?

Correct Answer is C

Explanation

After traveling to a country with a tropical climate, a young adult is diagnosed with a liver abscess and is taking antimicrobial therapy as an outpatient.During a follow-up visit at the community clinic, the nurse observes that the patient has developed jaundice.Which action should the nurse take?

A patient with a recent exacerbation of heart failure is feeling uncomfortable and anxious, with a sensation of flopping in the chest.While waiting for an electrocardiogram (ECG), which assessment should the nurse prioritize?

A patient arrives at the emergency department experiencing chest pain after taking sildenafil.Based on the patient’s history, which medication should the nurse withhold?

A patient has developed signs and symptoms of septic shock following a urinary tract infection one week ago.The healthcare provider has prescribed a sepsis protocol to be initiated.Which intervention should the nurse prioritize in the plan of care?

A client with a history of inflammatory bowel disease develops severe ulcerative colitis and is admitted to the intensive care unit after surgery for a fistula repair.Which intervention is most important for the nurse to include in the plan of care?

While caring for a client with a full thickness burn covering 40% of the body surface area (BSA), the nurse observes purulent drainage at the wound. Before reporting this finding to the healthcare provider, which of the client’s laboratory values should the nurse note?