A patient arrives in the emergency department with a swollen ankle after a soccer injury. Which action by the nurse is appropriate?

Ask the patient to try bearing weight on the ankle

Elevate the ankle above heart level

Apply a warm moist pack to the ankle

Assess the ankle's passive range of motion (ROM)

Answer and Explanation

The Correct Answer is B

Choice A reason: Asking the patient to try bearing weight on the injured ankle is not appropriate at this stage. Bearing weight can cause further injury or exacerbate the swelling and pain. The initial treatment should focus on reducing swelling and providing support.

Choice B reason: Elevating the ankle above heart level is appropriate because it helps to reduce swelling by promoting venous return and decreasing fluid accumulation in the affected area. Elevation is a standard first aid measure for managing acute injuries and swelling.

Choice C reason: Applying a warm moist pack to the ankle is not advisable immediately after an injury. In the acute phase, cold therapy (ice) is recommended to reduce swelling and pain. Warm therapy is more appropriate during the recovery phase, once swelling has subsided.

Choice D reason: Assessing the ankle's passive range of motion (ROM) may be necessary later, but not immediately upon arrival. The priority is to manage pain and swelling first. ROM assessments can be painful and might worsen the injury if conducted too soon.

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Correct Answer is ["A","B","C"]

Explanation

Choice A reason: Subcutaneous administration of anticoagulants like Lovenox (enoxaparin) or heparin is a common and effective method for preventing DVT and VTE. These medications help prevent clot formation by thinning the blood and reducing the risk of thrombus development.

Choice B reason: Graduated compression stockings, such as thromboembolic deterrent (TED) hose, are used to improve blood flow in the legs and prevent the formation of blood clots. They apply consistent pressure to the legs, helping to maintain venous return and reduce the risk of DVT.

Choice C reason: Intermittent pneumatic compression devices (IPCs) are also used to prevent DVT and VTE. These devices periodically inflate and deflate, applying pressure to the legs to stimulate blood flow and prevent blood stasis, which can lead to clot formation.

Choice D reason: Strict bed rest is not recommended for DVT and VTE prevention. Prolonged immobility can increase the risk of clot formation. Encouraging early mobilization and activity is crucial to reduce the risk of DVT.

Choice E reason: Early and aggressive mobilization is a key strategy in preventing DVT and VTE. Encouraging patients to move and engage in physical activity as soon as it is safe to do so helps promote blood circulation and prevent the development of blood clots.

A. Health care provider (MD, NP) B. Licensed practical/vocational nurse (LPN/LVN) C. Nursing Supervisor D. Registered nurse (RN)

Correct Answer is D

Explanation

Choice A reason: Health care providers such as medical doctors (MDs) and nurse practitioners (NPs) are responsible for diagnosing and treating medical conditions. While they play a crucial role in patient care, the development of a detailed, individualized nursing plan of care typically falls under the domain of nursing professionals.

Choice B reason: Licensed practical/vocational nurses (LPNs/LVNs) provide basic patient care under the supervision of registered nurses and physicians. They assist with implementing care plans but do not usually develop comprehensive nursing plans of care themselves.

Choice C reason: Nursing supervisors oversee the nursing staff and ensure that nursing care is delivered effectively. They may be involved in developing and overseeing care plans at a higher level but are not typically responsible for creating the individualized care plans for each patient.

Choice D reason: Registered nurses (RNs) are trained and licensed to develop individualized care plans that include nursing diagnoses, interventions, and outcomes. They work closely with patients to create and implement care plans that address specific health needs and promote self-management.

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A patient arrives in the emergency department with a swollen ankle after a soccer injury. Which action by the nurse is appropriate?

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Naxlex Comprehensive Predictor Exams

Deep vein thrombosis (DVT) and venous thromboembolism (VTE) prevention methods include which of the following? Select all that apply.

Correct Answer is ["A","B","C"]

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In any clinical setting, which health care team member is responsible for developing an individualized plan of care that includes nursing diagnoses, interventions, and outcomes including the patient's self-management care plan?

Correct Answer is D

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