What findings on assessment would indicate to the nurse that a client has developed osteomyelitis 10 weeks after a right shoulder arthroplasty? (Select All that Apply.)

Bradycardia

Chills

Elevated temperature of 102 degrees F.

Difficulty breathing.

Client complaining of increasing pain in shoulder with movement.

Answer and Explanation

Correct Answer : B,C,E

A.   Bradycardia (a slow heart rate) is not a typical sign of osteomyelitis. Instead, infections often cause tachycardia (increased heart rate) due to the body's response to fever and inflammation. Therefore, this finding would not indicate osteomyelitis.
B.   Chills can be a sign of infection, including osteomyelitis. They often occur as a result of the body trying to regulate temperature in response to fever. The presence of chills would raise suspicion of an underlying infection.
C.   An elevated temperature, particularly above normal (typically defined as over 100.4 degrees F), is a classic sign of infection. A temperature of 102 degrees F suggests that the body is fighting an infection, which could indicate osteomyelitis.
D.   Difficulty breathing is not a direct symptom of osteomyelitis and may indicate other conditions such as respiratory issues or complications unrelated to the shoulder infection. Therefore, this finding is not typically associated with osteomyelitis.
E.   Increased pain in the affected area, especially with movement, can indicate inflammation or infection. In the case of osteomyelitis, localized pain at the site of infection is a common symptom.

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Correct Answer is C

Explanation

A. While fever and anorexia can occur with active TB, a fever of more than 104°F is uncommon. Typically, TB may cause a low-grade fever rather than such a high temperature. Anorexia is also present, but this option does not fully capture the classic symptoms of active TB.
B. These symptoms are not typical of tuberculosis. Headaches and photophobia are more associated with conditions affecting the central nervous system, such as meningitis or migraines. They do not specifically relate to active TB.
C. These symptoms are classic indicators of active tuberculosis. Fatigue and night sweats are common, and hemoptysis (coughing up blood) is a serious symptom that can occur in pulmonary TB. This combination of symptoms is a hallmark of the disease and would prompt further investigation.
D. While chest pain can occur due to lung involvement in TB, lower back pain is not a typical symptom of pulmonary TB. Chest pain might be experienced, but it is not as definitive as the other symptoms associated with active TB.

A. Allow the client to verbalize feelings about having the white patches. B. Explain the patches will go away on their own in about 2 weeks. C. Instruct to rinse the mouth with diluted hydrogen peroxide and water daily. D. Notify the health care provider to obtain an antifungal medication.

Correct Answer is D

Explanation

A. While it's important for clients to express their feelings and concerns, this intervention does not directly address the issue of the white patches or the potential infection. It may provide emotional support, but it does not contribute to resolving the clinical problem.
B. While some mild cases may resolve on their own, oral thrush often requires antifungal treatment, especially in immunocompromised patients or those on prolonged antibiotic therapy. Telling the patient that it will go away without treatment could lead to worsening symptoms and complications.
C. While oral hygiene is important, rinsing with diluted hydrogen peroxide is not the standard treatment for oral thrush. This method could cause irritation and may not effectively eliminate the fungal infection. Other rinses (like saline) might be more appropriate for general oral care but would not address the underlying candidiasis.
D. White, cheesy patches in the mouth suggest oral thrush, which is commonly treated with antifungal medications (such as fluconazole or nystatin).

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What findings on assessment would indicate to the nurse that a client has developed osteomyelitis 10 weeks after a right shoulder arthroplasty? (Select All that Apply.)

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Naxlex Comprehensive Predictor Exams

A male client has active tuberculosis (TB). Which of the following symptoms will be exhibited?

Correct Answer is C

Explanation

A client with pneumonia receiving antibiotic therapy reports white, cheesy patches in the mouth. Which intervention should the nurse implement?

Correct Answer is D

Explanation

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